Rising incidence of late stage breast cancer after COVID-19 outbreak. Real-world data from the Italian COVID-DELAY study

Mentrasti, Giulia; Cantini, Luca; Vici, Patrizia; D’Ostilio, Nicola; Verde, Nicla La; Chiari, Rita; Paolucci, V.; Crocetti, Sonia; Filippis, Chiara De; Pecci, Federica; Lisa, Francesca Sofia Di; Traisci, Donatella; Cona, Maria Silvia; Nicolardi, Linda; Pizzuti, Laura; Gildetti, Simona; Oldani, Simone; Mora, A. Della; Rocchi, Marco; Berardi, Rossana

doi:10.1016/j.breast.2022.08.007

Cited by 14 publications

(30 citation statements)

References 36 publications

(42 reference statements)

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“…4,9 This analysis shows a steep reduction (36%) in new patients with breast cancer in 2020 at RCC compared with the prepandemic period which is similar to findings reported in Italy. 5,10 There was no significant difference in the time (in weeks) since symptom onset and reporting to hospital, and also the clinical stage at diagnosis was not different between the two cohorts. The most common stage at presentation was stage II in both cohorts (47.6 vs. 46.4%) followed by stage III (22.2 vs. 23.3%).…”

Section: Discussionmentioning

confidence: 86%

COVID-19 Impact on Newly Diagnosed Breast Cancers at Regional Cancer Centre, Thiruvananthapuram—An Audit

Babu,

Rajeev,

Mathew

et al. 2024

South Asian J Cancer

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The coronavirus pandemic has created havoc in every aspect of life including cancer care and was declared a pandemic. This audit was conducted to study the impact of the pandemic on diagnosis and treatment of newly diagnosed breast cancer patients at a tertiary cancer center in South India. A total of 1,647 patients who registered at Regional Cancer Centre (RCC), Thiruvananthapuram, Kerala, India for breast cancer during the period April 1, 2020, to September 30, 2020 (COVID-19 period) as well as April 1, 2019, to September 30, 2019 (pre-COVID-19 period) were included in the study. Data regarding the geographic distribution, stage at presentation, time factors for reporting for care, diagnosis, and treatment, referral for care elsewhere were collected and analyzed. The study was approved by the Institutional Review Board. Means and ranges were calculated for continuous type variables, and numbers and percentages for categorical variables. To determine whether there were significant differences between the two groups, independent t-test was used for continuous variables and chi-square test for categorical type of variables. A notable reduction (36%) in newly diagnosed breast cancer patients was seen in 2020 when compared with 2019. There was a significant difference in the geographic distribution of patients in both cohorts (p = 0.001) and a notable reduction in the number of patients reporting to RCC for treatment from the northern districts of Kerala (81%) and outside Kerala (89.5%). There was no significant difference in the time (in weeks) since symptom onset and reporting to hospital or the clinical stage at diagnosis between the groups. Also, coronavirus disease 2019 (COVID-19) did not seem to negatively impact time intervals between date of registration and pathological diagnosis or start of primary treatment. More patients received neoadjuvant systemic therapy during 2020 compared with 2019, and this difference was statistically significant (p = 0.004). There was no difference in the type of surgery (breast-conserving surgery vs. modified radical mastectomy). The results demonstrate that COVID-19 did not appear to negatively impact the diagnosis and treatment of newly diagnosed breast cancer patients. However, this is largely attributable to the significantly less number of patients who registered, for whom the departments were able to maintain timely cancer care despite the difficult pandemic times. Significantly more patients received neoadjuvant systemic therapy in 2020.

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Section: Discussionmentioning

confidence: 86%

COVID-19 Impact on Newly Diagnosed Breast Cancers at Regional Cancer Centre, Thiruvananthapuram—An Audit

Babu,

Rajeev,

Mathew

et al. 2024

South Asian J Cancer

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“…The decrease in cancer cases during the pandemic may equate to a delay in diagnosis and eventually lead to patients presenting at more advanced stages. 23,37,38 The strengths of this study include the large volume of patients from across the country and the ability to examine trends across subgroups such as different ages and races. Limitations include the fact that this study only examined cases reported to CoC sites, which may not be representative of the typical facility treating patients with breast cancer in the U.S. and may include sites with larger volumes of patients and more resources.…”

Section: Discussionmentioning

confidence: 99%

“…This study is limited in that 2020 is the most recent year available in the NCDB, and one year may not be enough time to note a stage difference in the U.S. The decrease in cancer cases during the pandemic may equate to a delay in diagnosis and eventually lead to patients presenting at more advanced stages 23,37,38 …”

Section: Discussionmentioning

confidence: 99%

Rates of newly diagnosed breast cancer at commission on cancer facilities during the early phase of the COVID‐19 pandemic

Fefferman,

Kuchta,

Wang

et al. 2023

Cancer Medicine

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IntroductionThe objective of this study was to examine the impact of the early part of the COVID‐19 pandemic on the number of newly diagnosed breast cancer cases at Commission on Cancer (CoC)‐accredited facilities relative to the United States (U.S.) population.MethodsWe examined the incidence of breast cancer cases at CoC sites using the U.S. Census population as the denominator. Breast cancer incidence was stratified by patient age, race and ethnicity, and geographic location.ResultsA total of 1,499,806 patients with breast cancer were included. For females, breast cancer cases per 100,000 individuals went from 188 in 2015 to 203 in 2019 and then dropped to 176 in 2020 with a 15.7% decrease from 2019 to 2020. Breast cancer cases per 100,000 males went from 1.7 in 2015 to 1.8 in 2019 and then declined to 1.5 in 2020 with a 21.8% decrease from 2019 to 2020. For both females and males, cases per 100,000 individuals decreased from 2019 to 2020 for almost all age groups. For females, rates dropped from 2019 to 2020 for all races and ethnicities and geographic locations. The largest percent change was seen among Hispanic patients (−18.4%) and patients in the Middle Atlantic division (−18.6%). The stage distribution (0–IV) for female and male patients remained stable from 2018 to 2020.ConclusionThe first year of the COVID‐19 pandemic was associated with a decreased number of newly diagnosed breast cancer cases at Commission on Cancer sites.

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“…Many studies reported a downscaling of cancer treatment with an increased risk of impaired efficacy. In addition, the delay in cancer diagnosis and treatment could have jeopardized patient prognosis and long‐term population outcomes 9–12 …”

Section: Introductionmentioning

confidence: 99%

“…In addition, the delay in cancer diagnosis and treatment could have jeopardized patient prognosis and long-term population outcomes. [9][10][11][12] Many medical oncologists tried to protect patients from nosocomial contagion, through the reorganization of hospital spaces and the application of all prevention and mitigation procedures (triage at the entrance, the use of individual protection devices, social distancing measures, etc.). Anyway, the real "ace up the sleeve" in the fight against SARS-CoV-2 was the vaccine.…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of the first two doses of anti‐SARS‐CoV‐2 mRNA vaccines in solid cancer patients

et al. 2023

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Introduction Cancer patients are frail individuals, thus the prevention of SARS‐CoV‐2 infection is essential. To date, vaccination is the most effective tool to prevent COVID‐19. In a previous study, we evaluated the immunogenicity of two doses of mRNA‐based vaccines (BNT162b2 or mRNA‐1273) in solid cancer patients. We found that seroconversion rate in cancer patients without a previous exposure to SARS‐CoV‐2 was lower than in healthy controls (66.7% vs. 95%, p = 0.0020). The present study aimed to evaluate the clinical efficacy of the vaccination in the same population. Methods This is a single‐institution, prospective observational study. Data were collected through a predefined questionnaire through phone call in the period between the second and third vaccine dose. The primary objective was to describe the clinical efficacy of the vaccination, defined as the percentage of vaccinated subjects who did not develop symptomatic COVID‐19 within 6 months after the second dose. The secondary objective was to describe the clinical features of patients who developed COVID‐19. Results From January to June 2021, 195 cancer patients were enrolled. Considering that 7 (3.59%) patients tested positive for SARS‐CoV‐2 and 5 developed symptomatic disease, the clinical efficacy of the vaccination was 97.4%. COVID‐19 disease in most patients was mild and managed at home; only one hospitalization was recorded and no patient required hospitalization in the intensive care unit. Discussion Our study suggests that increasing vaccination coverage, including booster doses, could improve the prevention of infection, hospitalization, serious illness, and death in the frail population of cancer patients.

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Rising incidence of late stage breast cancer after COVID-19 outbreak. Real-world data from the Italian COVID-DELAY study

Cited by 14 publications

References 36 publications

COVID-19 Impact on Newly Diagnosed Breast Cancers at Regional Cancer Centre, Thiruvananthapuram—An Audit

COVID-19 Impact on Newly Diagnosed Breast Cancers at Regional Cancer Centre, Thiruvananthapuram—An Audit

Rates of newly diagnosed breast cancer at commission on cancer facilities during the early phase of the COVID‐19 pandemic

Clinical efficacy of the first two doses of anti‐SARS‐CoV‐2 mRNA vaccines in solid cancer patients

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