The impact of the <scp>COVID</scp>‐19 pandemic on colorectal cancer diagnosis and management: a Binational Colorectal Cancer Audit study

Williams, E. J.; Kong, Joseph; Singh, Pushpendra; Prabhakaran, Swetha; Warrier, Satish; Bell, Stephen

doi:10.1111/ans.17071

Cited by 25 publications

(55 citation statements)

References 10 publications

(14 reference statements)

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“…There was also a troubling trend seen in the final pathology of the CRC diagnosed during the ramp up period with more advanced stages and more metastatic cancer was identified when compared to the same period in 2019. A similar finding of more advanced CRC at diagnosis was also seen in Australia and New Zealand, where the post-lockdown period saw an increase in urgent or emergency procedures for colorectal cancer, more stoma creation, and a proportionally higher rise in Stage II or III disease and decrease in stage I disease [ 23 ].…”

Section: Discussionmentioning

confidence: 59%

The impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention

et al. 2022

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Purpose The COVID-19 pandemic resulted in a partial to total shutdown of endoscopy in many healthcare centers. This study aims to quantify the impact of the reduction in colonoscopies on colorectal cancer (CRC) detection and screening . Methods After institutional ethics board approval, the endoscopy database at an academic tertiary-care center in Montreal, Canada, was searched for all colonoscopies performed from during the first wave locally (March–June 2020), and during the ramp up period where endoscopy service resumed (July to August 2020). We compared these periods to the same periods in 2019, the pre-pandemic periods. The indications, CRC and adenoma detection rates, as well as the prioritization of urgent procedures were compared. Results In the first wave, only 462 colonoscopies were performed, compared to 2515 in the same period in 2019, an 82% reduction. The ramp up period saw 843 colonoscopies performed compared to 1328 in 2019, a 35% reduction. Urgent and inpatient colonoscopies numbers increased (324 (24.8%) vs. 220 (5.7%)) while surveillance and high-risk screening colonoscopies fell (376 (28.8%) vs 1869 (48.6%)). Emergency access to colonoscopy was preserved with a median time to endoscopy of < 1 day (IQR 0,1) in both pandemic periods. During the pandemic periods, there was an absolute reduction in CRC diagnosis of 28, despite the CRC detection per colonoscopy rate increasing slightly in the first wave from 1.7% (44) to 3.9% (18), and in the ramp up period from 2.5% (33) to 3.6% (31). The rate of adenoma detection per colonoscopy did not increase significantly between the pre- and pandemic periods, resulting in reduction in adenoma removal in 723 patients. Discussion The restriction of access to colonoscopy resulted in a significant reduction in screening and surveillance of high-risk patients, adenomas removed, and CRCs diagnosed. Clinicians and patients will face the oncologic ramifications this the coming years. Supplementary Information The online version contains supplementary material available at 10.1007/s00464-022-09211-z.

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Section: Discussionmentioning

confidence: 59%

The impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention

et al. 2022

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“…Our results showed that the rate of elective primary tumor resections reached around 70% over time and did not decrease after 2020. A study in Australia and New Zealand and a single‐site Japanese study found a significantly larger share of urgent CRC cases during the pandemic 31,39 . The different definitions of “urgent” or “emergency” cases used between studies do not allow direct comparisons.…”

Section: Discussionmentioning

confidence: 99%

“…Single site studies in Romania and Brazil and a larger studies in France, Australia and New Zealand found significantly more advanced new CRC cases after the pandemic broke out, but a single‐site South‐Korean study found no statistically significant difference in pTNM stage distribution after Covid19. 13 , 14 , 16 , 30 , 31 Single‐site studies cannot exclude the fact that patients could have gone to another provider for treatment, whereas our study includes the AP‐HP teaching hospitals in Paris region.…”

Section: Discussionmentioning

confidence: 99%

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Impact of two waves of Sars‐Cov2 outbreak on the number, clinical presentation, care trajectories and survival of patients newly referred for a colorectal cancer: A French multicentric cohort study from a large group of university hospitals

Kempf

Priou

Lamé

et al. 2022

Intl Journal of Cancer

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The SARS‐Cov2 may have impaired care trajectories, patient overall survival (OS), tumor stage at initial presentation for new colorectal cancer (CRC) cases. This study aimed at assessing those indicators before and after the beginning of the pandemic in France. In this retrospective cohort study, we collected prospectively the clinical data of the 11.4 million of patients referred to the Greater Paris University Hospitals (AP‐HP). We identified new CRC cases between 1 January 2018 and 31 December 2020, and compared indicators for 2018‐2019 to 2020. pTNM tumor stage was extracted from postoperative pathology reports for localized colon cancer, and metastatic status was extracted from CT‐scan baseline text reports. Between 2018 and 2020, 3602 and 1083 new colon and rectal cancers were referred to the AP‐HP, respectively. The 1‐year OS rates reached 94%, 93% and 76% for new CRC patients undergoing a resection of the primary tumor, in 2018‐2019, in 2020 without any Sars‐Cov2 infection and in 2020 with a Sars‐Cov2 infection, respectively (HR 3.78, 95% CI 2.1‐7.1). For patients undergoing other kind of anticancer treatment, the percentages are 64%, 66% and 27% (HR 2.1, 95% CI 1.4‐3.3). Tumor stage at initial presentation, emergency level of primary tumor resection, delays between the first multidisciplinary meeting and the first anticancer treatment did not differ over time. The SARS‐Cov2 pandemic has been associated with less newly diagnosed CRC patients and worse 1‐year OS rates attributable to the infection itself rather than to its impact on hospital care delivery or tumor stage at initial presentation.

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“…If gastrointestinal malignancy case detection rates drop, such as has likely occurred in the COVID-19 pandemic, GN-BSI as a marker of occult gastrointestinal malignancy should be considered. (Søgaard et al, 2017;Williams et al, 2021) During the acute period following index blood culture collection, urinary tract infection and sepsis were common UCOD in patients with GN-BSI. Beyond 90 days, infection was not a common UCOD in the following years for either group.…”

Section: Discussionmentioning

confidence: 99%

Long term sepsis readmission, mortality and cause of death following Gram negative bloodstream infection: a propensity matched observational linkage study

McNamara

Harris

Chatfield

et al. 2022

International Journal of Infectious Diseases

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The impact of the COVID‐19 pandemic on colorectal cancer diagnosis and management: a Binational Colorectal Cancer Audit study

Abstract: Not based on previous communication to a society or meeting.

Cited by 25 publications

References 10 publications

The impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention

The impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention

Impact of two waves of Sars‐Cov2 outbreak on the number, clinical presentation, care trajectories and survival of patients newly referred for a colorectal cancer: A French multicentric cohort study from a large group of university hospitals

Long term sepsis readmission, mortality and cause of death following Gram negative bloodstream infection: a propensity matched observational linkage study

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