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Paffenholz P, Platen M, Kostev K, Loosen SH, Bohlken J, Michalowsky B. Medical care services provision and stress experience in urologists during all waves of the COVID-19 pandemic in Germany. Front Med (Lausanne) 2024; 11:1320489. [PMID: 38405189 PMCID: PMC10893761 DOI: 10.3389/fmed.2024.1320489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/15/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose Urologists' practices reported decreasing medical care provision and increasing stress experience in the first wave of the COVID-19 pandemic. However, long-term effects of the pandemic are unknown. Methods Medical record data of n = 127 urologists were used to assess changes in healthcare provision, comparing the pandemic with the pre-pandemic period. An online survey among n = 101 urologists was conducted to assess the physicians' perceptions of the identified healthcare provision and organizational changes and experiences of anxiety, stress, and support needs during the pandemic waves. Urologists consultations, specialists' referrals, hospital admissions, documented cancer diagnoses, urologists' perceptions of causes for these changes and experienced stress, anxiety and support needs. Results were demonstrated using descriptive statistics. Results Over the first two years of the pandemic, there was a slight decline in consultations (-0,94%), but more intensive reduction in hospital admissions (-13,6%) and identified cancer diagnoses (-6,2%). Although patients' behavior was seen as the main reason for the changes, 71 and 61% of consultations of high-risk patients or urgent surgeries were canceled. Telemedical approaches were implemented by 58% of urologists, and 88% stated that the reduced cancer detection rate would negatively affect patients' outcomes. Urologists reported higher anxiety, stress, and need for support during all waves of the pandemic than other disciplines, especially females. Conclusion The pandemic tremendously affects urologists' health care provision and stress experience, possibly causing long-term consequences for patients and physicians.
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Affiliation(s)
- Pia Paffenholz
- Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic Surgery, University of Cologne Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Moritz Platen
- German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
| | | | - Sven H Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Jens Bohlken
- Occupational Medicine, and Public Health (ISAP) of the Medical Faculty at the University of LeipzigInstitute for Social Medicine, Leipzig, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Ellernholzstrasse 1-2, Greifswald, Germany
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Fullard K, Steffens D, Solomon M, Shin JS, Koh C. Measuring the impact of the COVID-19 pandemic on colorectal cancer presentation: a retrospective comparative study. ANZ J Surg 2023; 93:2951-2957. [PMID: 37846781 DOI: 10.1111/ans.18701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUNDS The Coronavirus disease 2019 (COVID-19) pandemic provided challenges to surgical care in Australia. This study aimed to measure the potential impact of COVID-19 on colorectal cancer presentation through surgical volume and cancer staging at a major tertiary referral hospital in the city of Sydney Australia. METHODS A retrospective cohort study was performed using routinely collected data from consecutive colorectal cancer patients undergoing surgery during the COVID-19 period (1 March 2020 to 1 October 2021) and compared with the pre-COVID-19 period (1 March 2018 to 1 October 2019). The main outcomes included patient demographics, surgical volume (including overall, elective and emergency) and cancer staging. Differences in outcomes between the two studied periods were compared using Pearson's chi-squared test, Fisher test or t-test. RESULTS A total of 381 patients composed the COVID-19 group (Mean age = 62.4 years) and 364 patients composed the pre-COVID-19 group (Mean age = 65.6 years; P<0.001). No significant differences were observed for overall, elective or emergency surgical volumes. Patients in the COVID-19 group had a reduction in Stage I and an increase in Stage II and III disease, with Stage IV and recurrent disease being similar with a variation of <1% when compared to the pre-COVID-19 group (P<0.001). CONCLUSIONS Disruptions in patient screening, diagnosis and management from elective surgery restrictions and patient hesitancy may not have resulted in observed changes to surgical volume, however, it may have contributed to an increase in Stages II and III colorectal cancer during COVID-19.
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Affiliation(s)
- Kirsten Fullard
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, Australia
- Colorectal Department, Royal Prince Alfred Hospital, Sydney, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, Australia
| | - Michael Solomon
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, Australia
- Colorectal Department, Royal Prince Alfred Hospital, Sydney, Australia
| | - Joo-Shik Shin
- Department of Pathology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Cherry Koh
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, Australia
- Colorectal Department, Royal Prince Alfred Hospital, Sydney, Australia
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Agrawal V, Cantor J, Sood N, Whaley C. The impact of COVID-19 shelter-in-place policy responses on excess mortality. HEALTH ECONOMICS 2023; 32:2499-2515. [PMID: 37464737 DOI: 10.1002/hec.4737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/24/2023] [Accepted: 06/25/2023] [Indexed: 07/20/2023]
Abstract
As a way of slowing COVID-19 transmission, many countries and U.S. states implemented shelter-in-place (SIP) policies. However, the effects of SIP policies on public health are a priori ambiguous. Using an event study approach and data from 43 countries and all U.S. states, we measure changes in excess deaths following the implementation of COVID-19 shelter-in-place (SIP) policies. We do not find that countries or U.S. states that implemented SIP policies earlier had lower excess deaths. We do not observe differences in excess deaths before and after the implementation of SIP policies, even when accounting for pre-SIP COVID-19 death rates.
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Affiliation(s)
- Virat Agrawal
- University of Southern California, Los Angeles, California, USA
| | | | - Neeraj Sood
- University of Southern California, Los Angeles, California, USA
- National Bureau for Economic Research, Cambridge, Massachusetts, USA
| | - Christopher Whaley
- RAND Corporation, Santa Monica, California, USA
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA
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Miyamori D, Kamitani T, Yoshida S, Shigenobu Y, Ikeda K, Kikuchi Y, Kashima S, Yamamoto Y. Impact of the COVID-19 pandemic on the mortality among patients with colorectal cancer in Hiroshima, Japan: A large cancer registry study. Cancer Med 2023; 12:20554-20563. [PMID: 37877230 PMCID: PMC10660096 DOI: 10.1002/cam4.6630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/21/2023] [Accepted: 10/04/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND This retrospective cohort study aimed to evaluate the impact of the COVID-19 pandemic on colorectal cancer care and mortality using a large cancer registry in Hiroshima Prefecture, Japan. The study aimed to estimate the all-cause mortality rates within 1 year of diagnosis among colorectal cancer patients diagnosed during the pandemic period (2020 and 2021) compared to those diagnosed during the pre-pandemic period (2018 and 2019). METHODS The day of diagnosis was set as Day 0 and Cox regression models were utilized to estimate crude hazard ratios (HRs) and adjusted HRs, accounting for age, sex, cancer stage, and treatment status. Two sensitivity analyses of overall survival were performed with different cutoffs of the pre-pandemic/pandemic periods and year-to-year comparisons. Subgroup analyses were performed using likelihood ratio tests. RESULTS A total of 15,085 colorectal cancer patients were included, with 6499 eligible for follow-up. A median age of included patients was 72 years old, of which 59% were male. The distribution of cancer stages showed little variation between the pre-pandemic and pandemic periods. With a median follow-up of 177 days, the number of events was 316/3111 (173 events per 1000 person-years [E/1000PY], 95% confidence interval [CI]: 154-192 E/1000PY) in the pre-pandemic period, and 326/2746 (245 E/1000PY, 95% CI: 220-274 E/1000PY) in the pandemic period (crude HR: 1.42, 95% CI: 1.22-1.66; adjusted HR: 1.25, 95% CI: 1.07-1.46). The two sensitivity analyses and subgroup analyses consistently supported these findings. CONCLUSIONS The study revealed an increased colorectal cancer mortality during the pandemic period, suggesting a continuous impact of the COVID-19 pandemic on the known and unknown risk factors for colorectal cancer for several years. Further studies are necessary to mitigate the adverse effects on patient outcomes.
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Affiliation(s)
- Daisuke Miyamori
- Department of General Internal MedicineHiroshima University HospitalHiroshimaJapan
| | - Tsukasa Kamitani
- Section of Education for Clinical ResearchKyoto University HospitalKyotoJapan
| | - Shuhei Yoshida
- Department of General Internal MedicineHiroshima University HospitalHiroshimaJapan
| | - Yuya Shigenobu
- Department of General Internal MedicineHiroshima University HospitalHiroshimaJapan
| | - Kotaro Ikeda
- Department of General Internal MedicineHiroshima University HospitalHiroshimaJapan
| | - Yuka Kikuchi
- Department of General Internal MedicineHiroshima University HospitalHiroshimaJapan
| | - Saori Kashima
- Graduate School for International Development and CooperationHiroshima UniversityHiroshimaJapan
- Environmental Health Sciences Laboratory, Graduate School of Advanced Science and EngineeringHiroshima UniversityHiroshimaJapan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto UniversityKyotoJapan
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Hong M, Choi M, Lee J, Kim KH, Kim H, Lee CK, Kim HS, Rha SY, Pih GY, Choi YJ, Jung DH, Park JC, Shin SK, Lee SK, Lee YC, Cho M, Kim YM, Kim HI, Cheong JH, Hyung WJ, Shin J, Jung M. Impact of Coronavirus Disease 2019 on Gastric Cancer Diagnosis and Stage: A Single-Institute Study in South Korea. J Gastric Cancer 2023; 23:574-583. [PMID: 37932224 PMCID: PMC10630563 DOI: 10.5230/jgc.2023.23.e36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/14/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023] Open
Abstract
PURPOSE Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide. National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. MATERIALS AND METHODS We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the "before COVID" period, and the years 2020 and 2021 as the "during COVID" period. RESULTS Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it. Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. CONCLUSIONS During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.
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Affiliation(s)
- Moonki Hong
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
- Palliative Care Center, Yonsei Cancer Center, Seoul, Korea
| | - Mingee Choi
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - JiHyun Lee
- Division of Medical Oncology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Kyoo Hyun Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunwook Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Choong-Kun Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Song Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Young Rha
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
- Songdang Institute for Cancer Research, Yonsei University College of Medicine, Seoul, Korea
| | - Gyu Young Pih
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Yoon Jin Choi
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Da Hyun Jung
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Jun Chul Park
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Sung Kwan Shin
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Sang Kil Lee
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Yong Chan Lee
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Minah Cho
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Yoo Min Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoung-Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Ho Cheong
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Jin Hyung
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jaeyong Shin
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Health Services Research, Yonsei University, Seoul, Korea.
| | - Minkyu Jung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
- Palliative Care Center, Yonsei Cancer Center, Seoul, Korea
- Songdang Institute for Cancer Research, Yonsei University College of Medicine, Seoul, Korea.
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Dalamaga M, Nasiri-Ansari N, Spyrou N. Perspectives and Challenges of COVID-19 with Obesity-Related Cancers. Cancers (Basel) 2023; 15:cancers15061771. [PMID: 36980657 PMCID: PMC10046880 DOI: 10.3390/cancers15061771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
The emergence of COVID-19 has created an unprecedented threat worldwide, involving overwhelmed health-care systems in the majority of countries [...]
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Affiliation(s)
- Maria Dalamaga
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
- Correspondence:
| | - Narjes Nasiri-Ansari
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
| | - Nikolaos Spyrou
- Tisch Cancer Institute Icahn School of Medicine at Mount Sinai, 1190 One Gustave L. Levy Place, New York, NY 10029, USA
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Aparicio T, Layese R, Hemery F, Tournigand C, Paillaud E, De Angelis N, Quero L, Ganne N, Prat F, Pachev A, Galula G, Benderra MA, Canouï-Poitrine F. The 10-month mortality rate among older patients treated for digestive system cancer during the first wave of the COVID-19 pandemic: The CADIGCOVAGE multicentre cohort study. J Geriatr Oncol 2023; 14:101443. [PMID: 36709553 PMCID: PMC9883010 DOI: 10.1016/j.jgo.2023.101443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 12/11/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on cancer diagnosis and care pathways. Here, we assessed the mid-term impact of the COVID-19 pandemic on older adults with cancer before, during and after the lockdown period in 2020. MATERIALS AND METHODS We performed a retrospective, observational, multicentre cohort study of prospectively collected electronic health records. All adults aged 65 or over and having been newly treated for a digestive system cancer in our institution between January 2018 until August 2020 were enrolled. RESULTS Data on 7,881 patients were analyzed. Although the overall 10-month mortality rate was similar in 2020 vs. 2018-2019, the mortality rate among for patients newly treated in the 2020 post-lockdown period was (after four months of follow-up) significantly higher. A subgroup analysis revealed higher mortality rates for (i) patients diagnosed in the emergency department during the pre-lockdown period, (ii) patients with small intestine cancer newly treated during the post-lockdown period, and (iii) patients having undergone surgery with curative intent during the post-lockdown period. However, when considering individuals newly treated during the lockdown period, we observed lower mortality rates for (i) patients aged 80 and over, (ii) patients with a biliary or pancreatic cancer, and (iii) patients diagnosed in the emergency department. DISCUSSION There was no overall increase in mortality among patients newly treated in 2020 vs. 2018-2019. Longer follow-up is needed to assess the consequences of the pandemic. A subgroup analysis revealed significant intergroup differences in mortality.
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Affiliation(s)
- Thomas Aparicio
- AP-HP, Saint Louis Hospital, Gastroenterology and Digestive Oncology Department, F-75010 Paris, France; Université de Paris, F-75000 Paris, France.
| | - Richard Layese
- AP-HP, Henri-Mondor Hospital, Public Health and Clinical Research department (URC Mondor), F-94010 Créteil, France; Univ Paris Est Creteil, INSERM, IMRB U955, F-94000 Creteil, France
| | - François Hemery
- AP-HP, Henri-Mondor Hospital, Medical Information Departement, F-94010 Créteil, France
| | | | - Elena Paillaud
- Univ Paris Est Creteil, INSERM, IMRB U955, F-94000 Creteil, France; AP-HP, Paris Cancer Institute CARPEM, Georges Pompidou Hospital, Geriatric Department, F-75015 Paris, France
| | - Nicola De Angelis
- AP-HP, Henri-Mondor Hospital, Digestive Surgery, F-94010 Créteil, France
| | - Laurent Quero
- Université de Paris, F-75000 Paris, France; AP-HP, Saint Louis Hospital, Radiotherapy Department, F-75010 Paris, France
| | - Nathalie Ganne
- AP-HP, Avicenne Hospital, Hepatology Department, F-93000 Bobigny, France
| | - Fredéric Prat
- Université de Paris, F-75000 Paris, France; AP-HP, Beaujon Hospital, Endoscopy Department, F-92110 Clichy, France
| | - Atanas Pachev
- AP-HP, Saint Louis Hospital, Radiology Department, F-75010 Paris, France
| | - Gilles Galula
- AP-HP, Tenon Hospital, Medical Oncology, F-75020 Paris, France
| | | | - Florence Canouï-Poitrine
- AP-HP, Henri-Mondor Hospital, Public Health and Clinical Research department (URC Mondor), F-94010 Créteil, France; Univ Paris Est Creteil, INSERM, IMRB U955, F-94000 Creteil, France
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Bouza E, Martin M, Alés JE, Aragonés N, Barragán B, de la Cámara R, Pozo JLD, García-Gutiérrez V, García-Sanz R, Gracia D, Guillem V, Jiménez-Yuste V, Martin-Delgado MC, Martínez J, López R, Rodríguez-Lescure Á, Galiana JR, Sureda AM, Tejerina-Picado F, Trilla A, Zapatero A, Palomo E, San-Miguel J. Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2023; 36:1-25. [PMID: 36322133 PMCID: PMC9910677 DOI: 10.37201/req/087.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.
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Affiliation(s)
- Emilio Bouza
- CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), España. Patrono de la Fundación de Ciencias de la Salud. Servicio de Microbiología y Enfermedades Infecciosas Hospital General Universitario Gregorio Marañón. Catedrático de Medicina. Universidad Complutense. Madrid.,Correspondence: Emilio Bouza MD, PhD. Instituto de Investigación Sanitaria Gregorio Marañón. C/ Dr. Esquerdo, 46 28007 Madrid, España E-mail:
| | - Miguel Martin
- Universidad Complutense de Madrid. Jefe de Servicio de Oncología del Hospital Gregorio Marañón de Madrid
| | | | | | | | | | - José Luis Del Pozo
- Servicio de Enfermedades Infecciosas. Servicio de Microbiología. Clínica Universidad de Navarra. Pamplona España
| | | | - Ramón García-Sanz
- Laboratorio de HLA y biología molecular en hematología, Universidad de Salamanca. Sociedad Española de Hematología y Hemoterapia
| | | | - Vicente Guillem
- Servicio de Oncología Médica del Instituto Valenciano de Oncología (IVO)
| | | | - Mari Cruz Martin-Delgado
- Servicio Medicina Intensiva Hospital Universitario Torrejón. Universidad Francisco de Vitoria. Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva
| | - Joaquín Martínez
- Servicio de Hematología y Hemoterapia, Hospital 12 de Octubre, Madrid. Universidad Complutense. Madrid
| | - Rafael López
- Oncología Médica del Hospital Clínico Universitario, Santiago de Compostela
| | | | | | - Ana María Sureda
- Servicio de Hematología en Hospital Universitario Quiron Dexeus, Grupo Español de Trasplante y Terapia Celular, Electa del EBMT
| | | | - Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología del Hospital Clínic de Barcelona. Catedrático de Medicina (Salud Pública) Universidad de Barcelona
| | | | | | - Jesús San-Miguel
- Medicina Clínica y Traslacional de la Clínica Universidad de Navarra
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Aden D, Zaheer S, Raj S. Challenges faced in the cancer diagnosis and management-COVID-19 pandemic and beyond-Lessons for future. Heliyon 2022; 8:e12091. [PMID: 36483302 PMCID: PMC9721200 DOI: 10.1016/j.heliyon.2022.e12091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/28/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic with multiple waves of infection has caused panic and distress globally. Cancer patients being immuno-compromised are more susceptible to infection leading to increased morbidity and unpredictability of their survival. There has been a halt in the diagnosis and treatment of patients suffering from cancer because of the COVID-19 pandemic. Oncologists have the tedious task of assessing the urgency of managing cancer patients against the risk of Coronavirus infection. Timely diagnostic services along with the treatment strategy are needed for the proper management of cancer patients. Since the laboratories are already overwhelmed with the investigations related to the COVID-19 management, there has been a compromise and delay in the diagnosis, thus leading to an overall lag in the management of cancer patients.
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Affiliation(s)
- Durre Aden
- Department of Pathology, HIMSR and HAHC, New Delhi-62, India
| | - Sufian Zaheer
- Department of Pathology, VMMC, Safdarjang Hospital, New Delhi-29, India,Corresponding author.
| | - Swati Raj
- Department of Pathology, Government Doon Medical College, Dehradun, Uttarakhand, India
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10
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Bosch X, Montori‐Palacin E, Martínez‐Ferrer R, Aldea A, Moreno P, López‐Soto A. Time intervals in the care pathway to cancer diagnosis during the COVID-19 pandemic: A large retrospective study from a high-volume center. Int J Cancer 2022; 152:384-395. [PMID: 36053784 PMCID: PMC9539134 DOI: 10.1002/ijc.34260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/26/2022] [Accepted: 07/26/2022] [Indexed: 02/01/2023]
Abstract
Despite extensive research on cancer care during the COVID-19 pandemic, evidence on the impact on prediagnostic time intervals is lacking. To better understand how COVID-19 changed the pathway to diagnosis of cancer, we examined the length of intervals from symptom onset to diagnosis for 13 common cancer types with known clinical stage over 1-year nonpandemic period (March 2019 to March 2020; N = 844) and three biannual COVID periods (March 2020 to September 2021; N = 1172). We analyzed the patient interval (from first symptoms to presentation to a physician), the primary care/emergency department interval (from presentation with relevant symptoms to a primary care or emergency department physician to referral to a hospital-based diagnosis center) and the hospital interval (from referral to diagnosis). Compared to nonpandemic data, there were significant changes across COVID periods. The pandemic mostly impacted patient intervals for cancers diagnosed over the first 6 months after onset in March 2020. Overall median patient intervals were longest in the early COVID period (39 [IQR 22-64] days) and shortest in the nonpandemic period (20 [IQR 13-30] days; Kruskal-Wallis test [χ2 ], P < .0001). Differences in clinical stage between periods were relevant, with cancers from the mid-period (September 2020 to March 2021) showing the most advanced stage. A shift to later stage was plausibly a result of delayed intervals in the early COVID period. Since intervals are eventually relevant to prognosis, our results provide a baseline against which the impact of improvement strategies to minimize the negative outcomes of COVID-19-associated cancer delays can be assessed and implemented.
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Affiliation(s)
- Xavier Bosch
- Department of Internal Medicine, Hospital Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB)University of BarcelonaBarcelonaSpain,Campus Villarroel Medical CenterBarcelonaSpain
| | - Elisabet Montori‐Palacin
- Department of Internal Medicine, Hospital Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB)University of BarcelonaBarcelonaSpain,Campus Hospital Plató Medical CenterBarcelonaSpain
| | - Rosa Martínez‐Ferrer
- Department of Internal Medicine, Hospital Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB)University of BarcelonaBarcelonaSpain,Campus Hospital Plató Medical CenterBarcelonaSpain
| | - Anna Aldea
- Department of Internal Medicine, Hospital Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB)University of BarcelonaBarcelonaSpain,Campus Villarroel Medical CenterBarcelonaSpain
| | - Pedro Moreno
- Department of Internal Medicine, Hospital Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB)University of BarcelonaBarcelonaSpain,Campus Villarroel Medical CenterBarcelonaSpain
| | - Alfonso López‐Soto
- Department of Internal Medicine, Hospital Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB)University of BarcelonaBarcelonaSpain,Campus Villarroel Medical CenterBarcelonaSpain,Campus Hospital Plató Medical CenterBarcelonaSpain
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11
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Domper-Arnal MJ, Hijos-Mallada G, Lanas Á. The impact of COVID-19 pandemic in the diagnosis and management of colorectal cancer patients. Therap Adv Gastroenterol 2022; 15:17562848221117636. [PMID: 36035306 PMCID: PMC9403473 DOI: 10.1177/17562848221117636] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/18/2022] [Indexed: 02/04/2023] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to healthcare systems worldwide, causing downscaling of almost all other activities, especially in its early stages. Currently, the availability of vaccines along with the spread of new viral variants has modified the epidemiology of the disease, and the previous activity is being gradually resumed in most healthcare facilities. In this review, we have summarized the influence of the COVID-19 pandemic in the diagnosis and management of colorectal cancer (CRC) patients. Population-based screening with either colonoscopy or fecal occult blood tests has proven to reduce CRC incidence and mortality, so screening programs have been implemented in most western countries. However, during the first COVID-19 wave, most of these programs had to be disrupted temporarily. In this review, we have thoroughly analyzed the consequences of these disruptions of screening programs as well as of the forced delays in diagnostic and therapeutic services on CRC prognosis, although its exact impact cannot be exactly measured yet. In any way, strategies to minimize its effect, such as catch-up strategies expanding the colonoscopy capacity or using fecal occult blood concentration and other risk factors to prioritize patients, are urgently needed. The COVID-19 pandemic has also led to a change in CRC patient presentation, with an overall temporary decreased incidence due to postponed diagnoses, but with more patients presenting in need of an emergency admission or with symptoms. Finally, changes in treatment approaches in CRC patients have been reported during the pandemic, namely a drop in the proportion of laparoscopic surgeries or a rise in short-term radiotherapy courses. We have therefore aimed to summarize the available evidence to guide the healthcare professionals treating CRC patients to choose the best treatment options in the current pandemic situation.
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Affiliation(s)
| | | | - Ángel Lanas
- Service of Digestive Diseases, University
Clinic Hospital, Zaragoza, Spain,Aragón Health Research Institute (IIS Aragón),
Zaragoza, Spain,CIBERehd, Madrid, Spain,University of Zaragoza, Zaragoza, Spain
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12
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Nasir A, Hough B, Baffa C, Khazanchi A, Coppola D. An Analysis of the Impact of COVID-19 Pandemic-related Lockdown Measures on a Large Gastrointestinal Pathology Service in the United States. CANCER DIAGNOSIS & PROGNOSIS 2022; 2:422-428. [PMID: 35813009 PMCID: PMC9254096 DOI: 10.21873/cdp.10125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND/AIM The coronavirus disease 2019 (COVID-19) pandemic prompted global recommendations to delay non-urgent endoscopic procedures to limit the spread of SARS-COV-2, but such delays had unprecedented impact on the delivery of healthcare. Being a large specialty GI Pathology service, we sought to analyze the effect of the pandemic on the frequency of GI malignancies in our department. PATIENTS AND METHODS Based on the electronic search of departmental pathology records, we compared the total numbers of cancer diagnoses (primary and metastatic) from various GI biopsy sites during the 12-month pre- and post-pandemic periods. We summarized patient demographics and analyzed pertinent histopathologic data. RESULTS For all GI biopsy sites, the number of intramucosal/invasive malignancies reported during the one-year pre-COVID-19 pandemic (pre-COVID) and post-COVID-19 pandemic national lockdown (post-COVID) observation periods were 146 and 218, respectively. Among these, 32 and 70 malignancies were reported for the first quarter (representing the earliest post-lockdown period), 29 and 53 for the second, 41 and 54 for the third, and 44 and 41 for the fourth quarter. During the first two quarters of the post-COVID observation period, the increase in malignant diagnoses was most profound, showing 119% post-COVID increase compared to the pre-COVID levels. Of the two main primary histologic types of large intestinal carcinomas [adenocarcinoma (ADC) and squamous cell carcinoma (SCC)], the most profound post-COVID increase was noted in SCCs (136% vs. 58% for ADCs). CONCLUSION Compared to the pre-pandemic baseline, the COVID-19 pandemic caused a major increase in biopsy diagnoses of GI cancers in our department. The most plausible explanations for this trend include inevitable lockdowns to minimize the spread of SAR-COV2, which affected GI endoscopy procedure schedules/re-schedules as well as patient response and adaptation to emerging post-COVID GI healthcare patterns. The COVID-19 pandemic's long-term impact on the health of GI cancer patients will need to be determined through systematic analyses by multi-disciplinary teams.
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Affiliation(s)
- Aejaz Nasir
- Department of Pathology, Florida Digestive Health Specialists, Florida Research Institute, Bradenton, FL, U.S.A
| | - Brooke Hough
- Department of Pathology, Florida Digestive Health Specialists, Florida Research Institute, Bradenton, FL, U.S.A
| | - Caterina Baffa
- Department of Pathology, Florida Digestive Health Specialists, Florida Research Institute, Bradenton, FL, U.S.A
| | - Arun Khazanchi
- Department of Pathology, Florida Digestive Health Specialists, Florida Research Institute, Bradenton, FL, U.S.A
| | - Domenico Coppola
- Department of Pathology, Florida Digestive Health Specialists, Florida Research Institute, Bradenton, FL, U.S.A
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13
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Tankel J, Keinan A, Gillis R, Yoresh M, Gillis M, Tarnovsky Y, Riessman P. Exploring the trends of acute appendicitis following recovery or vaccination from COVID-19. J Surg Res 2022; 279:633-638. [PMID: 35926313 PMCID: PMC9234038 DOI: 10.1016/j.jss.2022.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/06/2022] [Accepted: 06/08/2022] [Indexed: 11/06/2022]
Abstract
Introduction The relationship that vaccination against corona virus disease 19 (COVID-19) or recovery from the acute form of the illness may have with the incidence or severity of acute appendicitis (AA) has not been explored. The aim of this study was to evaluate this relationship. Methods A single centre retrospective study of all consecutive adult patients presenting with AA in the 6 mo after the initiation of a national vaccination program was performed. The presenting characteristics and pathological data of patients who had either been vaccinated against or recovered from COVID-19 were compared with those who had not. In addition, historical data from the equivalent period 12 and 24 mo beforehand was also extracted. The incidence of AA was compared between each of these time-frames. Results Of the 258 patients initially identified, 255 were included in the analysis of which 156 had either been vaccinated and/or recovered from COVID-19 (61.2%) whilst 99 (38.8%) patients had not. When comparing these two groups, there were no significant differences in the presenting characteristics, operative findings or postoperative courses. There was also no significant change in the incidence of AA when comparing the study dates with historical data (median weekly incidence of AA 8.0 versus 8.0 versus 8.0 respectively, P = 0.672). Conclusions Based on the data presented here, we failed to find a relationship between a national vaccination program and both the nature and incidence of AA presenting to a busy urban hospital.
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14
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Diers J, Acar L, Wagner JC, Baum P, Hankir M, Flemming S, Kastner C, Germer CT, L'hoest H, Marschall U, Lock JF, Wiegering A. Cancer diagnosis is one quarter lower than the expected cancer incidence in the first year of COVID-19 pandemic in Germany: A retrospective register-based cohort study. Cancer Commun (Lond) 2022; 42:673-676. [PMID: 35633279 PMCID: PMC9257987 DOI: 10.1002/cac2.12314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/24/2022] [Accepted: 05/19/2022] [Indexed: 01/08/2023] Open
Affiliation(s)
- Johannes Diers
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany
| | - Laura Acar
- Department Medizin und Versorgungsforschung, Institut fuer Gesundheitssystemforschung, Barmer, Wuppertal, 42275, Germany
| | - Johanna C Wagner
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany
| | - Philip Baum
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany
| | - Mohammed Hankir
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany
| | - Sven Flemming
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany
| | - Carolin Kastner
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany.,Department of Biochemistry and Molecular Biology, University of Wuerzburg, Wuerzburg, 97074, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany.,Comprehensive Cancer Centre Mainfranken, University of Wuerzburg Medical Centre, Wuerzburg, 97080, Germany
| | - Helmut L'hoest
- Department Medizin und Versorgungsforschung, Institut fuer Gesundheitssystemforschung, Barmer, Wuppertal, 42275, Germany
| | - Ursula Marschall
- Department Medizin und Versorgungsforschung, Institut fuer Gesundheitssystemforschung, Barmer, Wuppertal, 42275, Germany
| | - Johan Friso Lock
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany
| | - Armin Wiegering
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Wuerzburg, 97080, Germany.,Department of Biochemistry and Molecular Biology, University of Wuerzburg, Wuerzburg, 97074, Germany.,Comprehensive Cancer Centre Mainfranken, University of Wuerzburg Medical Centre, Wuerzburg, 97080, Germany
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15
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Brugel M, Letrillart L, Evrard C, Thierry A, Tougeron D, El Amrani M, Piessen G, Truant S, Turpin A, d'Engremont C, Roth G, Hautefeuille V, Regimbeau JM, Williet N, Schwarz L, Di Fiore F, Borg C, Doussot A, Lambert A, Moulin V, Trelohan H, Bolliet M, Topolscki A, Ayav A, Lopez A, Botsen D, Piardi T, Carlier C, Bouché O. Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID). Eur J Cancer 2022; 166:8-20. [PMID: 35259629 PMCID: PMC8828421 DOI: 10.1016/j.ejca.2022.01.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic caused major oncology care pathway disruption. The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) - from diagnosis to treatment - of the reorganisation of the health care system during the first lockdown. METHODS This multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown. RESULTS During the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, -18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, -1.7%; p = 0.97). The number of borderline tumours increased (13.6%-21.7%), whereas the rate of metastatic diseases rate dropped (47.1%-40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%-32.6%) compared with upfront surgery (13%-7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%-69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%-9.6%) and advanced diseases increased (59.7%-69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%). CONCLUSION This cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up. TRIAL REGISTRATION Clinicaltrials.gov NCT04406571.
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Affiliation(s)
- Mathias Brugel
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France.
| | - Léa Letrillart
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France
| | - Camille Evrard
- Medical Oncology Department, CHU Poitiers, Poitiers, France
| | - Aurore Thierry
- Department of Research and Public Health, CHU Reims, Reims, France
| | - David Tougeron
- University of Poitiers, Hepatogastroenterology Department, CHU Poitiers, Poitiers, France
| | - Mehdi El Amrani
- Digestive Surgery and Liver Transplantation Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Guillaume Piessen
- Digestive and Oncological Surgery Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Stéphanie Truant
- Digestive Surgery and Liver Transplantation Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Anthony Turpin
- Medical Oncology Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Christelle d'Engremont
- Digestive Oncology and Hepatogastroenterology Department, CHU Grenoble-Alpes, Grenoble-Alpes University, Grenoble, France
| | - Gaël Roth
- Digestive Oncology and Hepatogastroenterology Department, CHU Grenoble-Alpes, Grenoble-Alpes University, Grenoble, France
| | - Vincent Hautefeuille
- Digestive Oncology and Gastroenterology Department, CHU Amiens-Picardie, Amiens, France
| | - Jean M Regimbeau
- Digestive Surgery Department, CHU Amiens-Picardie, SSPC (Simplification of Complex Patient Care) UR UPJV 7518, University of Picardie-Jules Verne, Amiens, France
| | - Nicolas Williet
- Hepatogastroenterology Department, CHU Saint Etienne, Saint-Priest-en-Jarez, France
| | - Lilian Schwarz
- Digestive Surgery Department, CHU Rouen, UNIROUEN, Inserm 1245, IRON Group, Normandie University, Rouen, France
| | - Frédéric Di Fiore
- Hepatogastroenterology Department, CHU Rouen, UNIROUEN, Inserm 1245, IRON Group, Normandie University, Rouen, France
| | - Christophe Borg
- Medical Oncology Department, CHU Besançon, INSERM, EFS BFC, UMR1098, RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | - Alexandre Doussot
- Digestive Surgical Oncology and Liver Transplantation Department, CHU Besançon, Besançon, France
| | - Aurélien Lambert
- Medical Oncology Department, Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - Valérie Moulin
- Oncology Department, GH La Rochelle, La Rochelle, France
| | | | - Marion Bolliet
- Hepatogastroenterology Department, CH Colmar, Colmar, France
| | | | - Ahmet Ayav
- Hepatobiliary and Pancreatic Surgery Departement, CHRU Nancy, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - Anthony Lopez
- Gastroenterology and Digestive Oncology, CHRU Nancy, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - Damien Botsen
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France; Department of Medical Oncology, Godinot Cancer Institute, Reims, France
| | - Tulio Piardi
- General, Digestive and Endocrine Surgery Department, CHU Reims, Research Unit EA 3797 (VieFra) University of Reims Champagne-Ardenne (URCA), Reims, France
| | - Claire Carlier
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France; Department of Medical Oncology, Godinot Cancer Institute, Reims, France
| | - Olivier Bouché
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France
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16
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The Role of Shared Decision-Making in Personalised Medicine: Opening the Debate. Pharmaceuticals (Basel) 2022; 15:ph15020215. [PMID: 35215327 PMCID: PMC8880233 DOI: 10.3390/ph15020215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/02/2022] [Accepted: 02/08/2022] [Indexed: 02/05/2023] Open
Abstract
Surgeons and cancer patients are starting to open the debate on how personalised medicine could use shared decision-making (SDM) to balance the personal and clinical components and thus improve the quality and value of care. Personalised precision medicine (PPM) has traditionally focused on the use of genomic information when prescribing treatments, which are usually pharmaceutical. However, the knowledge base is considerably scarcer in terms of how clinicians can individualise the information they provide patients about the consequences of different treatments, and in doing so involve them in the decision-making process. To achieve this, the ethical implications of SDM must be addressed from both sides. This paper explores the medical characteristics, the SDM implications in severe and fragile patients, potential risks, and observed benefits within this healthcare approach through four clinical cases. Findings shed light on current needs for clinician and patient training and tools related to SDM in PPM, and also remarks on the way in which this shift in healthcare settings is taking place to include the human component together with the biological and technological advances when designing care processes in colorectal cancer.
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17
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Kempf E, Priou S, Lamé G, Daniel C, Bellamine A, Sommacale D, Belkacemi Y, Bey R, Galula G, Taright N, Tannier X, Rance B, Flicoteaux R, Hemery F, Audureau E, Chatellier G, Tournigand C. 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. Int J Cancer 2022; 150:1609-1618. [PMID: 35001364 PMCID: PMC9015603 DOI: 10.1002/ijc.33928] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 12/17/2022]
Abstract
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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Affiliation(s)
- Emmanuelle Kempf
- Department of Medical Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France.,Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Sorbonne Université, Inserm, Université Sorbonne Paris Nord, Paris, France
| | - Sonia Priou
- IT Department, Assistance Publique-Hôpitaux de Paris, Innovation and Data, Paris, France
| | - Guillaume Lamé
- Laboratoire Génie Industriel, Université Paris-Saclay, CentraleSupélec, Gif-sur-Yvette, France
| | - Christel Daniel
- Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Sorbonne Université, Inserm, Université Sorbonne Paris Nord, Paris, France.,IT Department, Assistance Publique-Hôpitaux de Paris, Innovation and Data, Paris, France
| | - Ali Bellamine
- IT Department, Assistance Publique-Hôpitaux de Paris, Innovation and Data, Paris, France
| | - Daniele Sommacale
- Department of Digestive Surgery, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Yazid Belkacemi
- Department of Radiation Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Romain Bey
- IT Department, Assistance Publique-Hôpitaux de Paris, Innovation and Data, Paris, France
| | - Gilles Galula
- Department of Chronic Diseases and Cancer, Assistance Publique-Hôpitaux de Paris, Head Office, Paris, France
| | - Namik Taright
- Department of Medical Information, Assistance Publique-Hôpitaux de Paris, Head Office, Paris, France
| | - Xavier Tannier
- Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e-Santé, LIMICS, Sorbonne Université, Inserm, Université Sorbonne Paris Nord, Paris, France
| | - Bastien Rance
- Department of Medical Informatics, Centre-Université de Paris (APHP-CUP), Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Rémi Flicoteaux
- Department of Medical Information, Assistance Publique-Hôpitaux de Paris, Head Office, Paris, France
| | - François Hemery
- Department of Medical Information, Henri Mondor and Albert Chenevier Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Etienne Audureau
- Clinical Research Unit, Henri Mondor and Albert Chenevier Teaching Hospital, Université Paris Est Créteil, INSERM, IMRB, CEpiA Team, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Gilles Chatellier
- Department of Medical Informatics, Centre-Université de Paris (APHP-CUP), Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Christophe Tournigand
- Department of Medical Oncology, Henri Mondor and Albert Chenevier Teaching Hospital, Université Paris Est Créteil, INSERM, IMRB, Assistance Publique-Hôpitaux de Paris, Créteil, France
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18
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Ducrocq B. Impact de la Covid-19 sur la fertilité et la sexualité durant le confinement : quelles pertes de chance ? PSYCHO-ONCOLOGIE 2022. [DOI: 10.3166/pson-2022-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
La pandémie de Covid-19 liée au virus SARSCoV-2 a imposé un confinement mondial des populations en mars 2020. Outre les effets sur la santé publique et la santé physique, la santé mentale et la santé sexuelle ont été impactées. Les projets personnels des individus ont été bouleversés avec un impact sur les projets de couple et notamment de parentalités. La sexualité des individus s’est adaptée, entraînant des changements importants liés à l’isolement et les incertitudes en lien avec la pandémie mondiale.
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Circulating tumor DNA as a prognostic indicator of colorectal cancer recurrence-a systematic review and meta-analysis. Int J Colorectal Dis 2022; 37:1021-1027. [PMID: 35384496 PMCID: PMC8983807 DOI: 10.1007/s00384-022-04144-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Colorectal cancer (CRC) is one of the leading causes of cancer-related death worldwide. After resection, patients need extensive follow-up to detect asymptomatic recurrences as early as possible to obtain optimal treatment. This study evaluated the prognostic value of circulating tumor DNA (ctDNA) for CRC recurrence. METHODS Two investigators independently conducted a systematic literature search of peer-reviewed studies that investigated the prognostic value of ctDNA in CRC. Fixed effects or random effects models were applied for all analyses based on the assessment of heterogeneity. RESULTS A total of 189 studies were initially retrieved from all databases; ultimately, eight studies with 879 CRC patients were included in this analysis. The pooled median recurrence-free survival was 11.36 months for ctDNA-positive patients. Meta-analysis of hazard ratio (HR) suggested that postoperative ctDNA-positive patients were more likely to experience cancer recurrence than ctDNA-negative patients (pooled HR: 5.41; 95% confidence interval (CI): 2.37-8.45). CONCLUSIONS Successive monitoring of ctDNA status and follow-up with postoperative computed tomography (CT)/magnetic resonance imaging (MRI) are useful tools to detect early recurrence in postoperative ctDNA-positive patients.
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Habibzadeh P, Dastsooz H, Eshraghi M, Łos MJ, Klionsky DJ, Ghavami S. Autophagy: The Potential Link between SARS-CoV-2 and Cancer. Cancers (Basel) 2021; 13:cancers13225721. [PMID: 34830876 PMCID: PMC8616402 DOI: 10.3390/cancers13225721] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Coronavirus disease 2019 (COVID-19) has led to a global crisis. With the increasing number of individuals infected worldwide, the long-term consequences of this disease have become an active area of research. The constellation of symptoms COVID-19 survivors suffer from is commonly referred to as post-acute COVID-19 syndrome in the scientific literature. In this paper, we discuss the potential long-term complications of this infection resulting from the persistence of the viral particles in body tissues interacting with host cells’ autophagy machinery in the context of the development of cancer, cancer progression and metastasis, as well as response to treatment. We also propose a structured framework for future studies to investigate the potential impact of COVID-19 infection on cancer. Abstract COVID-19 infection survivors suffer from a constellation of symptoms referred to as post-acute COVID-19 syndrome. However, in the wake of recent evidence highlighting the long-term persistence of SARS-CoV-2 antigens in tissues and emerging information regarding the interaction between SARS-CoV-2 proteins and various components of the host cell macroautophagy/autophagy machinery, the unforeseen long-term consequences of this infection, such as increased risk of malignancies, should be explored. Although SARS-CoV-2 is not considered an oncogenic virus, the possibility of increased risk of cancer among COVID-19 survivors cannot be ruled out. Herein, we provide an overview of the possible mechanisms leading to cancer development, particularly obesity-related cancers (e.g., colorectal cancer), resulting from defects in autophagy and the blockade of the autophagic flux, and also immune escape in COVID-19 survivors. We also highlight the potential long-term implications of COVID-19 infection in the prognosis of patients with cancer and their response to different cancer treatments. Finally, we consider future directions for further investigations on this matter.
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Affiliation(s)
- Parham Habibzadeh
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran;
| | - Hassan Dastsooz
- Department of Life Sciences and Systems Biology, University of Turin, Via Accademia, Albertina, 13, 10123 Torino, Italy;
- IIGM-Italian Institute for Genomic Medicine, c/o IRCCS, Candiolo, 10126 Torino, Italy
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Torino, Italy
| | - Mehdi Eshraghi
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
| | - Marek J. Łos
- Biotechnology Center, Silesian University of Technology, 44-100 Gliwice, Poland
- Correspondence: (M.J.Ł.); (S.G.)
| | - Daniel J. Klionsky
- Life Sciences Institute, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Saeid Ghavami
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Research Institute of Oncology and Hematology, Cancer Care Manitoba, University of Manitoba, Winnipeg, MB R3E 0V9, Canada
- Faculty of Medicine, Katowice School of Technology, ul. Rolna 43, 40-555 Katowice, Poland
- Correspondence: (M.J.Ł.); (S.G.)
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