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Cwintal M, Shih H, Idrissi Janati A, Gigliotti J. The effect of the COVID-19 pandemic on the diagnosis and progression of oral cancer. Int J Oral Maxillofac Surg 2024; 53:629-634. [PMID: 38395689 DOI: 10.1016/j.ijom.2024.02.003] [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: 09/06/2023] [Revised: 01/21/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
The COVID-19 pandemic placed a significant burden on healthcare resources, limiting care to emergent and essential services only. The objective of this study was to describe the effect of the COVID-19 pandemic on the diagnosis and progression of oral cancer lesions in Montreal, Canada. A retrospective analysis of health records was performed. Patients presenting for a new oncology consultation for an oral lesion suspicious for cancer between March 2018 and March 2022, within the Department of Oral and Maxillofacial Surgery of the McGill University Health Center, were included. Data was collected on sociodemographic characteristics, oral cancer risk behaviors of study participants, oral cancer delays, tumor characteristics, and clinical management. A total of 190 patients were included, 91 patients from the pre-pandemic period and 99 from the pandemic period. The demographic characteristics of the patients in the two periods were comparable. There was no significant difference in the patient, professional, or treatment delay between the two periods. There was a non-significant increase in pathologic tumor size during the pandemic, but the pathologic staging and postoperative outcomes were comparable to those of the pre-pandemic cohort. The results indicate that emergent care pathways for oral cancer treatment were efficiently maintained despite the pandemic shutdown of services.
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Affiliation(s)
- M Cwintal
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - H Shih
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada; Department of Oral and Maxillofacial Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - A Idrissi Janati
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada; Department of Oral and Maxillofacial Surgery, McGill University Health Centre, Montreal, QC, Canada; The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - J Gigliotti
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada; Department of Oral and Maxillofacial Surgery, McGill University Health Centre, Montreal, QC, Canada.
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Petti S. Negative excess oral and pharyngeal cancer mortality in Europe during the early pandemic years. Oral Dis 2024. [PMID: 38938075 DOI: 10.1111/odi.15055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/14/2024] [Accepted: 06/16/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE The COVID-19 pandemic had direct and indirect effects on oral and pharyngeal cancer (OPC) mortality due to high COVID-19 mortality risk among cancer patients, and to the COVID-19 response that caused treatment delays and reduced routine visits. This study investigated the excess OPC mortality in Europe during the early pandemic years. METHODS Mortality and population data were gathered from the Eurostat database. The 2011-2019 mortality rates were used to estimate the 2020-2021 expected rates through joinpoint trend analysis. The excess mortality rates (observed minus expected mortality) with 95% confidence intervals (95 CIs) were assessed. RESULTS Statistically significant negative excess age-standardized and crude (age strata <65 and ≥65 years) OPC mortality rates in males and females, in the European Union (EU, 27 countries) and Europe were reported. The estimated OPC missing deaths in EU were 831 (95 CI, 630-985) and 1240 (95 CI, 1039-1394) in 2020 and 2021, respectively, with differences between sexes, age strata, and countries. The OPC deaths in the EU and Europe were 3.6% and 3.5% lower than expected. CONCLUSION Missing OPC deaths reported in Europe in 2020-2021 could be explained by changes in death certification of OPC patients who developed COVID-19, rather than a real OPC mortality decline.
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Affiliation(s)
- Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Zhou K, Robert M, Seegers V, Blanc-Lapierre A, Savouroux S, Bigot F, Frenel JS, Campone M, Conroy T, Penault-Llorca F, Raoul JL, Bellanger MM. Did the COVID-19 pandemic delay treatment for localized breast cancer patients? A multicenter study. PLoS One 2024; 19:e0304556. [PMID: 38820299 PMCID: PMC11142554 DOI: 10.1371/journal.pone.0304556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Longer times between diagnosis and treatments of cancer patients have been estimated as effects of the COVID-19 pandemic. However, relatively few studies attempted to estimate actual delay to treatment at the patient level. OBJECTIVE To assess changes in delays to first treatment and surgery among newly diagnosed patients with localized breast cancer (BC) during the COVID-19 pandemic. METHODS We used data from the PAPESCO-19 multicenter cohort study, which included patients from 4 French comprehensive cancer centers. We measured the delay to first treatment as the number of days between diagnosis and the first treatment regardless of whether this was neoadjuvant chemotherapy or surgery. COVID-19 pandemic exposure was estimated with a composite index that considered both the severity of the pandemic and the level of lockdown restrictions. We ran generalized linear models with a log link function and a gamma distribution to model the association between delay and the pandemic. RESULTS Of the 187 patients included in the analysis, the median delay to first treatment was 42 (IQR:32-54) days for patients diagnosed before and after the start of the 1st lockdown (N = 99 and 88, respectively). After adjusting for age and centers of inclusion, a higher composite pandemic index (> = 50 V.S. <50) had only a small, non-significant effect on times to treatment. Longer delays were associated with factors other than the COVID-19 pandemic. CONCLUSION We found evidence of no direct impact of the pandemic on the actual delay to treatment among patients with localized BC.
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Affiliation(s)
- Ke Zhou
- Department of Human and Social Sciences, Institut de Cancérologie de l’Ouest (ICO), Saint-Herblain, France
| | - Marie Robert
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Saint-Herblain, France
| | - Valérie Seegers
- Department of Biostatistics, Institut de Cancérologie de l’Ouest, St-Herblain, France
| | - Audrey Blanc-Lapierre
- Department of Biostatistics, Institut de Cancérologie de l’Ouest, St-Herblain, France
| | - Stéphane Savouroux
- Department of Health Promotion and Prevention, Institut de Cancérologie de l’Ouest (ICO), Saint-Herblain, France
| | - Frédéric Bigot
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Angers, France
| | - Jean-Sébastien Frenel
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Saint-Herblain, France
| | - Mario Campone
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Saint-Herblain, France
| | - Thierry Conroy
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | | | - Jean-Luc Raoul
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Saint-Herblain, France
| | - Martine M. Bellanger
- Department of Human and Social Sciences, Institut de Cancérologie de l’Ouest (ICO), Saint-Herblain, France
- Department of Health Promotion and Prevention, Institut de Cancérologie de l’Ouest (ICO), Saint-Herblain, France
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Wang S, Li K, Zhao T, Sun Y, Zeng T, Wu Y, Ding L, Huang X, Celentano A, Yang X, Hu Q, Ni Y. Oral tongue squamous cell carcinoma diagnosis from tissue metabolic profiling. Oral Dis 2024; 30:2158-2165. [PMID: 37486619 DOI: 10.1111/odi.14696] [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: 02/08/2023] [Revised: 06/15/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE Disease metabolomes have been studied for identifying diagnostic and predictive biomarkers of pathology. Oral tongue squamous cell carcinoma (OTSCC) is one of the most prevalent subtypes of head and neck squamous cell carcinoma, yet the profile and diagnostic value of its tissue metabolite are unclear. SUBJECTS AND METHODS Tumor tissue samples and matched normal mucosal tissue samples were collected from 40 OTSCC patients. Untargeted metabolic analysis by liquid chromatography-mass spectrometry/mass spectrometry, in positive and negative ion modes, was used to identify dysregulated metabolites in OTSCC. Further, utilizing LASSO regression and receiver operating characteristic analyses, biomarker metabolites were selected and validated, and a diagnostic model was established. RESULTS One hundred and ninety metabolites were detected. The OTSCC had a total of 89 dysregulated metabolites, of which 73 were elevated. A diagnostic panel of nine metabolites was subsequently created that could accurately identify OTSCC with 100% sensitivity of 100%, 100% specificity and an AUC of 1.00. CONCLUSIONS This study identified distinct metabolic characteristics of OTSCC and established a diagnostic model. Our research also contributes to the investigation of the pathogenesis of OTSCC.
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Affiliation(s)
- Shuai Wang
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Ke Li
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Tong Zhao
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yawei Sun
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Tao Zeng
- State Key Lab of Pharmaceutical Biotechnology, College of Life Sciences, Nanjing University, Nanjing, Jiangsu, China
| | - Yan Wu
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Oral Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Liang Ding
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaofeng Huang
- Department of Oral Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Antonio Celentano
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - Xihu Yang
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Qingang Hu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yanhong Ni
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
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Semprini J, Pagedar NA, Boakye EA, Osazuwa-Peters N. Head and Neck Cancer Incidence in the United States Before and During the COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg 2024; 150:193-200. [PMID: 38206603 PMCID: PMC10784997 DOI: 10.1001/jamaoto.2023.4322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/17/2023] [Indexed: 01/12/2024]
Abstract
Importance Research about population-level changes in the incidence and stage of head and neck cancer (HNC) associated with the COVID-19 pandemic is sparse. Objective To examine the change in localized vs advanced HNC incidence rates before and during the first year of the pandemic. Design, Setting, and Participants In this cross-sectional study of patients in the US diagnosed with HNC from 2017 to 2020, the estimated number with cancer of the oral cavity and pharynx (floor of mouth; gum and other mouth; lip; oropharynx and tonsil; and tongue) and larynx were identified from the SEER cancer registry. Subgroup analyses were stratified by race and ethnicity, age, and sex. Data were analyzed after the latest update in April 2023. Exposure The COVID-19 pandemic in 2020. Main Outcomes and Measures The primary outcomes were the annual incidence rates per 100 000 people for localized HNC (includes both localized and regional stages) and advanced HNC (distant stage) and weighted average annual percentage change from 2019 to 2020. Secondary outcomes included annual percentage change for 2017 to 2018 and 2018 to 2019, which provided context for comparison. Results An estimated 21 664 patients (15 341 [71%] male; 10 726 [50%] ≥65 years) were diagnosed with oral cavity and pharynx cancer in 2019 in the US, compared with 20 390 (4355 [70%] male; 10 393 [51%] ≥65 years) in 2020. Overall, the HNC incidence rate per 100 000 people declined from 11.6 cases in 2019 to 10.8 in 2020. The incidence rate of localized cancer declined to 8.8 cases (-7.9% [95% CI, -7.5 to -8.2]) from 2019 to 2020. The localized cancer incidence during the first year of the pandemic decreased the most among male patients (-9.3% [95% CI, -9.2 to -9.5]), Hispanic patients (-12.9% [95% CI, -12.9 to -13.0]), and individuals with larynx cancer (-14.3% [95% CI, -13.6 to -15.0]). No change in the overall incidence rate was found for advanced HNC. Conclusions and Relevance In this cross-sectional study, the incidence of localized HNC declined during the first year of the pandemic. A subsequent increase in advanced-stage diagnoses may be observed in later years.
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Affiliation(s)
- Jason Semprini
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City
| | - Nitin A Pagedar
- Department of Otolaryngology, University of Iowa Carver College of Medicine, Iowa City
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
- Department of Otolaryngology-Head & Neck Surgery, Henry Ford Health System, Detroit, Michigan
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
- Duke Cancer Institute, Duke University, Durham, North Carolina
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