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Tazawa M, Nawa N, Yamauchi S, Tokunaga M, Fushimi K, Kinugasa Y, Fujiwara T. Impact of the coronavirus disease 2019 pandemic on the number of colorectal cancer surgeries performed: analysis of a nationwide inpatient database in Japan. Surg Today 2024:10.1007/s00595-024-02913-y. [PMID: 39164425 DOI: 10.1007/s00595-024-02913-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 06/25/2024] [Indexed: 08/22/2024]
Abstract
PURPOSE This study examined the impact of the COVID-19 pandemic on the number of colorectal cancer surgeries performed in Japan. METHODS We selected patients who underwent colorectal cancer surgeries between January, 2017 and December, 2020 from the Diagnosis Procedure Combination database. The COVID-19 pandemic was divided into three waves. We evaluated the changes in the number of surgeries performed for colorectal cancer during each wave, stratified by cancer stage using Poisson regression. RESULTS During the first wave, the rate ratio (RR) for stage III colon cancer decreased significantly (RR, 0.94), whereas those for stages 0 to II (RR, 1.01) and stage IV (RR, 1.04) were not different. During the second and third waves, the RR for stage 0 to II colon cancer decreased significantly (RR, 0.96), that for stage IV increased (RR, 1.09), and that for stage III was not different (RR, 0.97). During the first wave, the RR for stage 0 to II rectal cancer increased significantly (RR, 1.09), that for stage IV decreased (RR, 0.84), and that for stage III was not different (RR, 0.97). CONCLUSIONS The number of colorectal cancer surgeries changed during the pandemic and varied according to the stage of disease.
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Affiliation(s)
- Miyako Tazawa
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Nobutoshi Nawa
- Department of Public Health, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Shinichi Yamauchi
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masanori Tokunaga
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Yusuke Kinugasa
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takeo Fujiwara
- Department of Public Health, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Fujita M, Nagashima K, Uno T, Hashimoto H, Suzuki K, Kasai T, Yamaguchi K, Onouchi Y, Sato D, Fujisawa T, Hata A. Impact of the COVID-19 Pandemic on Hypofractionated Radiation Therapy Use for Breast Cancer in Japan: A Nationwide Study. Adv Radiat Oncol 2024; 9:101555. [PMID: 39104876 PMCID: PMC11298581 DOI: 10.1016/j.adro.2024.101555] [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: 11/06/2023] [Accepted: 06/04/2024] [Indexed: 08/07/2024] Open
Abstract
Purpose Hypofractionated radiation therapy (RT) was recommended for several cancer sites to reduce outpatient visits during the COVID-19 pandemic. This study aimed to identify the impact of the pandemic on hypofractionated RT for breast cancer in Japan. Methods and Materials The monthly number of courses for hypofractionated and conventional RTs was counted using sample data sets from the National Database of Health Insurance Claims and Specific Health Checkups of Japan, a nationwide database accumulating insurance claims data comprehensively. Changes in the number of hypofractionated and conventional RTs were estimated using an interrupted time-series analysis. Results The number of hypofractionated RT courses gradually increased before the pandemic in contrast to that of conventional RT courses, which gradually decreased. However, conventional RT remained outnumbered by hypofractionated RT throughout the observation period. After the outbreak of the pandemic, the use of hypofractionated RT significantly increased in April 2020 (1312 courses; 95% CI, 801-1823) but decreased in October 2020 (-601; 95% CI, -1111 to -92). Subgroup analysis by age and the number of beds in medical institutions revealed similar trends. Conclusions Although conventional RT for breast cancer has been gradually replaced by hypofractionated RT, it remains predominant. The use of hypofractionated RT increased briefly early in the COVID-19 pandemic; however, this increase was not sustained, unlike in other countries. Considering the benefits of hypofractionated RT for breast cancer, its use should be encouraged in Japan.
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Affiliation(s)
- Misuzu Fujita
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba, Japan
- Department of Public Health, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Japan
| | - Hideyuki Hashimoto
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba, Japan
| | - Kiminori Suzuki
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba, Japan
| | - Tokuzo Kasai
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba, Japan
| | - Kazuya Yamaguchi
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Japan
| | - Daisuke Sato
- Hospital and Health Administration, Fujita Health University Graduate School of Medicine, 1-98 Dengakugakubo, Kutukake-cho, Toyoake, Aichi, Japan
| | - Takehiko Fujisawa
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba, Japan
| | - Akira Hata
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba, Japan
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Fujita M, Yamaguchi K, Nagashima K, Suzuki K, Kasai T, Hashimoto H, Onouchi Y, Sato D, Fujisawa T, Hata A. Impact of the COVID-19 pandemic on gastric surgery in Japan: A nationwide study using interrupted time-series analyses. J Gastroenterol Hepatol 2024; 39:1277-1284. [PMID: 38454806 DOI: 10.1111/jgh.16533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND AIM Changes in the number of surgeries for gastric cancer during the coronavirus disease 2019 (COVID-19) pandemic have been reported, but data are insufficient to understand the impact at the national level. This study aimed to determine the impact of the COVID-19 pandemic on gastric surgery in Japan. METHODS Insurance claims data registered from January 2015 to January 2021 were used. Changes in the number of endoscopic resections and gastrectomies for gastric cancer were estimated using an interrupted time-series analysis. RESULTS The number of endoscopic resections significantly decreased in July 2020 (-1565; 95% confidence interval [CI]: -2022, -1108) and January 2021 (-539; 95% CI: -970, -109), and the number of laparoscopic surgeries significantly decreased in July 2020 (-795; 95% CI: -1097, -492), October 2020 (-313; 95% CI: -606, -19), and January 2021 (-507; 95% CI: -935, -78). Meanwhile, the number of open gastrectomies remained unchanged, and the number of robot-assisted gastrectomies steadily increased since their coverage by public health insurance in April 2018. CONCLUSIONS The decreased number of endoscopic resections and laparoscopic surgeries in Japan suggests a decline in early-stage gastric cancer diagnosis, likely due to the suspension of gastric cancer screening and diagnostic testing during the pandemic. Meanwhile, the number of open and robot-assisted gastrectomies remained unchanged and increased, respectively, indicating that these applications were not affected by the pandemic-related medical crisis. These findings highlight that procedures for cancer diagnosis, including screening, should still be provided during pandemics.
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Affiliation(s)
- Misuzu Fujita
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kazuya Yamaguchi
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Kiminori Suzuki
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Tokuzo Kasai
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Hideyuki Hashimoto
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Daisuke Sato
- Hospital and Health Administration, Fujita Health University Graduate School of Medicine, Toyoake, Japan
| | - Takehiko Fujisawa
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Akira Hata
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
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Speichinger F, Berg AK, Stoyanova A, Lauscher JC, Kamphues C, Beyer K, Seifarth C, Slavova N, Schineis C. Influence of the COVID-19 Pandemic on Patients with Rectal Cancer. J Clin Med 2024; 13:3568. [PMID: 38930097 PMCID: PMC11204882 DOI: 10.3390/jcm13123568] [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: 05/06/2024] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Objectives: The COVID-19 pandemic and its associated restrictions have resulted in delayed diagnoses across various tumor entities, including rectal cancer. Our hypothesis was based on the expectation of a reduced number of primary operations due to higher tumor stages compared to the control group. Methods: In a single-center retrospective study conducted from 1 March 2018 to 1 March 2022, we analyzed 120 patients with an initial diagnosis of rectal cancer. Among them, 65 patients were part of the control group (pre-COVID-19), while 55 patients were included in the study group (during the COVID-19 pandemic). We compared tumor stages, treatment methods, and complications, presenting data as absolute numbers or mean values. Results: Fewer primary tumor resections during the COVID-19 pandemic (p = 0.010), as well as a significantly lower overall number of tumor resections (p = 0.025) were seen compared to the control group. Twenty percent of patients in the COVID-19 group received their diagnosis during lockdown periods. These patients presented significantly higher tumor stages (T4b: 27.3% vs. 6.2%, p = 0.025) compared to the control group prior to the pandemic. In addition, more patients with angiolymphatic invasion (ALI) were identified in the COVID-19 group following neoadjuvant treatment compared to the control group (p = 0.027). No differences were noted between the groups regarding complications, stoma placement, or conversion rates. Conclusions: The COVID-19 pandemic, particularly during lockdown, appears to have contributed to delayed diagnoses, resulting in higher tumor stages and a decreased number of surgeries. The quality of rectal cancer treatment can be maintained under pandemic conditions.
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Affiliation(s)
- Fiona Speichinger
- Department of General and Visceral Surgery, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany (C.S.)
| | - Ann-Kathrin Berg
- Department of General and Visceral Surgery, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany (C.S.)
| | - Ani Stoyanova
- Department of General and Visceral Surgery, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany (C.S.)
| | - Johannes Christian Lauscher
- Department of General and Visceral Surgery, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany (C.S.)
| | - Carsten Kamphues
- Department of General and Visceral Surgery, Park-Klinik Weißensee Berlin, 13086 Berlin, Germany
| | - Katharina Beyer
- Department of General and Visceral Surgery, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany (C.S.)
| | - Claudia Seifarth
- Department of General and Visceral Surgery, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany (C.S.)
| | - Nadia Slavova
- Department of General and Visceral Surgery, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany (C.S.)
| | - Christian Schineis
- Department of General and Visceral Surgery, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany (C.S.)
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Fujita M, Fujisawa T, Suzuki K, Nagashima K, Kasai T, Hashimoto H, Yamaguchi K, Onouchi Y, Sato D, Hata A. Impact of the coronavirus disease 2019 pandemic on primary and metastatic lung cancer treatments in Japan: A nationwide study using an interrupted time series analysis. Cancer Epidemiol 2024; 90:102549. [PMID: 38447249 DOI: 10.1016/j.canep.2024.102549] [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: 10/06/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic prompted healthcare providers to use different approaches from the current standards of care. We aimed to identify the changes in the number of treatments for primary non-small cell lung cancer (NSCLC) and metastatic lung cancer during the pandemic. METHODS We used nationwide insurance claims data from January 2015 to January 2021, and estimated changes in the number of treatments using an interrupted time series analysis. RESULTS The number of surgical resections for primary NSCLC significantly decreased in April 2020 (-888; 95% confidence interval [CI]: -1530 to -246) and July 2020 (-1314; 95% CI: -1935 to -694), while the number of stereotactic body radiotherapies (SBRTs) increased in April 2020 (95; 95% CI: 8-182) and July 2020 (111; 95% CI: 24-198). The total number of treatments for primary NSCLC remained unchanged; however, non-significant decreases were observed in 2020. The number of surgical resections for metastatic lung cancer significantly decreased in April 2020 (-201; 95% CI: -337 to -65), but it eventually increased in July 2020 (170; 95% CI: 32-308). Additionally, the number of SBRTs significantly increased in April 2020 (37; 95% CI: 3-71) and October 2020 (57; 95% CI: 23-91). The total number of treatments for metastatic lung cancer was maintained, with an initial decrease in April 2020 followed by a subsequent increase in July and October 2020. CONCLUSION In Japan, surgical triage for primary and metastatic lung cancer are likely to have been implemented during the pandemic. Despite these proactive measures, patients with primary NSCLC may have been untreated, likely owing to their undiagnosed disease, potentially leading to a deterioration in prognosis. By contrast, patients diagnosed with cancer prior to the pandemic are presumed to have received standard management throughout the course of the pandemic.
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Affiliation(s)
- Misuzu Fujita
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan; Department of Public Health, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Takehiko Fujisawa
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Kiminori Suzuki
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tokuzo Kasai
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Hideyuki Hashimoto
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Kazuya Yamaguchi
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Daisuke Sato
- Hospital and Health Administration, Fujita Health University Graduate School of Medicine, 1-98 Dengakugakubo, Kutukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Akira Hata
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan
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Komatsu H, Ikeda Y, Kawana K, Nagase S, Yoshino K, Yamagami W, Tokunaga H, Kato K, Kimura T, Aoki D, Obstetrics TCOGOOTJSO, Gynecology. Impact of COVID-19 on gynecological cancer incidence: a large cohort study in Japan. Int J Clin Oncol 2024; 29:72-77. [PMID: 38055097 DOI: 10.1007/s10147-023-02431-w] [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: 09/09/2023] [Accepted: 10/15/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND The influence of the coronavirus disease 2019 (COVID-19) pandemic on the number of newly diagnosed gynecological cancers has not been extensively investigated in Japan. This study determined the impact of COVID-19 on the incidence of gynecological cancer. METHODS Using the Japanese Society of Obstetricians and Gynecologic Oncology registry database, the distribution of the number of patients based on clinical staging or tumor-node-metastasis classifications before and during the COVID-19 pandemic was analyzed to compare the trends. The clinical staging classification of cervical cancer in Japan was based on the International Federation of Gynecology and Obstetrics (FIGO) 2008 from 2018 to 2020 and on the FIGO 2018 from 2021. Since FIGO-2018 classified N1 cases as stage IIIC, we focused on T classification without referencing the clinical staging (FIGO staging) of patients with cervical cancer in 2021. RESULTS The number of patients with endometrial cancer and malignant ovarian tumors of all clinical stages increased uniformly yearly, while that of those with stage III cervical cancer rapidly increased in 2021 owing to the adoption of the revised classification. On comparing cases of cervical cancer in 2020 and 2021, we found that T1 cases decreased and T2 and T3 cases increased in 2021 compared to those in 2020 (p = 0.006). Cervical intraepithelial neoplasia/adenocarcinoma in situ incidence decreased in 2020 compared to that in 2019 but increased again in 2021. The number of patients with cervical cancer decreased in most prefectures in 2020. CONCLUSION The incidence of locally advanced cervical cancer increased during the COVID-19 pandemic.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan
| | - Yuji Ikeda
- Department of Obstetrics and Gynecology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, Itabashi-Ku, Tokyo, 173-8610, Japan
| | - Kei Kawana
- Department of Obstetrics and Gynecology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, Itabashi-Ku, Tokyo, 173-8610, Japan.
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Yamagata University School of Medicine, Yamagata, Japan
| | - Kiyoshi Yoshino
- Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Wataru Yamagami
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Miyagi, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Kyushu University School of Medicine, Fukuoka City, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University School of Medicine, Osaka, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
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Weinberger Rosen A, Jensen H, Olesen TB, Møller H, Jensen JW, Gögenur I. Socioeconomic factors and colorectal cancer incidence, stage and quality of care in Denmark during the COVID-19 pandemic. Cancer Epidemiol 2023; 86:102447. [PMID: 37633057 DOI: 10.1016/j.canep.2023.102447] [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: 05/25/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 08/28/2023]
Abstract
AIM Efforts to control the COVID-19 pandemic might reduce accessibility for diagnostics and treatment of colorectal cancer. A universal public healthcare system may modify the availability of healthcare services. The aim of this study was to investigate changes in the quality of care for patients with colorectal cancer during the COVID-19 pandemic. METHOD Nationwide data from the Danish Colorectal Cancer database and Statistics Denmark on the number of new diagnoses, disease and health behaviour measures, socioeconomic measures, clinical quality measures and time to adjuvant chemotherapy were retrieved. Measures during the COVID-19 pandemic in 2020 and the different pandemic periods were compared to the pre-pandemic period. RESULT In 2020, 4035 patients were diagnosed with colorectal cancer, compared with 4346 in 2019 and 4496 in 2018. During the pandemic, patients were more likely to have UICC stage I disease (25.0% vs 23.4%; PR=1.07(95% confidence interval: 1.00;1.15)), belonging to the highest income quintile (PR=1.06(0.98;1.14), receive surgery with a curative aim (PR=1.02(1.01;1.03)), and to be operated on by a specialist (PR=1.07(1.06;1.08)), and less likely to be 60-69 years of age (PR=0.93(0.86;1.00)), non-western immigrants (PR=0.93(0.86;1.00)), diagnosed by screening (PR=0.79(0.73;0.86)) and receiving an acute operation (PR=0.77(0.66;0.91)). Furthermore, during the pandemic, 11.4% fewer patients waited 28 days or longer for initiation of adjuvant oncological treatment. CONCLUSION Based on nationwide data, we observed no major adverse effect on disease measures or clinical quality in a tax funded health care system. However, small changes in the socioeconomic composition of the patient population were observed.
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Affiliation(s)
| | - Henry Jensen
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Denmark.
| | - Tina Bech Olesen
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Denmark
| | - Henrik Møller
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Denmark; Danish Center for Clinical Health Services Research, Faculty of Medicine, Aalborg University, Denmark
| | - Jens Winther Jensen
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Denmark
| | - Ismail Gögenur
- Center for Surgical Science, Zealand University Hospital, Denmark; Institute for Clinical Medicine, Copenhagen University, Denmark
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