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Demoustier B, Seigneurin A, Jacquet E, Delafosse P, Riedel C, Epaulard O, Laramas M. COVID-19 impact on incidence and stage at diagnosis of five prominent cancers: A French cancer registry-based study. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202555. [PMID: 38968693 DOI: 10.1016/j.jeph.2024.202555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/19/2024] [Accepted: 05/14/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND The French healthcare system has been affected by the COVID-19 pandemic in 2020, including cancer care. METHODS In order to evaluate the impact of this pandemic on cancer incidence, the Isere Departmental Cancer Registry compared the actual 2020 incidence of melanoma, breast, colorectal, prostate and lung cancers with the expected 2020 incidence based on data collected by the Registry between 2015 and 2019, taking into account periods of lockdown and reopening. When available, cancer stages and/or prognostic scores were recorded. RESULTS During the period of initial confinement, a 54%, 50% and 36,8% drop in incidence was observed for breast, prostate and colorectal cancer respectively. Although their annual incidence remained stable, a worsening trend emerged as a decline in the number of low stages/scores at diagnosis in favour of higher stages/scores towards the end of 2020. In contrast, a significant 17,8% drop was observed in annual incidence of melanoma, particularly for Breslow scores < 1 (-27,4%). However, this trend was noticeable before the lockdown, as well as the 14% reduction in the incidence of lung cancer in women, but not in men. CONCLUSION The incidence of certain cancers was caught up over the year but the COVID-19 pandemic seems to be associated with a change in their severity at diagnosis throughout 2020. The downward trends in female lung cancer and melanoma incidence point to complex underlying phenomena. Further analysis is still needed to assess the global impact of the COVID-19 pandemic on cancer incidence.
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Affiliation(s)
- Bénédicte Demoustier
- Univ. Grenoble Alpes, Department of Medical Oncology, CHU Grenoble Alpes, 38000 Grenoble, France.
| | - Arnaud Seigneurin
- Univ. Grenoble Alpes, Department of Epidemiology and Medical Evaluation, CHU Grenoble Alpes Cancer Registry of Isère, 38000 Grenoble, France
| | - Emmanuelle Jacquet
- Univ. Grenoble Alpes, Department of Medical Oncology, CHU Grenoble Alpes, 38000 Grenoble, France
| | | | - Cédric Riedel
- Univ. Montpellier, Faculté de Médecine, Montpellier, 34090 France
| | - Olivier Epaulard
- Univ. Grenoble Alpes, Department of Infectious Diseases, CHU Grenoble Alpes, 38000 Grenoble, France
| | - Mathieu Laramas
- Univ. Grenoble Alpes, Department of Medical Oncology, CHU Grenoble Alpes, 38000 Grenoble, France
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Mangone L, Marinelli F, Bisceglia I, Filice A, Braghiroli MB, Roncaglia F, Palicelli A, Morabito F, Neri A, Sabbatini R, Iotti C, Pinto C. Impact of the COVID-19 Pandemic on Prostate Cancer Diagnosis, Staging, and Treatment: A Population-Based Study in Northern Italy. BIOLOGY 2024; 13:499. [PMID: 39056693 PMCID: PMC11274002 DOI: 10.3390/biology13070499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/02/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
The COVID-19 pandemic has caused delays in cancer diagnoses and reductions in treatments. The aim of this work is to evaluate the impact of the pandemic on prostate cancer by evaluating whether there has been a shift towards more aggressive (Gleason) and more advanced tumors (stage IV) and a decline in treatments. The study was conducted on 1123 cases of prostate cancer incident in the Province of Reggio Emilia, Northern Italy, in the period of 2018-2021. In 2020, there was a decline in new diagnoses of prostate cancer (-31%), followed by a slight recovery in 2021 (+5%). While Gleason 7 and 8-10 values remained constant, a significant decrease was recorded in stage I (38.7%, 41.6%, 35.5%, and 27.7%) and an increase in stage IV (13.1%, 13%, 15.4%, and 20%) cases in the years 2018, 2019, 2020, and 2021, respectively. However, there was no impact on surgical treatment (which remained constant at around 35%) and radiotherapy (around 39%). Our findings underline the profound impact of COVID-19 on prostate cancer management, highlighting the importance of healthcare resilience in the face of unprecedented disruptions.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (F.R.)
| | - Francesco Marinelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (F.R.)
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (F.R.)
| | - Angelina Filice
- Nuclear Medicine Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Maria Barbara Braghiroli
- Epidemiology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (F.R.)
| | - Francesca Roncaglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (F.R.)
| | - Andrea Palicelli
- Pathology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Fortunato Morabito
- Gruppo Amici Dell’Ematologia Foundation—GrADE, 42123 Reggio Emilia, Italy;
| | - Antonino Neri
- Scientific Directorate, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Roberto Sabbatini
- Medical Oncology Division, Department of Oncology and Hematology, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Cinzia Iotti
- Radiation Oncology Unit, Department of Advanced Technology, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Carmine Pinto
- Medical Oncology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
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Lee ML, Megwalu UC, Finegersh A, Noel JE, Chen MM. Impact of the COVID-19 Pandemic on Thyroid Cancer Surgery. Curr Oncol 2024; 31:3579-3590. [PMID: 38920746 PMCID: PMC11202414 DOI: 10.3390/curroncol31060263] [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: 05/06/2024] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
The COVID-19 pandemic caused major disruptions to healthcare services in 2020, delaying cancer diagnosis and treatment. While early-stage thyroid cancer often progresses slowly, it is crucial to determine whether treatment delays associated with the pandemic have impacted the clinical presentation and management of advanced-stage thyroid cancer. The purpose of our study was to determine the impact of the early COVID-19 pandemic on thyroid cancer presentation and treatment times. Utilizing the National Cancer Database, chi-squared tests and regression analyses were performed to compare patient demographic and clinical characteristics over time for 56,011 patients diagnosed with primary thyroid cancer who were treated at the Commission on Cancer-accredited sites in 2019 and 2020. We found that thyroid cancer diagnoses decreased between 2019 and 2020, with the biggest drop among patients with cT1 disease relative to other T stages. We also found that patients diagnosed with thyroid cancer in 2020 had similar treatment times to patients diagnosed in 2019, as measured by both the time between diagnosis and start of treatment and the time between surgery and start of radioactive iodine therapy. Overall, our study suggests that resources during the pandemic were allocated to patients with advanced thyroid disease, despite a decrease in diagnoses.
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Affiliation(s)
- Max L. Lee
- Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Uchechukwu C. Megwalu
- Department of Otolaryngology--Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA; (U.C.M.); (A.F.); (J.E.N.)
| | - Andrey Finegersh
- Department of Otolaryngology--Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA; (U.C.M.); (A.F.); (J.E.N.)
| | - Julia E. Noel
- Department of Otolaryngology--Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA; (U.C.M.); (A.F.); (J.E.N.)
- Santa Clara Valley Medical Center, San Jose, CA 95128, USA
| | - Michelle M. Chen
- Department of Otolaryngology--Head & Neck Surgery, Stanford University, Palo Alto, CA 94304, USA; (U.C.M.); (A.F.); (J.E.N.)
- ValleyCare Pleasanton Cancer Center, Pleasanton, CA 94588, USA
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Faisant M, Vincent N, Hubert B, Le Tertre A. Regional excess mortality in France during COVID-19 pandemic: the first three epidemic periods (March 2020-June 2021). Eur J Public Health 2024; 34:606-612. [PMID: 38390659 PMCID: PMC11161158 DOI: 10.1093/eurpub/ckae032] [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] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND This study aimed to describe the mortality excess during the three first epidemic periods of COVID-19 in all regions of France. METHODS Two complementary approaches were implemented. First, we described the number of death of patients infected with or diagnosed with COVID-19 in health care (HC) and medico-social (MS) institutions. Then, we estimated general all-cause mortality excess (all ages) by comparing the mortality observed with the expected mortality. We used a daily number of death model according to a negative binomial distribution, as a function of the long-term trend in mortality (penalized spline function of time) and its seasonal variation (cyclic spline function). The model provided expected mortality during epidemic periods with a 95% credibility interval. Each region defined three epidemic periods, including the overseas territories. RESULTS The two approaches were consistent in the most affected regions but there are major regional disparities that vary according to the epidemic period. There is an east-west gradient in the relative excess of deaths from all-causes during each epidemic period. The deaths observed in HC and MS institutions alone do not explain the excess (or deficit) of mortality in each region and epidemic period. CONCLUSION An analysis by age group according to the two approaches and a comparison of death specific causes could provide a better understanding of these differences. Electronic death registration system (mortality by medical causes) would allow a rapid mortality related estimation to an emerging pathology like Coronavirus Disease-2019 (COVID-19) but is still insufficient for real-time medical causes of death monitoring.
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Affiliation(s)
| | | | - Bruno Hubert
- Santé publique France, SpFrance, Saint-Maurice, France
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Ghanem G, Tsai HHC, Durant C, Feigenbaum GS, Glaeser AM. Outpatient hospitalist-run procedure service bridges the gap in oncology care. Transfus Apher Sci 2024; 63:103936. [PMID: 38658295 DOI: 10.1016/j.transci.2024.103936] [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: 10/18/2023] [Revised: 04/03/2024] [Accepted: 04/20/2024] [Indexed: 04/26/2024]
Abstract
Hospitalist-run procedure teams enable expedited care in the inpatient setting. However, wait times for outpatient interventional radiology (IR) are long at our institution. Our study thus aims to compare the safety and wait times between procedural teams and IR placement of outpatient temporary hemodialysis catheters (THDC) for patients undergoing Chimeric antigen receptor T-cell (CAR-T) therapy apheresis. A retrospective chart review was conducted on all patients receiving outpatient THDC for CAR-T therapy from August 2019 until November 2022. During our study period, only 7 of the central lines were placed by IR, while 75 were placed by the procedure service. The average wait time from CAR-T consenting to procedure was 8.9 days for the procedure service and 14.7 days for IR. The 30 day minor complication rate was low - 2.7% in the procedure group, and 0% in the IR group. No major complications were noted in either group.
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Affiliation(s)
- Ghadi Ghanem
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
| | - Hsin Hsiang Clarence Tsai
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Catherine Durant
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Gary S Feigenbaum
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Alexandra Milin Glaeser
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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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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7
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Wu QL, Brannon GE. Collaborative Care and Healthcare Usage in Families with Pediatric Patients During COVID-19: A Secondary Analysis of National Survey of Children's Health (NSCH) Data. HEALTH COMMUNICATION 2024; 39:1053-1065. [PMID: 37069500 DOI: 10.1080/10410236.2023.2201746] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
One of the most detrimental side effects of the COVID-19 pandemic is the needed but not received care. Forgone health care affects the general public, but particularly children with special care needs. Previous research focused on non-modifiable factors, such as demographic background and insurance coverage. Based on Politi and Street's model of collaborative decision-making, we explored how two modifiable communication factors contributed to the prevention of forgone pediatric care during the COVID-19 pandemic. Using a nationally representative sample (n = 10845) from the 2020 National Survey of Children's Health (NSCH) survey, we found that health-care providers' family-centered communication and shared decision-making may reduce the possibility of forgone care through improved satisfaction with providers' communication. For children with mental health needs, providers' family-centered communication may also stimulate family's capacity to openly communicate, leading to better involvement in care and timely health care seeking. This helps to address COVID-related uncertainty, prevent higher health-care expenditures, and reduce negative health outcomes.
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Axenhus M, Schedin-Weiss S, Tjernberg L, Winblad B. The impact of the COVID-19 pandemic on neurosurgery in the elderly population in Sweden. BMC Public Health 2024; 24:823. [PMID: 38491396 PMCID: PMC10941451 DOI: 10.1186/s12889-024-18332-0] [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: 09/12/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic prompted a refocus of health care resources to acute care which has impacted on the capacity of healthcare systems to conduct neurological surgeries. The elderly population has been shown to be particularly vulnerable to the consequences of the pandemic. Less neurosurgery can result in great impact on public health by increasing morbidity and mortality in patients with malignancies and traumatic injuries. The aim of this study was to investigate the effects of the COVID-19 pandemic on neurosurgical procedures in the elderly population in Sweden. METHODS In this retrospective observational study, the reported incidence of all neurosurgical procedures registered in the 21 Regions of Sweden during 2015-2021 in people aged 65 year or older was collected. Surgical procedures were classified according to the NOMESCO system of classification. Neurosurgery incidence was defined as the number of NOMESCO associated interventions per 100.000 inhabitants. ICD-10 codes associated with neurosurgery-related diagnoses and deaths were also collected. Expected incidence of neurosurgery, neurosurgery-associated deaths and brain cancer diagnoses was estimated and compared to actual outcomes. Decrease in the incidence of neurosurgery was compared to regional COVID-19 incidence, other types of surgery and surgery waiting times. RESULTS The incidence of several categories of neurosurgery decreased in Sweden during 2020 and 2021, although not as much as other surgical categories. Women were more affected than men by the decrease in neurosurgery which could be partly explained by a decrease in brain cancer diagnoses amongst women. There was an association between regional decrease in neurosurgery incidence and longer surgery waiting time. COVID-19 incidence in the region did not have an effect on regional decreases in neurosurgery incidence. CONCLUSIONS The COVID-19 pandemic resulted in a reduction in the number of neurosurgical procedures performed in Sweden during 2020-2021, although not as much as in other European countries. There was regional difference in Sweden with respect to number of surgeries, and waiting time for elective surgeries although there was no increase in mortality.
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Affiliation(s)
- Michael Axenhus
- Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Sophia Schedin-Weiss
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lars Tjernberg
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University hospital, Huddinge, Sweden
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Youn HM, Zhang Y, Liu A, Ng CS, Liang J, Lau GKK, Lee SF, Lok J, Lam CLK, Wan EYF, Quan J. Decline in Cancer Diagnoses during the 'Zero COVID' Policy in Hong Kong: Indirect Spillover Impact of the COVID-19 Pandemic. Clin Oncol (R Coll Radiol) 2024; 36:157-164. [PMID: 38262779 DOI: 10.1016/j.clon.2024.01.008] [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: 06/21/2023] [Revised: 11/26/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
AIMS Despite a largely successful 'zero COVID' policy in 2020, the COVID-19 pandemic disrupted routine cancer services in the city of Hong Kong. The aims of this study were to examine the trends in cancer incidence before and during the COVID-19 pandemic and estimate missed cancer diagnoses. MATERIALS AND METHODS We used population-based data from the Hong Kong Cancer Registry 1983-2020 to examine the trends of age- and sex-standardised cancer incidence before and during the COVID-19 pandemic. We applied: (i) the annual average percentage change (AAPC) calculated using the Joinpoint regression model and (ii) the autoregressive integrated moving average (ARIMA) model to forecast cancer incidence rates in 2020. Missed cancer diagnoses in 2020 were estimated by comparing forecasted incidence rates to reported rates. A subgroup analysis was conducted by sex, age and cancer site. RESULTS The cancer incidence in Hong Kong declined by 4.4% from 2019 to 2020 (male 8.1%; female 1.1%) compared with the long-term AAPC of 0.5% from 2005 to 2019 (95% confidence interval 0.3, 0.7). The gap between the reported and forecasted incidence for 2020 ranged from 5.1 to 5.7% (male 8.5%, 9.8%; female 2.3%, 3.5%). We estimated 1525-1596 missed cancer diagnoses (ARIMA estimate -98, 3148; AAPC 514, 1729) in 2020. Most missed diagnoses were in males (ARIMA 1361 [327, 2394]; AAPC 1401 [1353, 1460]), with an estimated 479-557 missed cases of colorectal cancer (ARIMA 112, 837; AAPC 518, 597) and 256-352 missed cases of prostate cancer (AAPC 231, 280; ARIMA 110, 594). CONCLUSION The incidence of new cancer diagnoses declined in 2020 contrary to the long-term increase over the previous decades. Significantly lower diagnoses than expected were observed in males, particularly for colorectal and prostate cancers. Fewer reported cancer cases indicate missed diagnoses and could lead to delayed treatment that could impact future health outcomes.
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Affiliation(s)
- H M Youn
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Y Zhang
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - A Liu
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - C S Ng
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - J Liang
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - G K K Lau
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - S F Lee
- Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - J Lok
- Department of Pathology, United Christian Hospital, Hong Kong SAR, China
| | - C L K Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - E Y F Wan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China
| | - J Quan
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; HKU Business School, University of Hong Kong, Hong Kong SAR, China.
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Wei X, Yu S, Wang J, Xiang Z, Liu L, Min Y. Association between time from diagnosis to treatment and survival of patients with nasopharyngeal carcinoma: A population-based cohort study. Curr Probl Cancer 2024; 48:101060. [PMID: 38211418 DOI: 10.1016/j.currproblcancer.2024.101060] [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: 05/05/2023] [Revised: 12/06/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Treatment delays have frequently been observed in cancer patients. Whether the treatment delays would impair the survival of patients with nasopharyngeal carcinoma (NPC) is still unclear. METHODS The data were derived from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. Patients were divided into groups of timely treatment (<1 month), intermediate delay (1 and 2 months), and long delay (3-6 months). The influence of different treatment delay intervals on long-term survival was evaluated by multivariate Cox regression analysis. RESULTS In total, 2,048 patients with NPC were included in our study. There were 551 patients in the early stage (I, II stage: 26.9 %) and 1,497 patients in the advanced stage (III, IV stage: 73.1 %). No significant difference in overall survival (OS) or cancer-specific survival (CSS) was observed among the groups with various treatment delay intervals (p = 0.48 in OS and p = 0.43 in CSS, respectively). However, upon adjusting for covariates, a significantly improved OS probability emerged in patients with intermediate treatment delays compared to those who received timely interventions in both the entire study population (adjustedHazard Ratio (aHR)=0.86, 95 % CI: 0.74-0.99, p = 0.043) and the subgroup with advanced stage (aHR=0.85, 95 % CI: 0.72-1.00, p = 0.049). Regarding the CSS probability, similar associations were also observed in the entire study population (aHR=0.84, 95 % CI: 0.71-0.98, p = 0.030) as well as the advanced-stage patients (aHR=0.83, 95 % CI: 0.70-0.99, p = 0.038). CONCLUSIONS Our results revealed that treatment delays are not associated with worse survival of NPC patients. Tumor-specific characteristics and subsequent treatment modalities play more pivotal roles in the prognosis of NPC.
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Affiliation(s)
- Xiaoyuan Wei
- Department of Head and Neck Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Siting Yu
- Department of Head and Neck Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Jun Wang
- Department of Head and Neck Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Zhongzheng Xiang
- Department of Head and Neck Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Lei Liu
- Department of Head and Neck Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China.
| | - Yu Min
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, PR China
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Resende BDS, Dias RM, Ferrari G, Rezende LFM. Excess mortality in adults from Sao Paulo during the COVID-19 pandemic in 2020: analyses of all-cause and noncommunicable diseases mortality. Sci Rep 2023; 13:23006. [PMID: 38155297 PMCID: PMC10754941 DOI: 10.1038/s41598-023-50388-7] [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: 10/10/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
In this study, we estimated the excess mortality from all-causes of death and noncommunicable diseases (NCDs) in adults living in the state of São Paulo during the COVID-19 pandemic in 2020. Number of deaths were retrieved from the Mortality Information System before (2017-2019) and during (2020) the COVID-19 pandemic, considering the following underlying causes of death: Neoplasms; Diabetes Mellitus; Circulatory System Diseases, and Respiratory System Diseases. Standardized Mortality Ratio (SMR) were calculated by dividing the mortality rates in 2020 by average mortality rates in 2017-2019, according to sex, age group, geographic location (state, capital, and Regional Health Departments). In 2020, occurred 341,704 deaths in the state of São Paulo vs 290,679 deaths in 2017-2019, representing an 18% increase in all-cause mortality (SMR 1.18) or 51,025 excess deaths during the first year of COVID-19 pandemic. The excess mortality was higher in men (186,741 deaths in 2020 vs 156,371 deaths in 2017-2019; SMR 1.18; 30,370 excess deaths) compared to women (154,963 deaths in 2020 vs 134,308 deaths in 2017-2019; SMR 1.15; 20,655 excess deaths). Regarding NCDs mortality, we observed a reduction in cancer mortality (SMR 0.98; -1,354 deaths), diseases of the circulatory system (SMR 0.95; -4,277 deaths), and respiratory system (SMR 0.88; -1,945). We found a 26% increase in Diabetes Mellitus mortality (SMR 1.26; 2885 deaths) during the pandemic year. Our findings corroborate the need to create and strengthen policies aimed at the prevention and control of NCDs, in order to mitigate the impact of future infectious disease pandemics.
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Affiliation(s)
- Bruna de Souza Resende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Rayara Mozer Dias
- Department of Epidemiology, Instituto de Medicina Social Hesio Cordeiro, Universidade Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de La Actividad Física, El Deporte y La Salud, Santiago, Chile
| | - Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil.
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile.
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12
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Molinier O, Guguen C, Marcq M, Chene AL, Masson P, Bigot F, Denis F, Empereur F, Saulnier P, Urban T. A Comparative Multicenter Cohort Study Evaluating the Long-Term Influence of the Strict Lockdown during the First COVID-19 Wave on Lung Cancer Patients (ARTEMISIA Trial). Cancers (Basel) 2023; 15:5729. [PMID: 38136275 PMCID: PMC10742265 DOI: 10.3390/cancers15245729] [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: 11/09/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
The consequences of the strict health restrictions during the first wave of COVID-19 on lung cancer (LC) patients are not known. This cohort study evaluated the impact of the initial lockdown on management of and long-term outcome in LC patients. This exposed-unexposed-type study included two evaluation periods of 6 months each in non-selected patients; one began on the first day of lockdown in 2020, and the other in 2019 during the same calendar period. Various indicators were compared: clinical profiles, management delays and overall survival beyond 2 years. A total of 816 patients from 7 public or private centers were enrolled. The clinical characteristics of the patients in 2020 did not differ from those in 2019, except that the population was older (p = 0.002) with more non-smokers (p = 0.006). Delays for pre-therapeutic medical management were generally reduced after the first imaging in 2020 (1.28 [1.1-1.49]). In the multivariate analysis, being part of the 2020 cohort was correlated with better prognosis (HR = 0.71 [0.5-0.84], p < 0.001). The gain observed in 2020 mainly benefited non-smoking patients, along with ECOG PS 0-2 (p = 0.01), stage 4 (p = 0.003), squamous cell carcinoma (p = 0.03) and receiving systemic therapy (p = 0.03). In conclusion, the first lockdown did not exert any deleterious impact on LC patients.
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Affiliation(s)
- Olivier Molinier
- Respiratory Medicine Department, Hospital Center, 194 Avenue Rubillard, CEDEX 9, 72037 Le Mans, France
| | - Camille Guguen
- Respiratory Medicine Department, Hospital Center, 194 Avenue Rubillard, CEDEX 9, 72037 Le Mans, France
| | - Marie Marcq
- Respiratory Medicine Department, Hospital Center, 85925 La Roche-sur-Yon, France
| | - Anne-Laure Chene
- Respiratory Medicine Department, Thorax Institute, University Hospital Center, University of Nantes, 44093 Nantes, France
| | - Philippe Masson
- Respiratory Medicine Department, Hospital Center, 49300 Cholet, France
| | - Frédéric Bigot
- Oncology Department, Western Cancer Institute Paul Papin, 49105 Angers, France;
| | - Fabrice Denis
- Oncology Department, Clinique Victor Hugo, 72000 Le Mans, France;
| | | | - Philippe Saulnier
- Biostatistics Department, National Institute of Health and Medical Research, University of Angers, 49100 Angers, France
| | - Thierry Urban
- Respiratory Medicine Department, University Hospital Center, 49100 Angers, France;
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13
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Mostafavi Zadeh SM, Tajik F, Gheytanchi E, Kiani J, Ghods R, Madjd Z. COVID-19 pandemic impact on screening and diagnosis of prostate cancer: a systematic review. BMJ Support Palliat Care 2023:spcare-2023-004310. [PMID: 37748857 DOI: 10.1136/spcare-2023-004310] [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: 04/04/2023] [Accepted: 09/06/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The healthcare level has been greatly affected by the COVID-19 pandemic compared with before the outbreak. This study aimed to review the impact of COVID-19 on the screening and diagnosis of prostate cancer (PCa). METHOD The current study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. The keywords used to perform the search strategy were COVID-19 and prostate neoplasms. The four primary electronic databases comprising PubMed/MEDLINE, Web of Science, Scopus and Embase were searched until 1 September 2022. After screening and selecting studies through the EndNote software, data were extracted from each included study by two independent authors. All studies were evaluated according to Newcastle-Ottawa Scale quality assessment tool. RESULTS As a result, 40 studies were included, categorised into two subjects. The majority of studies indicated a significant decrease in screening prostate-specific antibody tests during the COVID-19 pandemic compared with the pre-pandemic period, leading to delays in cancer diagnosis. The decrease in the number of diagnosed cases with low/intermediate stages to some extent was more than those with advanced stages. The PCa screening and diagnosis reduction ranged from nearly 0% to 78% and from 4.1% to 71.7%, respectively. CONCLUSION Our findings showed that during the COVID-19 lockdown, delays in PCa screening tests and diagnoses led to the negative health effects on patients with PCa. Thus, it is highly recommended performing regular cancer screening to reduce the impact of the COVID-19 lockdown. PROSPERO REGISTRATION NUMBER CRD42021291656.
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Affiliation(s)
- Seyed Mostafa Mostafavi Zadeh
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Tajik
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Elmira Gheytanchi
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Kiani
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Ghods
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Madjd
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Iran University of Medical Sciences, Tehran, Iran
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14
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Bogaert B, Kozlakidis Z, Caboux E, Péron J, Saintingy P. What went right during the COVID crisis: The capabilities of local actors and lasting innovations in oncology care and research. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002366. [PMID: 37747872 PMCID: PMC10519589 DOI: 10.1371/journal.pgph.0002366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/16/2023] [Indexed: 09/27/2023]
Abstract
This article will elaborate how oncology care and research was adapted during the COVID pandemic in the Metropole of Lyon (France), including the lasting innovations that came out of the crisis. The research method involved 22 semi-structured qualitative interviews of healthcare professionals, managers, and researchers in the Lyon, France region coming from both public and private academic hospitals. The interviews took place from February 2021-December 2022 in order to assess the long-term adaptations and innovations in cancer care organization in the post-COVID era. The main results show adaptations and innovations in 1) new processes and resources to facilitate disciplinary and interdisciplinary work; 2) harmonization and streamlining of patient journeys. In the discussion section, we will mobilize the capabilities approach, an interdisciplinary social sciences approach that focuses on the capabilities of persons to be and to do, to elaborate the conditions by which local actors were able to be agile, to adapt and to innovate in spite of the healthcare emergency and in coherence with their professional and personal values.
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Affiliation(s)
- Brenda Bogaert
- Department of Social Sciences and Humanities, Centre Léon Bérard, Lyon, France and Institut des Humanités en Médecine, UNIL/CHUV, Lausanne, Switzerland
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elodie Caboux
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Julien Péron
- Department of Medical Oncology and Research Center on Healthcare Performance (RESHAPE) INSERM U1290, Hospices Civils de Lyon, Pierre-Benite, France
| | - Pierre Saintingy
- Department of Medical Oncology, Centre Léon Bérard and Claude Bernard Lyon 1 University, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon, Lyon, France
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15
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Davis KL, Ackermann N, Klesges LM, Leahy N, Walsh-Bailey C, Humble S, Drake B, Sanders Thompson VL. Understanding disruptions in cancer care to reduce increased cancer burden. eLife 2023; 12:e85024. [PMID: 37643471 PMCID: PMC10449381 DOI: 10.7554/elife.85024] [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: 11/18/2022] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
Background This study seeks to understand how and for whom COVID-19 disrupted cancer care to understand the potential for cancer health disparities across the cancer prevention and control continuum. Methods In this cross-sectional study, participants age 30+residing in an 82-county region in Missouri and Illinois completed an online survey from June-August 2020. Descriptive statistics were calculated for all variables separately and by care disruption status. Logistic regression modeling was conducted to determine the correlates of care disruption. Results Participants (N=680) reported 21% to 57% of cancer screening or treatment appointments were canceled/postponed from March 2020 through the end of 2020. Approximately 34% of residents stated they would need to know if their doctor's office is taking the appropriate COVID-related safety precautions to return to care. Higher education (OR = 1.26, 95% CI:1.11-1.43), identifying as female (OR = 1.60, 95% CI:1.12-2.30), experiencing more discrimination in healthcare settings (OR = 1.40, 95% CI:1.13-1.72), and having scheduled a telehealth appointment (OR = 1.51, 95% CI:1.07-2.15) were associated with higher odds of care disruption. Factors associated with care disruption were not consistent across races. Higher odds of care disruption for White residents were associated with higher education, female identity, older age, and having scheduled a telehealth appointment, while higher odds of care disruption for Black residents were associated only with higher education. Conclusions This study provides an understanding of the factors associated with cancer care disruption and what patients need to return to care. Results may inform outreach and engagement strategies to reduce delayed cancer screenings and encourage returning to cancer care. Funding This study was supported by the National Cancer Institute's Administrative Supplements for P30 Cancer Center Support Grants (P30CA091842-18S2 and P30CA091842-19S4). Kia L. Davis, Lisa Klesges, Sarah Humble, and Bettina Drake were supported by the National Cancer Institute's P50CA244431 and Kia L. Davis was also supported by the Breast Cancer Research Foundation. Callie Walsh-Bailey was supported by NIMHD T37 MD014218. The content does not necessarily represent the official view of these funding agencies and is solely the responsibility of the authors.
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Affiliation(s)
- Kia L Davis
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | - Nicole Ackermann
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | - Lisa M Klesges
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | - Nora Leahy
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | | | - Sarah Humble
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
| | - Bettina Drake
- Department of Surgery, Public Health Sciences, School of Medicine, Washington University in St. LouisSt LouisUnited States
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16
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Seo SH, Cho S, Yoo SH, Keam B, Shin A. Changes in the Utilization of Health Care Services by Cancer Patients during the COVID-19 Pandemic. Yonsei Med J 2023; 64:463-470. [PMID: 37365741 DOI: 10.3349/ymj.2023.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE The first year of the COVID-19 pandemic in Korea elicited changes in healthcare service utilization. This study aimed to report changes in healthcare service utilization among cancer patients during the first year of the COVID-19 pandemic in Korea. MATERIALS AND METHODS We analyzed records from National Health Insurance Service Database and identified cancer patients as those with specific beneficiary codes ("V193" or "V194") assigned to cancer patients. We calculated percentage changes in the number of patients between 2019 and 2020 based on claims records for outpatient clinic visits, hospitalization, and emergency room visits by month, age group, residential areas, and hospital location. RESULTS The number of newly diagnosed cancer patients in 2020 decreased by 3.2%, compared to the previous year. The number of patients who visited an outpatient clinic, were hospitalized, and visited the emergency room decreased by 2.6%, 4.0%, and 3.5%, respectively, in 2020, compared to the year 2019. CONCLUSION During the first year of the COVID-19 pandemic, the number of newly diagnosed cancer patients decreased by 3.2%, compared to the previous year, and their utilization of healthcare services declined significantly after the outbreak of COVID-19.
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Affiliation(s)
- Seung Hee Seo
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
| | - Sooyoung Cho
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Medical Research Center, Genomic Medicine Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Shin Hye Yoo
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Korea
| | - Bhumsuk Keam
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Aesun Shin
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
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17
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Poh SS, Tan BF, Yong FY, Fong KW, Wee JTS, Tan TWK, Chua MLK, Sommat K, Wang FQ, Soong YL. The impact of the COVID-19 pandemic on nasopharyngeal carcinoma patients - a national cancer centre experience. HOLISTIC INTEGRATIVE ONCOLOGY 2023; 2:17. [PMID: 37520028 PMCID: PMC10244848 DOI: 10.1007/s44178-023-00041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/30/2023] [Indexed: 08/01/2023]
Abstract
Purpose or objective The COVID-19 pandemic has resulted in significant healthcare implications, with care for cancer patients compromised due to resource diversion towards battling the pandemic. We aim to investigate the impact of the peak wave of the pandemic in 2020 on the delivery of cancer care in Singapore, specifically via our nasopharyngeal carcinoma (NPC) treatment data. This study applies real world numbers to the impact of COVID-19 on cancer care delivery in Singapore. The choice of nasopharyngeal cancer allows a good direct estimate of common treatment measures such as time to biopsy, time to staging scans, time to treatment commencement, due to its clear protocol and algorithms for staging and treatment; thus serving as an excellent surrogate for the effectiveness and timeliness of the different aspects of cancer care delivery. Materials and methods In this retrospective study, we included all patients with newly diagnosed NPC from 1st January to 31st May from 2017 to 2020 at our centre. This time period was chosen as it coincided with the period in 2020 during the COVID-19 pandemic where there was the most strain on healthcare resources and the most restrictions on population movement within Singapore, which may impact on healthcare seeking behaviour. Narrowing down the time period to the first 5 months of the 4 respective years also allowed us to reduce the effect of annual seasonal variation in patient numbers seen as a result of holidays and festive periods such as the Lunar New Year and scheduled school holidays. Electronic medical records (EMR) were accessed. Only newly diagnosed NPC cases were included in our analysis. Patients with second synchronous primary malignancies or NPC disease recurrence were excluded. Data analysis was carried out using a combination of SPSS and Microsoft Excel. Results Significantly, there was a reduction of 37-46.3% in newly diagnosed NPC cases during the peak of the COVID-19 pandemic from January to end May 2020 compared to the preceding three years. Despite the reduction in numbers of newly diagnosed NPC, there was no statistically significant differences in delay from biopsy to the first radiation oncology visit and from biopsy to the first day of treatment in 2020 compared to the preceding years. All the patients treated in our centre also received the standard NPC treatment for their disease stage as per international guidelines. Conclusion We recommend a heightened awareness of the dangers of delaying cancer presentation and care in healthcare policies and resource allocation and at the same time, encourage patient's confidence in their ability to seek care. With the resurgence of new COVID-19 variants and case numbers worldwide and in Singapore, this study focuses upon the need to be aware of the exigencies of other clinical groups in resource utilization. It would be instructive to compare this study with future long term follow up to investigate the trajectory of our cancer care delivery, as well as survival outcomes.
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Affiliation(s)
- Sharon S. Poh
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Oncology Academic Clinical Programme, Singapore, Singapore
| | - Boon Fei Tan
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
| | - Fang Yue Yong
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
| | - Kam Weng Fong
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Oncology Academic Clinical Programme, Singapore, Singapore
| | - Joseph T. S. Wee
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Oncology Academic Clinical Programme, Singapore, Singapore
| | - Terence W. K. Tan
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Oncology Academic Clinical Programme, Singapore, Singapore
| | - Melvin L. K. Chua
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Oncology Academic Clinical Programme, Singapore, Singapore
| | - Kiattisa Sommat
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Oncology Academic Clinical Programme, Singapore, Singapore
| | - Fu Qiang Wang
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Oncology Academic Clinical Programme, Singapore, Singapore
| | - Yoke Lim Soong
- Division of Radiation Oncology, Duke-NUS Graduate Medical School, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Oncology Academic Clinical Programme, Singapore, Singapore
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18
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Fu R, Sutradhar R, Li Q, Kamalraj P, Dare A, Hanna TP, Chan KKW, Irish JC, Coburn N, Hallet J, Singh S, Parmar A, Earle CC, Lapointe-Shaw L, Krzyzanowska MK, Louie AV, Mahar A, Urbach DR, McIsaac DI, Enepekides D, Gomez D, Look Hong NJ, Tinmouth J, Eskander A. Early survival for patients newly diagnosed with cancer during COVID-19 in Ontario, Canada: A population-based cohort study. Cancer Med 2023. [PMID: 36999960 DOI: 10.1002/cam4.5861] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/15/2023] [Accepted: 03/16/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Little is known about the association between the COVID-19 pandemic and early survival among newly diagnosed cancer patients. METHODS This retrospective population-based cohort study used linked administrative datasets from Ontario, Canada. Adults (≥18 years) who received a cancer diagnosis between March 15 and December 31, 2020, were included in a pandemic cohort, while those diagnosed during the same dates in 2018/2019 were included in a pre-pandemic cohort. All patients were followed for one full year after the date of diagnosis. Cox proportional hazards regression models were used to assess survival in relation to the pandemic, patient characteristics at diagnosis, and the modality of first cancer treatment as a time-varying covariate. Interaction terms were explored to measure the pandemic association with survival for each cancer type. RESULTS Among 179,746 patients, 53,387 (29.7%) were in the pandemic cohort and 37,741 (21.0%) died over the first post-diagnosis year. No association between the pandemic and survival was found when adjusting for patient characteristics at diagnosis (HR 0.99 [95% CI 0.96-1.01]), while marginally better survival was found for the pandemic cohort when the modality of treatment was additionally considered (HR 0.97 [95% CI 0.95-0.99]). When examining each cancer type, only a new melanoma diagnosis was associated with a worse survival in the pandemic cohort (HR 1.25 [95% CI 1.05-1.49]). CONCLUSIONS Among patients able to receive a cancer diagnosis during the pandemic, one-year overall survival was not different than those diagnosed in the previous 2 years. This study highlights the complex nature of the COVID-19 pandemic impact on cancer care.
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Affiliation(s)
- Rui Fu
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Qing Li
- ICES, Toronto, Ontario, Canada
| | - Pabiththa Kamalraj
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Anna Dare
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Timothy P Hanna
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
- Ontario Institute for Cancer Research (OICR), Toronto, Ontario, Canada
| | - Kelvin K W Chan
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Ontario Health-Cancer Care Ontario, Toronto, Ontario, Canada
| | - Jonathan C Irish
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Natalie Coburn
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Hallet
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Ontario Institute for Cancer Research (OICR), Toronto, Ontario, Canada
| | - Simron Singh
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ambica Parmar
- ICES, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Craig C Earle
- ICES, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Lapointe-Shaw
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Monika K Krzyzanowska
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alexander V Louie
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Alyson Mahar
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - David R Urbach
- ICES, Toronto, Ontario, Canada
- Department of Surgery, Women's College Hospital, Toronto, Ontario, Canada
| | - Daniel I McIsaac
- ICES, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Danny Enepekides
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - David Gomez
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of General Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Nicole J Look Hong
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jill Tinmouth
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Ontario Health-Cancer Care Ontario, Toronto, Ontario, Canada
| | - Antoine Eskander
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
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19
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Ramírez-Soto MC, Salazar-Peña M, Vargas-Herrera J. Estimating Excess Mortality Due to Prostate, Breast, and Uterus Cancer during the COVID-19 Pandemic in Peru: A Time Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5156. [PMID: 36982065 PMCID: PMC10049374 DOI: 10.3390/ijerph20065156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
During the COVID-19 pandemic, most of the deaths in Peru were related to COVID-19; however, cancer deaths have also been exacerbated in the first months of the pandemic. Despite this, excess mortalities of prostate, breast, and uterus cancer are not available by age group and region from January to December 2020. Therefore, we estimated the excess deaths and excess death rates (per 100,000 habitants) due to prostate, breast, and uterus cancer in 25 Peruvian regions. We did a time series analysis. Prostate, breast, and uterus cancer death data for 25 Peruvian regions were retrieved during the COVID-19 pandemic in 2020, as well as data for up to 3 years prior (2017-2019) from the Sistema Informatico Nacional de Defunciones at the Ministry of Health of Peru. Deaths in 2020 were defined as observed deaths. The expected deaths (in 2020) were estimated using the average deaths over 3 preceding years (2017, 2018 and 2019). Excess mortality was calculated as the difference between observed mortality and expected mortality in 2020. We estimated that the number of excess deaths and the excess death rates due to prostate, breast, and uterus cancer were 610 deaths (55%; 12.8 deaths per 100,000 men), 443 deaths (43%; 6 deaths per 100,000 women), and 154 deaths (25%; 2 deaths per 100,000 women), respectively. Excess numbers of deaths and excess death rates due to prostate and breast cancer increased with age. These excess deaths were higher in men aged ≥ 80 years (596 deaths (64%) and 150 deaths per 100,000 men) and women aged 70-79 years (229 deaths (58%) and 15 deaths per 100,000 women), respectively. In summary, during the COVID-19 pandemic, there were excess prostate and breast cancer mortalities in 2020 in Peru, while excess uterus cancer mortalities were low. Age-stratified excess death rates for prostate cancer and breast cancer were higher in men ≥ 80 years and in women ≥ 70 years, respectively.
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Affiliation(s)
| | | | - Javier Vargas-Herrera
- Unidad de Telemedicina, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima 15001, Peru;
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20
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Mangone L, Marinelli F, Bonfante G, Bisceglia I, Morabito F, Masini C, Bergamaschi FAM, Pinto C. The Impact of COVID-19 on New Kidney Cancer Diagnosis: Stage and Treatment in Northern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4755. [PMID: 36981664 PMCID: PMC10048571 DOI: 10.3390/ijerph20064755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
This study aims to evaluate the impact of COVID-19 on new renal carcinoma (RC) diagnoses using data from the Reggio Emilia Cancer Registry in 2018-2020. A total of 293 RCs were registered, with roughly 100 cases yearly. The distribution by age shows a significant decrease in the 30-59 age group (33.7% in 2018, 24.8% in 2019, and 19.8% in 2020). The incidence of Stage I was 59.4%, 46.5%, and 58.2% in 2018, 2019, and 2020, respectively, whereas the Stage II rate had values of 6.9%, 7.9%, and 2.2% in the years 2018, 2019, and 2020, respectively. Slight non-significant variations were observed in Stages III and IV. Surgery was performed in 83.2% of cases in 2018, 78.2% in 2019, and 82.4% in 2020; the surgery distribution by stage showed no significant differences. Chemotherapy showed an increase in 2020, which was statistically significant only for Stage IV. The gender incidence trends over the last 25 years showed an increase in the male sex in the first period; then, a decline was documented, likely due to a decrease in cigarette consumption. In females, the trend was constant. The RC mortality trend significantly dropped in both genders over the entire study period.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Francesco Marinelli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Giulia Bonfante
- Unit of Urology, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | | | - Cristina Masini
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | | | - Carmine Pinto
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
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21
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Nguyen NP, Karlsson UL, Lehrman D, Mazibuko T, Saghatelyan T, Thariat J, Baumert BG, Vinh-Hung V, Gorobets O, Giap H, Singh S, Chi A, Alessandrini G, Ahluwalia A, Durosinmi-Etti F, Zegarra Cárdenas J, Diabate K, Oboite J, Oboite E, Mehmood T, Vuong T, Kim L, Page BR. Impact of COVID-19 pandemic on older cancer patients: Proposed solution by the International Geriatric Radiotherapy Group. Front Oncol 2023; 13:1091329. [PMID: 36959795 PMCID: PMC10027708 DOI: 10.3389/fonc.2023.1091329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/18/2023] [Indexed: 03/09/2023] Open
Abstract
Older cancer patients are disproportionally affected by the Coronavirus 19 (COVID-19) pandemic. A higher rate of death among the elderly and the potential for long-term disability have led to fear of contracting the virus in these patients. This fear can, paradoxically, cause delay in diagnosis and treatment that may lead to a poor outcome that could have been prevented. Thus, physicians should devise a policy that both supports the needs of older patients during cancer treatment, and serves to help them overcome their fear so they seek out to cancer diagnosis and treatment early. A combination of telemedicine and a holistic approach, involving prayers for older cancer patients with a high level of spirituality, may improve vaccination rates as well as quality of life during treatment. Collaboration between health care workers, social workers, faith-based leaders, and cancer survivors may be crucial to achieve this goal. Social media may be an important component, providing a means of sending the positive message to older cancer patients that chronological age is not an impediment to treatment.
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Affiliation(s)
- Nam Phong Nguyen
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Ulf Lennart Karlsson
- Department of Radiation Oncology, International Geriatric Radiotherapy Group, Washington, DC, United States
| | - David Lehrman
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Thandeka Mazibuko
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Tatul Saghatelyan
- Department of Radiation Oncology, National Center of Oncology, Yerevan, Armenia
| | - Juliette Thariat
- Department of Radiation Oncology, Francois Baclesse Cancer Center, Cain, France
| | - Brigitta G. Baumert
- Institute of Radiation Oncology, Cantonal Hospital Graubuenden, Chur, Switzerland
| | - Vincent Vinh-Hung
- Department of Radiation Oncology, Centre Hospitalier de La Polynesie Francaise, Tahiti, French Polynesia
| | - Olena Gorobets
- Department of Oral Surgery, Centre Hospitalier Universitaire de Martinique, Martinique, France
| | - Huan Giap
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, United States
| | - Sankalp Singh
- Department of Radiation Oncology, Army Hospital (Research & Referral), New Delhi, India
| | - Alexander Chi
- Department of Radiation Oncology, Beijing Chest Hospital, Beijing, China
| | | | - Abhinav Ahluwalia
- Department of Radiation Oncology, Advanced Care Oncology Center, Dubai, United Arab Emirates
| | | | - Jorge Zegarra Cárdenas
- Division of Medical Oncology, Regional Institute of Neoplastic Disease, Concepcion, Peru
| | | | - Joan Oboite
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Eromosele Oboite
- Department of Radiation Oncology, Howard University, Washington, DC, United States
| | - Tahir Mehmood
- Department of Radiation Oncology, Northampton General Hospital, Northampton, United Kingdom
| | - Te Vuong
- Department of Radiation Oncology, McGill University, Montreal, QC, Canada
| | - Lyndon Kim
- Division of Neuro-Oncology, Mount Sinai Hospital, New York, NY, United States
| | - Brandi R. Page
- Department of Radiation Oncology, Johns Hopkins University, Baltimore, MD, United States
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22
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van Doren TP, Brown RA. Consequences of delayed care during the COVID-19 pandemic: Emerging research and new lines of inquiry for human biologists and anthropologists. Am J Hum Biol 2023:e23886. [PMID: 36862016 DOI: 10.1002/ajhb.23886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE Research regarding ongoing epidemic or pandemic events is often proximate, focusing on the immediate need to understand the epidemiology of the outbreak and the populations at highest risk for negative outcomes. There are other characteristics of pandemics that can only be uncovered after time has passed, and some long-lasting health consequences may not be directly linked to infection with or disease from the pandemic pathogen itself. METHODS We discuss the emerging literature on observations delayed care during the COVID-19 pandemic and the potential population health consequences of this phenomenon in postpandemic years, especially for conditions such as cardiovascular disease, cancer, and reproductive health. RESULTS Delayed care has occurred for various conditions since the beginning of the COVID-19 pandemic, but the drivers for those delays have yet to be thoroughly investigated. While delayed care can be either voluntary or involuntary, the determinants of delayed care often intersect with systemic inequalities that are important to understand for pandemic responses and future preparedness. CONCLUSION Human biologists and anthropologists are well poised to lead the research on postpandemic population health consequences of delayed care.
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23
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Peyret R, Pozin N, Sockeel S, Kammerer-Jacquet SF, Adam J, Bocciarelli C, Ditchi Y, Bontoux C, Depoilly T, Guichard L, Lanteri E, Sockeel M, Prévot S. Multicenter automatic detection of invasive carcinoma on breast whole slide images. PLOS DIGITAL HEALTH 2023; 2:e0000091. [PMID: 36854026 PMCID: PMC9974110 DOI: 10.1371/journal.pdig.0000091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/12/2022] [Indexed: 03/02/2023]
Abstract
Breast cancer is one of the most prevalent cancers worldwide and pathologists are closely involved in establishing a diagnosis. Tools to assist in making a diagnosis are required to manage the increasing workload. In this context, artificial intelligence (AI) and deep-learning based tools may be used in daily pathology practice. However, it is challenging to develop fast and reliable algorithms that can be trusted by practitioners, whatever the medical center. We describe a patch-based algorithm that incorporates a convolutional neural network to detect and locate invasive carcinoma on breast whole-slide images. The network was trained on a dataset extracted from a reference acquisition center. We then performed a calibration step based on transfer learning to maintain the performance when translating on a new target acquisition center by using a limited amount of additional training data. Performance was evaluated using classical binary measures (accuracy, recall, precision) for both centers (referred to as "test reference dataset" and "test target dataset") and at two levels: patch and slide level. At patch level, accuracy, recall, and precision of the model on the reference and target test sets were 92.1% and 96.3%, 95% and 87.8%, and 73.9% and 70.6%, respectively. At slide level, accuracy, recall, and precision were 97.6% and 92.0%, 90.9% and 100%, and 100% and 70.8% for test sets 1 and 2, respectively. The high performance of the algorithm at both centers shows that the calibration process is efficient. This is performed using limited training data from the new target acquisition center and requires that the model is trained beforehand on a large database from a reference center. This methodology allows the implementation of AI diagnostic tools to help in routine pathology practice.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Sophie Prévot
- Bicêtre hospital, APHP, Paris Saclay University, France
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24
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Mangone L, Marinelli F, Bisceglia I, Filice A, De Leonibus L, Rapicetta C, Paci M. The Influence of COVID-19 on New Lung Cancer Diagnoses, by Stage and Treatment, in Northern Italy. BIOLOGY 2023; 12:biology12030390. [PMID: 36979081 PMCID: PMC10045495 DOI: 10.3390/biology12030390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
The COVID-19 pandemic has had a significant impact on new cancer diagnoses. This study aims to evaluate the implications of the lockdown period on new lung cancer diagnoses in northern Italy. We compared 2020 with 2019 cancer registry data, reporting the variations by age, stage, and treatments. In 2020, 303 lung cancer cases were registered, 21 fewer than in 2019. Cases fell in men (−31 patients, 9.6%) but not in women (+10 patients, +3.1%). A significant drop in stage I from 19.8% to 12.9% (p < 0.05) and an increase in stage III (12.7% vs. 19.1%; p < 0.05) was observed. Histological confirmation dropped (70.1% vs. 60.1%; p < 0.05) while cytology increased (12% vs. 20.8%; p < 0.01). Surgery declined (28.7% vs. 21.5%; p < 0.05) but increased in stage III (19.5% vs. 25.9%; p = 0.46), while chemotherapy increased (17.6% vs. 34.3%; p < 0.01) for all stages. During the pandemic, new lung cancer diagnoses dropped only in men. The reorganization of health services has ensured a decrease in surgical interventions (due to the unavailability of operating rooms) counterbalanced by an increase in chemotherapy.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
- Correspondence:
| | - Francesco Marinelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Angelina Filice
- Nuclear Medicine Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Lisa De Leonibus
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Cristian Rapicetta
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Massimiliano Paci
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
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25
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van Vliet ED, Eijkelboom AH, van Giessen A, Siesling S, de Wit GA. Physical and mental health outcomes of COVID-19 induced delay in oncological care: A systematic review. Front Oncol 2023; 13:998940. [PMID: 36776332 PMCID: PMC9911660 DOI: 10.3389/fonc.2023.998940] [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: 07/20/2022] [Accepted: 01/16/2023] [Indexed: 01/29/2023] Open
Abstract
Background During the COVID-19 pandemic cancer patients might have experienced delays in screening, diagnosis and/or treatment. A systematic review was conducted to give an overview of the effects of COVID-19 induced delays in oncological care on the physical and mental health outcomes of cancer patients. Methods MEDLINE and EMBASE databases were searched for articles on the effects of COVID-19 induced delays on physical and mental health outcomes. Results Out of 1333 papers, eighteen observational, and twelve modelling studies were included. In approximately half of the studies, tumor stage distribution differed during the pandemic compared to before the pandemic. Modelling studies predicted that the estimated increase in the number of deaths ranged from -0.04 to 30%, and the estimated reduction in survival ranged from 0.4 to 35%. Varying results on the impact on mental health, e.g. anxiety and depression, were seen. Conclusions Due to large methodological discrepancies between the studies and the varying results, the effect of COVID-19 induced delays on the physical and mental health outcomes of cancer patients remains uncertain. While modelling studies estimated an increase in mortality, observational studies suggest that mortality might not increase to a large extent. More longitudinal observational data from the pandemic period is needed for more conclusive results.
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Affiliation(s)
- Ella D. van Vliet
- Center for Health Protection, National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands,*Correspondence: Ella D. van Vliet,
| | - Anouk H. Eijkelboom
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands,Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Anoukh van Giessen
- Center for Nutrition, Prevention and Healthcare, National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands,Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - G. Ardine de Wit
- Center for Nutrition, Prevention and Healthcare, National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands,Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam & Amsterdam Health Research Institute, Amsterdam, Netherlands
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26
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Li T, Nickel B, Ngo P, McFadden K, Brennan M, Marinovich ML, Houssami N. A systematic review of the impact of the COVID-19 pandemic on breast cancer screening and diagnosis. Breast 2023; 67:78-88. [PMID: 36646004 PMCID: PMC9813855 DOI: 10.1016/j.breast.2023.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Breast cancer care has been affected by the COVID-19 pandemic. This systematic review aims to describe the observed pandemic-related changes in clinical and health services outcomes for breast screening and diagnosis. METHODS Seven databases (January 2020-March 2021) were searched to identify studies of breast cancer screening or diagnosis that reported observed outcomes before and related to the pandemic. Findings were presented using a descriptive and narrative approach. RESULTS Seventy-four studies were included in this systematic review; all compared periods before and after (or fluctuations during) the pandemic. None were assessed as being at low risk of bias. A reduction in screening volumes during the pandemic was found with over half of studies reporting reductions of ≥49%. A majority (66%) of studies reported reductions of ≥25% in the number of breast cancer diagnoses, and there was a higher proportion of symptomatic than screen-detected cancers. The distribution of cancer stage at diagnosis during the pandemic showed lower proportions of early-stage (stage 0-1/I-II, or Tis and T1) and higher proportions of relatively more advanced cases than that in the pre-pandemic period, however population rates were generally not reported. CONCLUSIONS Evidence of substantial reductions in screening volume and number of diagnosed breast cancers, and higher proportions of advanced stage cancer at diagnosis were found during the pandemic. However, these findings reflect short term outcomes, and higher-quality research examining the long-term impact of the pandemic is needed.
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Affiliation(s)
- Tong Li
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Brooke Nickel
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Preston Ngo
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Kathleen McFadden
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Meagan Brennan
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
| | - M Luke Marinovich
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nehmat Houssami
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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27
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Giorgi Rossi P, Carrozzi G, Falini P, Sampaolo L, Gorini G, Zorzi M, Armaroli P, Senore C, Sassoli de Bianchi P, Masocco M, Zappa M, Battisti F, Mantellini P. The impact of the COVID-19 pandemic on Italian population-based cancer screening activities and test coverage: Results from national cross-sectional repeated surveys in 2020. eLife 2023; 12:81804. [PMID: 36734526 PMCID: PMC9934859 DOI: 10.7554/elife.81804] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Background In Italy, regions have the mandate to implement population-based screening programs for breast, cervical, and colorectal cancer. From March to May 2020, a severe lockdown was imposed due to the COVID-19 pandemic by the Italian Ministry of Health, with the suspension of screening programs. This paper describes the impact of the pandemic on Italian screening activities and test coverage in 2020 overall and by socioeconomic characteristics. Methods The regional number of subjects invited and of screening tests performed in 2020 were compared with those in 2019. Invitation and examination coverage were also calculated. PASSI surveillance system, through telephone interviews, collects information about screening test uptake by test provider (public screening and private opportunistic). Test coverage and test uptake in the last year were computed by educational attainment, perceived economic difficulties, and citizenship. Results A reduction of subjects invited and tests performed, with differences between periods and geographical macro areas, was observed in 2020 vs. 2019. The reduction in examination coverage was larger than that in invitation coverage for all screening programs. From the second half of 2020, the trend for test coverage showed a decrease in all the macro areas for all the screening programs. Compared with the pre-pandemic period, there was a greater difference according to the level of education in the odds of having had a test last year vs. never having been screened or not being up to date with screening tests. Conclusions The lockdown and the ongoing COVID-19 emergency caused an important delay in screening activities. This increased the preexisting individual and geographical inequalities in access. The opportunistic screening did not mitigate the impact of the pandemic. Funding This study was partially supported by Italian Ministry of Health - Ricerca Corrente Annual Program 2023 and by the Emilian Region DGR 839/22.
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Affiliation(s)
- Paolo Giorgi Rossi
- Azienda Unità Sanitaria Locale - IRCCS di Reggio EmiliaReggio EmiliaItaly
| | | | - Patrizia Falini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO)FlorenceItaly
| | | | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO)FlorenceItaly
| | - Manuel Zorzi
- Registro Tumori del Veneto, Azienda ZeroPaduaItaly
| | - Paola Armaroli
- Centro di Prevenzione Oncologica, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di TorinoTurinItaly
| | - Carlo Senore
- Centro di Prevenzione Oncologica, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di TorinoTurinItaly
| | - Priscilla Sassoli de Bianchi
- Servizio Prevenzione Collettiva e Sanità Pubblica, Direzione Generale Cura della Persona, Salute e Welfare, Regione Emilia-RomagnaBolognaItaly
| | | | - Marco Zappa
- Osservatorio Nazionale ScreeningFlorenceItaly
| | - Francesca Battisti
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO)FlorenceItaly
| | - Paola Mantellini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO)FlorenceItaly,Osservatorio Nazionale ScreeningFlorenceItaly
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28
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Sorayaie Azar A, Babaei Rikan S, Naemi A, Bagherzadeh Mohasefi J, Pirnejad H, Bagherzadeh Mohasefi M, Wiil UK. Application of machine learning techniques for predicting survival in ovarian cancer. BMC Med Inform Decis Mak 2022; 22:345. [PMID: 36585641 PMCID: PMC9801354 DOI: 10.1186/s12911-022-02087-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Ovarian cancer is the fifth leading cause of mortality among women in the United States. Ovarian cancer is also known as forgotten cancer or silent disease. The survival of ovarian cancer patients depends on several factors, including the treatment process and the prognosis. METHODS The ovarian cancer patients' dataset is compiled from the Surveillance, Epidemiology, and End Results (SEER) database. With the help of a clinician, the dataset is curated, and the most relevant features are selected. Pearson's second coefficient of skewness test is used to evaluate the skewness of the dataset. Pearson correlation coefficient is also used to investigate the associations between features. Statistical test is utilized to evaluate the significance of the features. Six Machine Learning (ML) models, including K-Nearest Neighbors , Support Vector Machine (SVM), Decision Tree (DT), Random Forest (RF), Adaptive Boosting (AdaBoost), and Extreme Gradient Boosting (XGBoost), are implemented for survival prediction in both classification and regression approaches. An interpretable method, Shapley Additive Explanations (SHAP), is applied to clarify the decision-making process and determine the importance of each feature in prediction. Additionally, DTs of the RF model are displayed to show how the model predicts the survival intervals. RESULTS Our results show that RF (Accuracy = 88.72%, AUC = 82.38%) and XGBoost (Root Mean Squad Error (RMSE)) = 20.61%, R2 = 0.4667) have the best performance for classification and regression approaches, respectively. Furthermore, using the SHAP method along with extracted DTs of the RF model, the most important features in the dataset are identified. Histologic type ICD-O-3, chemotherapy recode, year of diagnosis, age at diagnosis, tumor stage, and grade are the most important determinant factors in survival prediction. CONCLUSION To the best of our knowledge, our study is the first study that develops various ML models to predict ovarian cancer patients' survival on the SEER database in both classification and regression approaches. These ML algorithms also achieve more accurate results and outperform statistical methods. Furthermore, our study is the first study to use the SHAP method to increase confidence and transparency of the proposed models' prediction for clinicians. Moreover, our developed models, as an automated auxiliary tool, can help clinicians to have a better understanding of the estimated survival as well as important features that affect survival.
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Affiliation(s)
- Amir Sorayaie Azar
- grid.412763.50000 0004 0442 8645Department of Computer Engineering, Urmia University, Urmia, Iran
| | - Samin Babaei Rikan
- grid.412763.50000 0004 0442 8645Department of Computer Engineering, Urmia University, Urmia, Iran
| | - Amin Naemi
- grid.10825.3e0000 0001 0728 0170Center for Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | | | - Habibollah Pirnejad
- grid.412763.50000 0004 0442 8645Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran ,grid.6906.90000000092621349Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Uffe Kock Wiil
- grid.10825.3e0000 0001 0728 0170Center for Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
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Impact of the COVID-19 epidemic on cancer burden and cancer care in Slovenia: a follow-up study. Radiol Oncol 2022; 56:488-500. [PMID: 36503711 PMCID: PMC9784361 DOI: 10.2478/raon-2022-0050] [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: 10/11/2022] [Accepted: 10/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In Slovenia, cancer care services were exempt from government decrees for COVID-19 containment. Nevertheless, cancer control can be impacted also by access to other health services and changes in health-seeking behaviour. In this follow up study, we explored changes in cancer burden and cancer care beyond the first months after the onset of the COVID-19 epidemic. MATERIALS AND METHODS We analysed routinely collected data for the period January 2019 through July 2022 from three sources: (1) pathohistological and clinical practice cancer notifications from two major cancer centres in Ljubljana and Maribor (source: Slovenian Cancer Registry); (2) referrals issued for oncological services (source: e-referral system); and (3) outpatient appointments and diagnostic imaging performed (source: administrative data of the Institute of Oncology Ljubljana - IOL). Additionally, changes in certain clinical and demographic characteristics in patients diagnosed and treated during the epidemic were analysed using the Hospital-Based Cancer Registry of the IOL (period 2015-2021). RESULTS After a drop in referrals to follow-up cancer appointments in April 2020, in June-August 2020, there was an increase in referrals, but it did not make-up for the drop in the first wave; the numbers in 2021 and 2022 were even lower than 2020. Referrals to first cancer care appointments and genetic testing and counselling increased in 2021 compared to 2019 and in 2022 increased further by more than a quarter. First and follow-up outpatient appointments and cancer diagnostic imaging at the IOL dropped after the onset of the epidemic in March 2020 but were as high as expected according to 2019 baseline already in 2021. Some deficits remain for follow-up outpatients' appointments in surgical and radiotherapy departments. There were more CT, MRI and PET scans performed during the COVID-19 period than before. New cancer diagnoses dropped in all observed years 2020, 2021 and until July 2022 by 6%, 3% and 8%, respectively, varying substantially by cancer type. The largest drop was seen in the 50-64 age group (almost 14% in 2020 and 16% in 2021), while for patients older than 80 years, the numbers were above expected according to the 2015-2019 average (4% in 2020, 8% in 2021). CONCLUSIONS Our results show a varying effect of COVID-19 epidemic in Slovenia for different types of cancers and at different stages on the patient care pathway - it is probably a mixture of changes in health-seeking behaviour and systemic changes due to modifications in healthcare organisation on account of COVID-19. A general drop in new cancer cases reflects disruptions in the pre-diagnostic phase and could have profound long-term consequences on cancer burden indicators.
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Gertz AH, Pollack CC, Schultheiss MD, Brownstein JS. Delayed medical care and underlying health in the United States during the COVID-19 pandemic: A cross-sectional study. Prev Med Rep 2022; 28:101882. [PMID: 35813398 PMCID: PMC9254505 DOI: 10.1016/j.pmedr.2022.101882] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 11/19/2022] Open
Abstract
This study assesses the association between underlying health conditions and delaying medical care during the COVID-19 pandemic. An online cross-sectional survey administered by OutbreaksNearMe.org on Momentive.ai collected self-reported data from April 27 to June 2, 2020 and May 10 to June 13, 2021. We used weighted multivariable logistic regressions to assess the association between delaying care and self-reported health status, adjusting for demographics. Of 312,661 total responses (99.6% completion rate), 17.1% reported delayed medical care. Compared to good health, those with poor health were more likely to delay care (AOR = 2.62, 95% CI [2.47, 2.78]). Individuals with any underlying condition (AOR = 1.62, 95% CI [1.58, 1.65]) and each of the conditions were more likely to delay care. Differences in delaying care were observed across region, year, and demographics. Our finding is that those at higher risk of severe COVID-19 were more likely to delay medical care in 2020 and 2021, which could exacerbate existing health conditions and existing disparities.
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Affiliation(s)
- Autumn H. Gertz
- Computational Epidemiology Lab, Boston Children’s Hospital, Boston, MA, USA
- Corresponding author.
| | - Catherine C. Pollack
- Computational Epidemiology Lab, Boston Children’s Hospital, Boston, MA, USA
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - John S. Brownstein
- Computational Epidemiology Lab, Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
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Ahmad J, Muthyala A, Kumar A, Dani SS, Ganatra S. Disparities in Cardio-oncology: Effects On Outcomes and Opportunities for Improvement. Curr Cardiol Rep 2022; 24:1117-1127. [PMID: 35759170 PMCID: PMC9244335 DOI: 10.1007/s11886-022-01732-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
Purpose of Review The purpose of this article is to provide a comprehensive review of available data on health disparities and the interconnected social determinants of health (SDOH) in cardio-oncology. We identify the gaps in the literature and suggest areas for future research. In addition, we propose strategies to address these disparities at various levels. Recent Findings There has been increasing recognition of health disparities and the role of SODH on an individual’s access to health care, quality of care, and outcomes of the illness. There is growing evidence of sex and race-based differences in cancer therapy-related cardiotoxicity. Recent studies have shown how access and quality of health care are affected by financial stability and rurality. Our recent study utilizing the social vulnerability index (SVI) and county-level patient data found graded increase in county-level cardio-oncology mortality with greater social vulnerability. The incremental impact of social vulnerability was higher for cardio-oncology mortality than for mortality related to either cancer or CVD alone. The mortality rates in these patients were higher in rural areas compared to urban areas regardless of social vulnerability. Additionally, for those within the counties within highest social vulnerability, Black individuals had significantly higher cardio-oncology mortality compared with White individuals. Summary Disparities in the cardio-oncology population are deep-rooted and widespread, leading to poor quality of life and increased mortality. It is crucial to integrate SDOH, not only in clinical care delivery but also in future research, and registry data to improve our understanding and the outcomes in our unique subset of cardio-oncology patients.
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Affiliation(s)
- Javaria Ahmad
- Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Anjani Muthyala
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA
| | - Ashish Kumar
- Department of Medicine, Cleveland Clinic Akron General, Akron, OH, USA
| | - Sourbha S Dani
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Sarju Ganatra
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA
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Prompt Resumption of Screening Programme Reduced the Impact of COVID-19 on New Breast Cancer Diagnoses in Northern Italy. Cancers (Basel) 2022; 14:cancers14123029. [PMID: 35740694 PMCID: PMC9221346 DOI: 10.3390/cancers14123029] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary The aim of this study was to compare 2020 tumours with 2019 tumours by age, stage and treatment in four different periods. In 2020 there was no decrease of invasive tumours nor in situ (513 vs. 493 and 76 vs. 73, respectively), while there was a significant decrease in surgery and an increase in neoadjuvant chemotherapy (p = 0.016). During the Italian lockdown period (March–May), we observed a decrease in all ages and a significant one among people aged 75+ [IRR 0.45 (95% CI 0.25–0.79)], but in the last period there was a significant increase among people of the screening age range of 45–74 [IRR 1.48 (95% CI 1.11–1.98)]. Screening activities were suspended from March to May, but over the summer and the autumn the backlog was eliminated. This suggests that a prompt resumption of programmed screening may have limited the impact of the pandemic on the delay of breast cancer diagnoses. Abstract The aim of this study is to evaluate the real impact of COVID-19 during the entire 2020 period, compared with 2019. The data comes from a Cancer Registry in Northern Italy and we compared clinical and treatment characteristics of breast cancer by age, stage, treatment, and status screening. In 2020 there was no decrease in invasive tumours nor in in situ (513 vs. 493 and 76 vs. 73, respectively), while there was a significant decrease in surgery and increase in neoadjuvant chemotherapy (p = 0.016). In the screening range (aged 45–74), no change in stage and grading was observed. In the four periods examined there was an increase in new diagnoses during pre-lockdown, a decrease in tumours especially at age 75+ [IRR 0.45; 95%CI 0.25–0.79] during lockdown, a recovery of new diagnoses in women 45+ in the low incidence period while in the last period there was a significant increase only for ages 45–74 [IRR 1.48; 95% CI 1.11–1.98]. Screening activities were suspended from March to May, but over the summer and autumn the backlog was addressed. This suggests that a prompt resumption of programmed screening may have limited the impact of the pandemic on the delay of breast cancer diagnoses.
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Carvalho AS, Brito Fernandes Ó, de Lange M, Lingsma H, Klazinga N, Kringos D. Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a scoping review. BMC Health Serv Res 2022; 22:786. [PMID: 35715795 PMCID: PMC9204363 DOI: 10.1186/s12913-022-08166-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/06/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer comprises a high burden on health systems. Performance indicators monitoring cancer outcomes are routinely used in OECD countries. However, the development of process and cancer-pathway based information is essential to guide health care delivery, allowing for better monitoring of changes in the quality of care provided. Assessing the changes in the quality of cancer care during the COVID-19 pandemic requires a structured approach considering the high volume of publications. This study aims to summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020) in OECD countries and to assess changes in the quality of care as reported via selected indicators. METHODS Search conducted in MEDLINE and Embase databases. Performance indicators and their trends were collated according to the cancer care pathway. RESULTS This study included 135 articles, from which 1013 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n = 30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n = 64, 58%) and diagnoses (n = 130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed increasing trends (n = 8, 89% and n = 14, 56%, respectively). A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n = 9), and 70% (n = 43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79%(n = 82) of indicators concerning surgeries, 72%(n = 41) of indicators assessing radiotherapy, and 93%(n = 40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64%(n = 195) of indicators revealed changes in treatment. CONCLUSIONS This study provides a summary of performance indicators used in the literature to assess the cancer care pathway from January 2020 to June 2020 in OECD countries, and the changes in the quality of care signalled by these indicators. The trends reported inform on potential bottlenecks of the cancer care pathway. Monitoring this information closely could contribute to identifying moments for intervention during crises.
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Affiliation(s)
- Ana Sofia Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Mats de Lange
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Duarte MB, Argenton JL, Carvalheira JB. Impact of COVID-19 in Cervical and Breast Cancer Screening and Systemic Treatment in São Paulo, Brazil: An Interrupted Time Series Analysis. JCO Glob Oncol 2022; 8:e2100371. [PMID: 35696624 PMCID: PMC9225667 DOI: 10.1200/go.21.00371] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE COVID-19 caused a disruption in cancer management around the world, resulting in an estimated excess burden secondary to screening disruption and excess lag time for treatment initiation. METHODS We gathered information from primary reimbursement data sets of the public health system of São Paulo, Brazil, from April 2020 to November 2021, and compared these data with those of the pre–COVID-19 period. We used an interrupted time series model to estimate the effect of the COVID-19 pandemic on the rate of key procedures of breast and cervical cancer health care chain. RESULTS We estimated that 1,149,727, 2,693, and 713,616 pap smears, conizations, and mammograms, respectively, were missed or delayed during the COVID-19 pandemic, compared with those in the years immediately before the COVID-19 stay-at-home restrictions. Specifically, we observed an acute decrease of procedures after the COVID-19 stay-at-home restrictions, with a trend to recovery in the long term. Regarding the systemic treatment analysis, we observed a 25% reduction in the rate of initiation of adjuvant systemic treatment for early breast cancer (stage I/II). However, we did not find a clear effect on the other settings of systemic treatment for breast cancer. We estimated an excess of 156 patients starting palliative care for cervical cancer after the COVID-19 stay-at-home restrictions. CONCLUSION The COVID-19 pandemic significantly reduced the performance rate of pap smears, conizations, and mammograms. The initiation of adjuvant treatment for early-stage breast cancer was most susceptible to COVID-19's health system disruption. Furthermore, the downward trend of treatment of advanced cervical cancer was interrupted. Therefore, public health policies are urgently needed to decrease the incidence of advanced cervical and breast cancers caused by delayed diagnosis and treatment initiation. The COVID-19 control policies resulted in reduction of cancer patients' delivery of care. This study evaluated the pandemic's influence in key procedures of breast and cervical cancer chain of care in São Paulo, Brazil. We observed a substantial reduction in the number of mammograms, pap smears, and conizations performed since the onset of the COVID-19 pandemic. In addition, stage I and II breast cancer adjuvant treatment presented a reduced realization rate, whereas palliative treatment delivered for advanced cervical cancer increased. Our results support the need for public health policies focused on mitigating the long-term effects of COVID-19 in cancer-related mortality.
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Affiliation(s)
- Mateus B.O. Duarte
- Division of Oncology, Department of Anesthesiology, Oncology and Radiology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil
- Uberlândia Cancer Hospital, Federal University of Uberlândia, UFU, Uberlândia, Minas Gerais, Brazil
| | - Juliana L.P. Argenton
- Fundação de Desenvolvimento da Universidade Estadual de Campinas (FUNCAMP), Campinas, São Paulo, Brazil
| | - José B.C. Carvalheira
- Division of Oncology, Department of Anesthesiology, Oncology and Radiology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil
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Laurent L, Brugel M, Carlier C, Clere F, Bertrand A, Botsen D, Boulagnon‐Rombi C, Dalstein V, Debreuve‐Theresette A, Deguelte S, Garbar C, Mahmoudi R, Marechal A, Morland D, Rey J, Schvartz C, Vallet C, Merrouche Y, Slimano F, Bouché O. One-year COVID-19 outcomes on the oncology care patient pathway: Results of a French descriptive, cross-sectional comprehensive study (ONCOCARE-COV). Cancer Med 2022; 11:4865-4879. [PMID: 35593199 PMCID: PMC9348299 DOI: 10.1002/cam4.4817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic led to a widely documented disruption in cancer care pathway. Since a resurgence of the pandemic was expected after the first lockdown in France, the global impact on the cancer care pathway over the year 2020 was investigated. AIMS This study aimed to describe the changes in the oncology care pathway for cancer screening, diagnosis, assessment, diagnosis annoucement procedure and treatment over a one-year period. MATERIALS & METHODS The ONCOCARE-COV study was a comprehensive, retrospective, descriptive, and cross-sectional study comparing the years 2019 and 2020. All key indicators along the cancer care pathway assessing the oncological activity over four periods were described. This study was set in a high-volume, public, single tertiary care center divided in two complementary sites (Reims University Hospital and Godinot Cancer Institute, Reims, France) which was located in a high COVID-19 incidence area during both peaks of the outbreak. RESULTS A total of 26,566 patient's files were active during the year 2020. Breast screening (-19.5%), announcement dedicated consultations (-9.2%), Intravenous and Hyperthermic Intraoperative Intraperitoneal Chemotherapy (HIPECs) (-25%), and oncogeriatric evaluations (-14.8%) were heavily disrupted in regard to 2020 activity. We identified a clear second outbreak wave impact on medical announcement procedures (October, -14.4%), radiotherapy sessions (October, -16%), number of new health record discussed in multidisciplinary tumor board meeting (November, -14.6%) and HIPECs (November, -100%). Moreover, 2020 cancer care activity stagnated compared to 2019. DISCUSSION The oncological care pathway was heavily disrupted during the first and second peaks of the COVID-19 outbreak. Between lockdowns, we observed a remarkable but non-compensatory recovery as well as a lesser impact from the pandemic resurgence. However, in absence of an increase in activity, a backlog persisted. CONCLUSION Public health efforts are needed to deal with the consequences of the COVID-19 pandemic on the oncology care pathway.
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Affiliation(s)
- Léonard Laurent
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance
| | - Mathias Brugel
- Ambulatory Oncology Care UnitReims University HospitalReimsFrance
| | - Claire Carlier
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance,Ambulatory Oncology Care UnitReims University HospitalReimsFrance
| | - Florentin Clere
- Care‐Associated Risks and Care Quality DepartmentUniversity HospitalReimsFrance
| | - Aurélie Bertrand
- Marne Site, Regional Coordination Center for Cancer Screening Grand‐EstReimsFrance
| | - Damien Botsen
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance,Ambulatory Oncology Care UnitReims University HospitalReimsFrance
| | | | - Véronique Dalstein
- Pathology DepartmentReims University HospitalReimsFrance,INSERM, P3 Cell UMR‐S1250, SFR CAP‐SANTEUniversité de Reims Champagne‐ArdenneReimsFrance
| | | | | | | | - Rachid Mahmoudi
- Department of Internal Medicine and GeriatricsReims University HospitalReimsFrance,Université de Reims Champagne‐ArdenneReimsFrance
| | | | - David Morland
- Nuclear Medicine DepartmentGodinot Cancer InstituteReimsFrance,CReSTIC EA 3804Université de Reims Champagne‐ArdenneReimsFrance
| | | | - Claire Schvartz
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance,INSERM, P3 Cell UMR‐S1250, SFR CAP‐SANTEUniversité de Reims Champagne‐ArdenneReimsFrance
| | - Catherine Vallet
- Medical Information DepartmentReims University HospitalReimsFrance
| | - Yacine Merrouche
- Medical Oncology DepartmentGodinot Cancer InstituteReimsFrance,Université de Reims Champagne‐ArdenneReimsFrance
| | - Florian Slimano
- Université de Reims Champagne‐ArdenneReimsFrance,Pharmacy DepartmentReims University HospitalReimsFrance
| | - Olivier Bouché
- Ambulatory Oncology Care UnitReims University HospitalReimsFrance,Université de Reims Champagne‐ArdenneReimsFrance
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Della Vecchia C, Girodet M, Ginguené S, Carpentier C, Leroy T, Siméone A, Vayre E, Mabire X, Ferraz D, Morin-Messabel C, Préau M. At the heart of the COVID-19 crisis: Perceived concerns of changes in long-term cancer care in French women with cancer. Eur J Cancer Care (Engl) 2022; 31:e13599. [PMID: 35523418 PMCID: PMC9349365 DOI: 10.1111/ecc.13599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 12/15/2022]
Abstract
Objective In the COVID‐19 crisis context, the main objective of the study is to investigate factors associated with perceived concerns of change in long‐term cancer care in patients currently under treatment. Methods A French population‐based cross‐sectional study was performed using an online questionnaire in April 2020. All persons currently receiving cancer treatment and belonging to the Seintinelles Association (https://www.seintinelles.com) were included in this present analysis. Individual sociodemographic characteristics, medical status and information regarding cancer care were collected. Multivariate binomial logistic regression analysis was performed. Results We included 298 women in the analysis. Younger participants (OR = 0.96 [0.94–0.99]), the need to visit healthcare facilities to receive treatment (OR = 2.93 [1.16–8.52]), deterioration in the quality of communication with the medical team since the beginning of the COVID‐19 crisis (OR = 3.24 [1.61–7.02]) and being cared for by a university hospital or a public hospital (OR = 2.19 [1.16–4.23] versus comprehensive cancer centre) were associated with a perceived fear of change in long‐term cancer care. Conclusion To address patients' concerns regarding changes in their long‐term cancer care, medical teams should consider the patients' own perceptions of the situation and provide clear, appropriate, precise information on cancer care, especially in the centres mostly affected by the COVID‐19 crisis.
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Affiliation(s)
- Claire Della Vecchia
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Magali Girodet
- Human and Social Sciences Department/Medical Evaluation and Sarcomas Team, Comprehensive Cancer Care Centre Léon Bérard, Lyon, France.,Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, Lyon, France
| | - Stéphéline Ginguené
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Camille Carpentier
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Tanguy Leroy
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Arnaud Siméone
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Emilie Vayre
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Xavier Mabire
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Dulce Ferraz
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France.,PHASE (Psychology of Health, Aging and Sport Examination), University of Lausanne Faculty of Social and Political Science, Lausanne, Switzerland
| | - Christine Morin-Messabel
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Marie Préau
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
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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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Janah A, Demoor-Goldschmidt C, De Vathaire F, Bougas N, Clavel J, Poulalhon C, Lacour B, Souchard V, Jackson A, Casagranda L, Berger C, Allodji R, Haddy N, El Fayech C, Fresneau B, Dumas A. Risk perceptions and health care use in the era of the COVID-19 pandemic in adults treated for childhood cancer. Support Care Cancer 2022; 30:6263-6271. [PMID: 35460426 PMCID: PMC9033518 DOI: 10.1007/s00520-022-07035-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/03/2022] [Indexed: 12/11/2022]
Abstract
Purpose During the COVID-19 pandemic, childhood cancer survivors (CCS) may have felt more at risk of having severe consequences of COVID-19 and therefore may have been more likely to defer their health care use. We aimed to assess the risk perceptions of CCS related to COVID-19 (perceived infection risk, perceived risk of experiencing a severe illness in the event of infection), and their forgoing of health care during the year 2020. Methods In December 2020, we interviewed through an online self-report questionnaire 580 5-year CCS participating in the French Childhood Cancer Survivor Study (FCCSS) cohort. Combining clinical and patient-reported outcomes, we studied predictors of perceived risks related to COVID-19 and forgoing health care. Results Overall, 60% of respondents stated that COVID-19 could have severe consequences for their health if infected. Survivors with a cardiovascular disease and those who felt more at risk of being infected were more likely to think that COVID-19 could have severe health consequences for them. Moreover, 30% of respondents seeking care declared they had forgone at least one medical appointment in 2020. Forgoing medical appointments was more common among CCS who reported a deterioration in their financial situation in 2020 and those who felt more at risk of being infected. Conclusions This study shows that a considerable proportion of survivors had forgone medical appointments because of the pandemic; forgoing care was more frequent among the most socioeconomically disadvantaged survivors. Implications for cancer survivors. This study presents data hitherto absent in the literature and suggests the need to develop telehealth to ensure appropriate long-term follow-up of CCS.
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Affiliation(s)
- Asmaa Janah
- ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research, University of Paris, F-75010, Paris, France
| | - Charlotte Demoor-Goldschmidt
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
- Pediatric Oncology Department, CHU Angers, F-49100, Angers, France
- Radiotherapy Department, François Baclesse Center, 14000, Caen, France
| | - Florent De Vathaire
- University of Paris-Saclay, F-94800, Villejuif, France.
- Gustave Roussy, F-94800, Villejuif, France.
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France.
| | - Nicolas Bougas
- ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research, University of Paris, F-75010, Paris, France
| | - Jacqueline Clavel
- Centre of Research in Epidemiology and Statistics, INSERM, Villejuif, France
- National Registry of Childhood Cancer, Paul Brousse Hospital (AP-HP), Villejuif, France
- Regional University Hospital Center of Nancy (CHRU Nancy), Vandœuvre-lès-Nancy, France
| | - Claire Poulalhon
- Centre of Research in Epidemiology and Statistics, INSERM, Villejuif, France
- National Registry of Childhood Cancer, Paul Brousse Hospital (AP-HP), Villejuif, France
- Regional University Hospital Center of Nancy (CHRU Nancy), Vandœuvre-lès-Nancy, France
| | - Brigitte Lacour
- Centre of Research in Epidemiology and Statistics, INSERM, Villejuif, France
- National Registry of Childhood Cancer, Paul Brousse Hospital (AP-HP), Villejuif, France
- Regional University Hospital Center of Nancy (CHRU Nancy), Vandœuvre-lès-Nancy, France
| | - Vincent Souchard
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Angela Jackson
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Leonie Casagranda
- Pediatric Oncology Department, CHU Saint-Etienne, Saint-Etienne, France
- University of Jean Monnet, INSERM, University of Lyon, U 1059, Sainbiose, France
| | - Claire Berger
- Pediatric Oncology Department, CHU Saint-Etienne, Saint-Etienne, France
- University of Jean Monnet, INSERM, University of Lyon, U 1059, Sainbiose, France
| | - Rodrigue Allodji
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Nadia Haddy
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Chiraz El Fayech
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Brice Fresneau
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Agnès Dumas
- ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research, University of Paris, F-75010, Paris, France
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Jardim BC, Migowski A, Corrêa FDM, Silva GAE. Covid-19 in Brazil in 2020: impact on deaths from cancer and cardiovascular diseases. Rev Saude Publica 2022; 56:22. [PMID: 35476100 PMCID: PMC9004704 DOI: 10.11606/s1518-8787.2022056004040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/20/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To analyze the impact of the covid-19 pandemic on mortality from cancer and cardiovascular diseases (CVD) as underlying cause and comorbidity in Brazil and Brazilian regions in 2020. METHODS We used the 2019 and 2020 databases of the Mortality Information System (SIM) to analyze deaths occurring between March and December of each year that had cancer or CVD as the underlying cause or comorbidity. Deaths from covid-19 in 2020 were also analyzed. To estimate the Standardized Mortality Ratio (SMR) and the excess of deaths, 2019 data were considered as standard. RESULTS Between March and December 2020, there were 181,377 deaths from cancer and 291,375 deaths from cardiovascular diseases in Brazil, indicating reduction rates of 9.7% and 8.8%, respectively, compared to the same period of the previous year. The pattern was maintained in the five Brazilian regions, with lower variation for cancer (-8.4% in the South to -10.9% in the Midwest). For CVD, the variation was greater, from -2.2% in the North to -10.5 in the Southeast and South. In the same period of 2020, these diseases were classified as comorbidities in 18,133 deaths from cancer and 188,204 deaths from cardiovascular diseases, indicating a proportional excess compared to data from 2019, of 82.1% and 77.9%, respectively. This excess was most significant in the Northern Region, with a ratio of 2.5 between observed and expected deaths for the two conditions studied. CONCLUSIONS Excess deaths from cancer and CVD as comorbidities in 2020 may indicate that covid-19 had an important impact among patients with these conditions.
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Affiliation(s)
- Beatriz Cordeiro Jardim
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hésio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hésio Cordeiro. Rio de Janeiro, RJ, Brasil
| | - Arn Migowski
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
- Instituto Nacional de CardiologiaCoordenação de Ensino e PesquisaNúcleo de EpidemiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia. Coordenação de Ensino e Pesquisa. Núcleo de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Flávia de Miranda Corrêa
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
| | - Gulnar Azevedo e Silva
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hésio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hésio Cordeiro. Rio de Janeiro, RJ, Brasil
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Heudel P, Favier B, Solodky ML, Assaad S, Chaumard N, Tredan O, Bachelot T, Ray-Coquard I, Russias B, Fournier ML, Mastroianni B, Avrillon V, Michallet AS, Zrounba P, Chabaud S, Perol D, Blay JY. Survival and risk of COVID-19 after SARS-COV-2 vaccination in a series of 2391 cancer patients. Eur J Cancer 2022; 165:174-183. [PMID: 35245864 PMCID: PMC8828434 DOI: 10.1016/j.ejca.2022.01.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/15/2022] [Accepted: 01/27/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with cancer are at high risk of severe or lethal COVID-19. The impact of SARS-COV-2 vaccination on the risk of developing COVID-19 was investigated in an exhaustive series of patients from a comprehensive cancer center. METHODS This is a study of the exhaustive population of 2391 cancer patients who were prescribed SARS-COV-2 vaccination until 09/21. Patient characteristics, documented SARS-COV-2 infection with RT-PCR, and survival were collected. The primary endpoint was the rate of COVID-19 after vaccination. Secondary endpoints included risk factors to develop COVID-19 after vaccination, with a comparison with the cohort of vaccinated health care workers (HCW), and risk factors for death. RESULTS From January to September 2021, among 2391 patients with cancer under active treatment in whom a SARS-COV-2 vaccine was prescribed, 659 (28%), 1498 (63%) and 139 (6%) received 1, 2, and 3 doses, respectively. Ninety five patients received a single dose of vaccine after a previous COVID-19. Two thousand two hundred eighty five health care workers (HCW) received one (N = 17, 0.7%), 2-3 (N = 2026, 88.7%) vaccine doses and one dose after COVID-19 (N = 242, 10.6%). With a median follow-up of 142 and 199 days for patients and HCW, respectively. Thirty nine (1.6%) patients and 35 (1.5%) HCW developed COVID-19 after vaccination. Six of 39 cancer patients and no HCW died because ofCOVID-19 within 50 days after diagnosis. Independent risk factors for COVID-19 in vaccinated patients were age, single dose of vaccine without previous COVID-19 and anti-CD20 treatment in the last three months. Independent risk factors for death included metastatic disease, gender, cancer type, but also documented COVID-19 before vaccination. CONCLUSIONS Patients receiving two or more doses of COVID-19 vaccine have reduced risk of COVID-19. The risk of death of vaccinated cancer patients presenting COVID-19 remains high. COVID-19 before vaccination is associated with an increased overall risk of death.
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Affiliation(s)
- Pierre Heudel
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France
| | - Bertrand Favier
- Department of Pharmacy, Centre Léon Bérard Cancer Center, Lyon, France
| | - Marie-Laure Solodky
- Department of Medecine of Health Care Workers, Centre Léon Bérard Cancer Center, Lyon, France
| | - Souad Assaad
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France
| | - Natacha Chaumard
- Department of Pharmacy, Centre Léon Bérard Cancer Center, Lyon, France
| | - Olivier Tredan
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France
| | - Thomas Bachelot
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France
| | | | - Bruno Russias
- Department DCSEI, Centre Léon Bérard Cancer Center, Lyon, France
| | | | | | - Virginie Avrillon
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France
| | | | - Philippe Zrounba
- Department of Surgery, Centre Léon Bérard Cancer Center, Lyon, France
| | - Sylvie Chabaud
- Department of Clinical Research, Centre Léon Bérard Cancer Center, Lyon, France
| | - David Perol
- Department of Clinical Research, Centre Léon Bérard Cancer Center, Lyon, France
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard Cancer Center, Lyon, France; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, France; Presidence, Unicancer, Paris, France.
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Alpuim Costa D, Nobre JGG, Fernandes JP, Batista MV, Simas A, Sales C, Gouveia H, Ribeiro LA, Coelho A, Brito M, Inácio M, Cruz A, Mariano M, Savva-Bordalo J, Fernandes R, Oliveira A, Chaves A, Fontes-Sousa M, Sampaio-Alves M, Martins-Branco D, Afonso N. Impact of the COVID-19 Pandemic on Breast Cancer Management in Portugal: A Cross-Sectional Survey-Based Study of Medical Oncologists. Oncol Ther 2022; 10:225-240. [PMID: 35312952 PMCID: PMC8935098 DOI: 10.1007/s40487-022-00191-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Cancer care providers have faced many challenges in delivering safe care for patients during the COVID-19 pandemic. This cross-sectional survey-based study investigated the impact of the pandemic on clinical practices of Portuguese medical oncologists caring for patients with breast cancer. METHODS An anonymous online survey comprising 42 questions gathered information regarding COVID-19 testing, treatment in (neo)adjuvant and metastatic settings, and other aspects of breast cancer management. Practices before and during the pandemic were compared, and potential differences in outcomes according to respondents' regions, case volumes, and practice type were explored. RESULTS Of 129 respondents, 108 worked in the public health system, giving a representative national picture of the impact of the COVID-19 pandemic on breast cancer management. Seventy-one percent of respondents reported a reduction in visits for new cases of breast cancer, and there was a shift towards increased use of telemedicine. Clinical decision-making was largely unaffected in the most aggressive indications (i.e., triple-negative, HER2-positive, visceral crisis). The use of neoadjuvant therapy increased when access to surgery was difficult, whereas dose-dense regimens decreased, and cyclin-dependent kinase 4/6 inhibitor treatment decreased for less aggressive disease and increased for more aggressive disease. The use of oral formulations and metronomic chemotherapy regimens increased, and clinical trial participation decreased. Some differences by respondents' region and case volume were noted. CONCLUSION Medical oncologists in Portugal implemented many changes during the COVID-19 pandemic, most of which were logical and reasonable responses to the current healthcare emergency; however, the true impact on patient outcomes remains unknown.
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Affiliation(s)
- Diogo Alpuim Costa
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal. .,NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Campo dos Mártires da Pátria 130, 1169-056, Lisbon, Portugal.
| | | | - João Paulo Fernandes
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal
| | - Marta Vaz Batista
- Medical Oncology Department, Hospital Prof. Doutor Fernando Fonseca (HFF), IC19, 2720-276, Amadora, Portugal
| | - Ana Simas
- Medical Oncology Department, Hospital de Santa Luzia (HSL), Unidade Local Saúde Alto Minho (ULSAM), Estr. de Santa Luzia 50 4900, Viana do Castelo, Portugal
| | - Carolina Sales
- Medical Oncology Department, Hospital Dr. Nélio Mendonça, Hospital Central Do Funchal (HCF), Av. Luís de Camões 6180, 9000-177, Funchal, Madeira, Portugal
| | - Helena Gouveia
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Leonor Abreu Ribeiro
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal.,Medical Oncology Department, Hospital de Santa Maria (HSM), Centro Hospitalar Universitário de Lisboa Norte (CHULN), Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal
| | - Andreia Coelho
- Medical Oncology Department, Hospital de Santo Espírito da Ilha Terceira (HSEIT), Canada do Briado, Canada do Briado, 9700-049, Terceira, Azores, Portugal
| | - Margarida Brito
- Medical Oncology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), E.P.E., Rua Prof. Lima Basto, Lisbon, Portugal.,Medical Oncology Department, Hospital de São Bernardo (HSB), Centro Hospitalar de Setúbal (CHS), Rua Camilo Castelo Branco, Aptd. 140, Setúbal, Portugal
| | - Mariana Inácio
- Medical Oncology Department, Hospital Do Espírito Santo de Évora (HESE), Largo do Sr. da Pobreza, 7000-811, Évora, Portugal
| | - André Cruz
- Medical Oncology Department, Hospital Particular Do Algarve-Gambelas, Grupo HPA Saúde, Urbanização Casal de Gambelas, Lote 2, 8005-226, Faro, Portugal
| | - Mónica Mariano
- Medical Oncology Department, Instituto Português de Oncologia de Coimbra Francisco Gentil (IPOCFG), E.P.E., Av. Prof. Dr. Bissaya Barreto 98, 3000-075, Coimbra, Portugal
| | - Joana Savva-Bordalo
- Medical Oncology Department, Instituto Português de Oncologia Do Porto Francisco Gentil (IPOPFG), E.P.E., Rua Dr. António Bernardino de Almeida, 4200-072, Oporto, Portugal
| | | | - André Oliveira
- Medical Oncology Department, Hospital Do Divino Espírito Santo (HDES), Av. D. Manuel I, 9500-370, Ponta Delgada, Azores, Portugal
| | - Andreia Chaves
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal.,Medical Oncology Department, Hospital Prof. Doutor Fernando Fonseca (HFF), IC19, 2720-276, Amadora, Portugal
| | - Mário Fontes-Sousa
- Breast Cancer Unit, CUF Oncologia, Rua Mário Botas, s/n 1998-018, Lisbon, Portugal.,Medical Oncology Department, Hospital de São Bernardo (HSB), Centro Hospitalar de Setúbal (CHS), Rua Camilo Castelo Branco, Aptd. 140, Setúbal, Portugal.,Medical Oncology Department, Hospital de São Francisco Xavier (HSFX), Centro Hospitalar de Lisboa Ocidental (CHLO), Estr. Forte do Alto Duque, 1449-005, Lisbon, Portugal
| | - Mafalda Sampaio-Alves
- Faculdade de Medicina, Universidade Do Porto (FMUP), Alameda Prof. Hernâni Monteiro, 4200-319, Oporto, Portugal.,PTSurg-Portuguese Surgical Research Collaborative, Lisbon, Portugal
| | - Diogo Martins-Branco
- Academic Trials Promoting Team, Institut Jules Bordet, l'Université Libre de Bruxelles (ULB), Av. Franklin Roosevelt 50, 1050, Brussels, Belgium
| | - Noémia Afonso
- Medical Oncology Department, Centro Hospitalar Vila Nova de Gaia/Espinho (CHVNG/E), R. Conceição Fernandes S/N, 4434-502, Vila Nova de Gaia, Portugal
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Varlas VN, Borș RG, Pop AL, Năsui BA, Bacalbasa N, Bohîlțea R, Vlădăreanu R, Manolea C. Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields. J Clin Med 2022; 11:jcm11051221. [PMID: 35268312 PMCID: PMC8911324 DOI: 10.3390/jcm11051221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background: COVID-19 infection has dominated our lives and left its mark on it. The impact on fertility is major, and the long-term consequences may be disastrous. When we talk about oncofertility, we are talking about those patients worried about the delay in receiving medical services (possible cancelation of surgery, decreased availability of medical services, reorientation of medical resources) due to COVID-19. Finally, patients’ worsening biological and reproductive statuses, associated with high levels of anxiety and depression, are closely related to social restrictions, economic impact, reorientation of medical resources, health policies, and fears of SARS-CoV-2 infection. Aim: We reviewed the current literature on fertility during the COVID-19 pandemic and its effect on cancer patients. Specifically, how cancer treatment can affect fertility, the options to maintain fertility potential, and the recovery options available after treatment are increasingly common concerns among cancer patients. Methods: A systematic literature search was conducted using two main central databases (PubMed®/MEDLINE, and Web of Science) to identify relevant studies using keywords SARS-CoV-2, COVID-19, oncofertility, young cancer patient, cryopreservation, assisted reproductive techniques (ART), psychosocial, telemedicine. Results: In the present study, 45 papers were included, centered on the six main topics related to COVID-19. Conclusions: Fertility preservation (FP) should not be discontinued, but instead practiced with adjustments to prevent SARS-CoV-2 transmission. The increased risk of SARS-CoV-2 infection in cancer patients requires screening for COVID-19 before FP procedures, among both patients and medical staff in FP clinics, to prevent infection that would rapidly worsen the condition and lead to severe complications.
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Affiliation(s)
- Valentin Nicolae Varlas
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
| | - Roxana Georgiana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Correspondence: (R.G.B.); (R.B.)
| | - Anca Lucia Pop
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Clinical Laboratory, Food Safety, Carol Davila University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania
| | - Bogdana Adriana Năsui
- Department of Community Health, Iuliu Hațieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania;
| | - Nicolae Bacalbasa
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Cantacuzino Clinical Hospital, 030167 Bucharest, Romania
| | - Roxana Bohîlțea
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Correspondence: (R.G.B.); (R.B.)
| | - Radu Vlădăreanu
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynecology, Elias Clinical Hospital, 17 Mărăști Blvd., 011461 Bucharest, Romania
| | - Corina Manolea
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Assisted Reproduction Department, Columna Medical Center, 021522 Bucharest, Romania
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Popovic M, Fiano V, Moirano G, Chiusa L, Conway DI, Garzino Demo P, Gilardetti M, Iorio GC, Moccia C, Ostellino O, Pecorari G, Ramieri G, Ricardi U, Riva G, Virani S, Richiardi L. The Impact of the COVID-19 Pandemic on Head and Neck Cancer Diagnosis in the Piedmont Region, Italy: Interrupted Time-Series Analysis. Front Public Health 2022; 10:809283. [PMID: 35265573 PMCID: PMC8899030 DOI: 10.3389/fpubh.2022.809283] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/24/2022] [Indexed: 12/16/2022] Open
Abstract
Background The COVID-19 pandemic has likely affected the most vulnerable groups of patients and those requiring time-critical access to healthcare services, such as patients with cancer. The aim of this study was to use time trend data to assess the impact of COVID-19 on timely diagnosis and treatment of head and neck cancer (HNC) in the Italian Piedmont region. Methods This study was based on two different data sources. First, regional hospital discharge register data were used to identify incident HNC in patients ≥18 years old during the period from January 1, 2015, to December 31, 2020. Interrupted time-series analysis was used to model the long-time trends in monthly incident HNC before COVID-19 while accounting for holiday-related seasonal fluctuations in the HNC admissions. Second, in a population of incident HNC patients eligible for recruitment in an ongoing clinical cohort study (HEADSpAcE) that started before the COVID-19 pandemic, we compared the distribution of early-stage and late-stage diagnoses between the pre-COVID-19 and the COVID-19 period. Results There were 4,811 incident HNC admissions in the 5-year period before the COVID-19 outbreak and 832 admissions in 2020, of which 689 occurred after the COVID-19 outbreak in Italy. An initial reduction of 28% in admissions during the first wave of the COVID-19 pandemic (RR 0.72, 95% CI 0.62-0.84) was largely addressed by the end of 2020 (RR 0.96, 95% CI 0.89-1.03) when considering the whole population, although there were some heterogeneities. The gap between observed and expected admissions was particularly evident and had not completely recovered by the end of the year in older (≥75 years) patients (RR: 0.88, 0.76-1.01), patients with a Romano-Charlson comorbidity index below 2 (RR 0.91, 95% CI: 0.84-1.00), and primary surgically treated patients (RR 0.88, 95% CI 0.80-0.97). In the subgroup of patients eligible for the ongoing active recruitment, we observed no evidence of a shift toward a more advanced stage at diagnosis in the periods following the first pandemic wave. Conclusions The COVID-19 pandemic has affected differentially the management of certain groups of incident HNC patients, with more pronounced impact on older patients, those treated primarily surgically, and those with less comorbidities. The missed and delayed diagnoses may translate into worser oncological outcomes in these patients.
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Affiliation(s)
- Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | - Valentina Fiano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | - Luigi Chiusa
- Pathology Unit, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza Hospital, Turin, Italy
| | - David I. Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Paolo Garzino Demo
- Maxillofacial Unit, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza Hospital, Turin, Italy
| | - Marco Gilardetti
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | | | - Chiara Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | - Oliviero Ostellino
- Oncology Unit, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza Hospital, Turin, Italy
| | - Giancarlo Pecorari
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Maxillofacial Unit, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Giuseppe Riva
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Shama Virani
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
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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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Double-Layer Fatty Acid Nanoparticles as a Multiplatform for Diagnostics and Therapy. NANOMATERIALS 2022; 12:nano12020205. [PMID: 35055222 PMCID: PMC8780348 DOI: 10.3390/nano12020205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 02/03/2023]
Abstract
Today, public health is one of the most important challenges in society. Cancer is the leading cause of death, so early diagnosis and localized treatments that minimize side effects are a priority. Magnetic nanoparticles have shown great potential as magnetic resonance imaging contrast agents, detection tags for in vitro biosensing, and mediators of heating in magnetic hyperthermia. One of the critical characteristics of nanoparticles to adjust to the biomedical needs of each application is their polymeric coating. Fatty acid coatings are known to contribute to colloidal stability and good surface crystalline quality. While monolayer coatings make the particles hydrophobic, a fatty acid double-layer renders them hydrophilic, and therefore suitable for use in body fluids. In addition, they provide the particles with functional chemical groups that allow their bioconjugation. This work analyzes three types of self-assembled bilayer fatty acid coatings of superparamagnetic iron oxide nanoparticles: oleic, lauric, and myristic acids. We characterize the particles magnetically and structurally and study their potential for resonance imaging, magnetic hyperthermia, and labeling for biosensing in lateral flow immunoassays. We found that the myristic acid sample reported a large r2 relaxivity, superior to existing iron-based commercial agents. For magnetic hyperthermia, a significant specific absorption rate value was obtained for the oleic sample. Finally, the lauric acid sample showed promising results for nanolabeling.
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Seneviratne SL, Wijerathne W, Yasawardene P, Somawardana B. OUP accepted manuscript. Trans R Soc Trop Med Hyg 2022; 116:767-797. [PMID: 35276734 PMCID: PMC8992310 DOI: 10.1093/trstmh/trac015] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/13/2022] [Accepted: 02/08/2022] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has currently affected >220 million individuals worldwide. The complex interplay of immune dysfunction, active malignancy, the effect of cancer treatment on the immune system and additional comorbidities associated with cancer and COVID-19 all affect the outcomes of COVID-19 in patients with cancer. We have discussed the published findings (through the end of September 2021) on the effects of cancer on the morbidity and mortality of COVID-19, common factors between cancer and COVID-19, the interaction of cancer and COVID-19 treatments, the impact of COVID-19 on cancer clinical services, immune test findings in cancer patients with COVID-19 and the long-term effects of COVID-19 on cancer survivors.
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Nardin C, Senot L, Pernot P, Puzenat E, Aubin F, Morin L. Increase in American Joint Committee on Cancer Stage at Diagnosis for Patients with Skin Cancers after the COVID-19 Lockdown. Acta Derm Venereol 2021; 102:adv00630. [PMID: 34842933 PMCID: PMC9574687 DOI: 10.2340/actadv.v101.213] [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] [Indexed: 11/16/2022] Open
Abstract
is missing (Short communication).
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Affiliation(s)
- Charlée Nardin
- Department of Dermatology, University Hospital, 3 Bd Fleming, FR-25000 Besançon.
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48
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The Impact of the COVID-19 Pandemic on Cancer Patient's Management-Lithuanian Cancer Center Experience. Healthcare (Basel) 2021; 9:healthcare9111522. [PMID: 34828568 PMCID: PMC8623620 DOI: 10.3390/healthcare9111522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/31/2021] [Accepted: 11/04/2021] [Indexed: 12/31/2022] Open
Abstract
The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) of Lithuania. We assessed the time period from 1 February 2020 to 31 December 2020 and compared it to the same period of 2019. Data for our analysis were extracted from the NCI Hospital Information System (HIS) and the National Health Insurance Fund (NHIF). Contingency table analysis and ANOVA were performed. The COVID-19 pandemic negatively affected the cancer services provided by NCI. Reductions in diagnostic radiology (−16%) and endoscopy (−29%) procedures were accompanied by a decreased number of patients with ongoing medical (−30%), radiation (−6%) or surgical (−10%) treatment. The changes in the number of newly diagnosed cancer patients were dependent on tumor type and disease stage, showing a rise in advanced disease at diagnosis already during the early period of the first lockdown. The extent of out-patient consultations (−14%) and disease follow-up visits (−16%) was also affected by the pandemic, and only referrals to psychological/psychiatric counselling were increased. Additionally, the COVID-19 pandemic had an impact on the structure of cancer services by fostering the application of modified systemic anticancer therapy or hypofractionated radiotherapy. The most dramatic drop occurred in the number of patients participating in cancer prevention programs; the loss was 25% for colon cancer and 62% for breast cancer screening. Marked restriction in access to preventive cancer screening and overall reduction of the whole spectrum of cancer services may negatively affect cancer survival measures in the nearest future.
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