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Shah R, Loo CE, Hanna NM, Hughes S, Mafra A, Fink H, McFerran E, Garcia M, Acharya S, Langselius O, Frick C, Niyigaba J, Lasebikan N, Steinberg J, Sullivan R, Bray F, Ilbawi AM, Ginsburg O, Chiam K, Cylus J, Caruana M, David M, Hui H, Canfell K, Soerjomataram I. Global review of COVID-19 mitigation strategies and their impact on cancer service disruptions. J Cancer Policy 2024; 41:100486. [PMID: 38830535 DOI: 10.1016/j.jcpo.2024.100486] [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: 10/16/2023] [Revised: 04/15/2024] [Accepted: 05/24/2024] [Indexed: 06/05/2024]
Abstract
During the COVID-19 pandemic, countries adopted mitigation strategies to reduce disruptions to cancer services. We reviewed their implementation across health system functions and their impact on cancer diagnosis and care during the pandemic. A systematic search was performed using terms related to cancer and COVID-19. Included studies reported on individuals with cancer or cancer care services, focusing on strategies/programs aimed to reduce delays and disruptions. Extracted data were grouped into four functions (governance, financing, service delivery, and resource generation) and sub-functions of the health system performance assessment framework. We included 30 studies from 16 countries involving 192,233 patients with cancer. Multiple mitigation approaches were implemented, predominantly affecting sub-functions of service delivery to control COVID-19 infection via the suspension of non-urgent cancer care, modified treatment guidelines, and increased telemedicine use in routine cancer care delivery. Resource generation was mainly ensured through adequate workforce supply. However, less emphasis on monitoring or assessing the effectiveness and financing of these strategies was observed. Seventeen studies suggested improved service uptake after mitigation implementation, yet the resulting impact on cancer diagnosis and care has not been established. This review emphasizes the importance of developing effective mitigation strategies across all health system (sub)functions to minimize cancer care service disruptions during crises. Deficiencies were observed in health service delivery (to ensure equity), governance (to monitor and evaluate the implementation of mitigation strategies), and financing. In the wake of future emergencies, implementation research studies that include pre-prepared protocols will be essential to assess mitigation impact across cancer care services.
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Affiliation(s)
- Richa Shah
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - Ching Ee Loo
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | | | - Suzanne Hughes
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Allini Mafra
- Cancer Epidemiology and Prevention Team, Public Health Expertise, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Hanna Fink
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Montse Garcia
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), Early Detection of Cancer Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | | | - Oliver Langselius
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Clara Frick
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Jean Niyigaba
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Richard Sullivan
- King's College London, Institute of Cancer Policy, Guy's Hospital, London, UK
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - André Michel Ilbawi
- Department of Non-communicable Diseases, World Health Organization, Geneva, Switzerland
| | | | - Karen Chiam
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Jonathan Cylus
- WHO Barcelona Office for Health Systems Financing, World Health Organization Regional Office for Europe, Barcelona, Spain; London School of Hygiene and Tropical Medicine Faculty of Public Health, London, UK
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Michael David
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia; School of Medicine & Dentistry, Griffith University, Gold Coast, Australia
| | - Harriet Hui
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
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Uğur ZB, Durak A. The Impact of COVID-19 on Healthcare Utilization in Turkey. Value Health Reg Issues 2024; 43:101000. [PMID: 38754257 DOI: 10.1016/j.vhri.2024.101000] [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: 11/22/2023] [Revised: 02/12/2024] [Accepted: 03/25/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES This study investigates the impact of the COVID-19 pandemic on healthcare utilization in Turkey. METHODS We utilized individual-level data derived from Turkish Statistical Institute's annual surveys between 2014 and 2022 and estimated probit regression models. RESULTS We find that COVID-19 pandemic reduced healthcare utilization by 11.8% after taking into account a large set of background variables. Although our study finds that the elderly and those with health problems are more likely to use healthcare services under normal circumstances, the COVID-19 pandemic has caused notable drops in the healthcare utilization among the elderly (-6.5%) and those with health problems (-3.8%). Although those without health insurance had lower utilization of healthcare services before the pandemic, during the pandemic they were not particularly hit. CONCLUSION We conclude that the pandemic did not lower the healthcare utilization in Turkey because of the supply constraints. Also, the evidence points to the reduced demand due to the fear of contagion rather than financial concerns.
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Affiliation(s)
- Zeynep B Uğur
- Department of Economics/Associate Professor, Social Sciences University of Ankara, Ankara, Turkey.
| | - Ayşenur Durak
- Department of Economics/Research Assistant, Abdullah Gül University, Kayseri, Turkey
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Estupiñán-Romero F, Royo-Sierra S, González-Galindo J, Martínez-Lizaga N, Bogaert P, Schutte N, Van Eycken L, Van Damme N, Henau K, Lyons RA, Aldridge SJ, Faragalli A, Carle F, Gesuita R, Palmieri L, Misiņš J, Thiβen M, Bernal-Delgado E. Delayed treatment in breast cancer patients during the COVID-19 pandemic: a population health information research infrastructure (PHIRI) case study. Eur J Public Health 2024; 34:i50-i57. [PMID: 38946448 PMCID: PMC11215325 DOI: 10.1093/eurpub/ckae038] [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: 07/02/2024] Open
Abstract
BACKGROUND The indirect impact of the coronavirus disease 2019 pandemic on healthcare services was studied by assessing changes in the trend of the time to first treatment for women 18 or older who were diagnosed and treated for breast cancer between 2017 and 2021. METHODS An observational retrospective longitudinal study based on aggregated data from four European Union (EU) countries/regions investigating the time it took to receive breast cancer treatment. We compiled outputs from a federated analysis to detect structural breakpoints, confirming the empirical breakpoints by differences between the trends observed and forecasted after March 2020. Finally, we built several segmented regressions to explore the association of contextual factors with the observed changes in treatment delays. RESULTS We observed empirical structural breakpoints on the monthly median time to surgery trend in Aragon (ranging from 9.20 to 17.38 days), Marche (from 37.17 to 42.04 days) and Wales (from 28.67 to 35.08 days). On the contrary, no empirical structural breakpoints were observed in Belgium (ranging from 21.25 to 23.95 days) after the pandemic's beginning. Furthermore, we confirmed statistically significant differences between the observed trend and the forecasts for Aragon and Wales. Finally, we found the interaction between the region and the pandemic's start (before/after March 2020) significantly associated with the trend of delayed breast cancer treatment at the population level. CONCLUSIONS Although they were not clinically relevant, only Aragon and Wales showed significant differences with expected delays after March 2020. However, experiences differed between countries/regions, pointing to structural factors other than the pandemic.
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Affiliation(s)
- Francisco Estupiñán-Romero
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
| | - Santiago Royo-Sierra
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
| | - Javier González-Galindo
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
| | - Natalia Martínez-Lizaga
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
| | | | | | | | | | - Kris Henau
- Belgian Cancer Registry, Brussels, Belgium
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University (SU), Swansea, United Kingdom
| | - Sarah J Aldridge
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University (SU), Swansea, United Kingdom
| | - Andrea Faragalli
- Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche Home, Marche, Italy
| | - Flavia Carle
- Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche Home, Marche, Italy
| | - Rosaria Gesuita
- Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche Home, Marche, Italy
| | - Luigi Palmieri
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Italy
| | - Jānis Misiņš
- Department of Research and Health Statistics, Centre for Disease Prevention and Control (CDPC), Riga, Latvia
| | - Martin Thiβen
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Enrique Bernal-Delgado
- Data Science for Health Services and Policy Research, Health Science Institute in Aragon (IACS), Aragon, Spain
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Sommariva M, Dolci M, Triulzi T, Ambrogi F, Dugo M, De Cecco L, Le Noci V, Bernardo G, Anselmi M, Montanari E, Pupa SM, Signorini L, Gagliano N, Sfondrini L, Delbue S, Tagliabue E. Impact of in vitro SARS-CoV-2 infection on breast cancer cells. Sci Rep 2024; 14:13134. [PMID: 38849411 PMCID: PMC11161491 DOI: 10.1038/s41598-024-63804-3] [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: 07/23/2023] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
The pandemic of coronavirus disease 19 (COVID-19), caused by severe respiratory syndrome coronavirus 2 (SARS-CoV-2), had severe repercussions for breast cancer patients. Increasing evidence indicates that SARS-CoV-2 infection may directly impact breast cancer biology, but the effects of SARS-CoV-2 on breast tumor cells are still unknown. Here, we analyzed the molecular events occurring in the MCF7, MDA-MB-231 and HCC1937 breast cancer cell lines, representative of the luminal A, basal B/claudin-low and basal A subtypes, respectively, upon SARS-CoV-2 infection. Viral replication was monitored over time, and gene expression profiling was conducted. We found that MCF7 cells were the most permissive to viral replication. Treatment of MCF7 cells with Tamoxifen reduced the SARS-CoV-2 replication rate, suggesting an involvement of the estrogen receptor in sustaining virus replication in malignant cells. Interestingly, a metagene signature based on genes upregulated by SARS-CoV-2 infection in all three cell lines distinguished a subgroup of premenopausal luminal A breast cancer patients with a poor prognosis. As SARS-CoV-2 still spreads among the population, it is essential to understand the impact of SARS-CoV-2 infection on breast cancer, particularly in premenopausal patients diagnosed with the luminal A subtype, and to assess the long-term impact of COVID-19 on breast cancer outcomes.
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Affiliation(s)
- Michele Sommariva
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.
- Microambiente e Biomarcatori dei Tumori Solidi, Dipartimento di Oncologia Sperimentale, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Amadeo 42, 20133, Milan, Italy.
| | - Maria Dolci
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Via Pascal 36, 20133, Milan, Italy
| | - Tiziana Triulzi
- Microambiente e Biomarcatori dei Tumori Solidi, Dipartimento di Oncologia Sperimentale, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Amadeo 42, 20133, Milan, Italy
| | - Federico Ambrogi
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Via Celoria 22, 20133, Milan, Italy
| | - Matteo Dugo
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Loris De Cecco
- Integrated Biology of Rare Tumors, Dipartimento di Oncologia Sperimentale, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Amadeo 42, 20133, Milan, Italy
| | - Valentino Le Noci
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Giancarla Bernardo
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Martina Anselmi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Elena Montanari
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Serenella M Pupa
- Microambiente e Biomarcatori dei Tumori Solidi, Dipartimento di Oncologia Sperimentale, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Amadeo 42, 20133, Milan, Italy
| | - Lucia Signorini
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Via Pascal 36, 20133, Milan, Italy
| | - Nicoletta Gagliano
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Lucia Sfondrini
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
- Microambiente e Biomarcatori dei Tumori Solidi, Dipartimento di Oncologia Sperimentale, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Amadeo 42, 20133, Milan, Italy
| | - Serena Delbue
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Via Pascal 36, 20133, Milan, Italy
| | - Elda Tagliabue
- Microambiente e Biomarcatori dei Tumori Solidi, Dipartimento di Oncologia Sperimentale, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Amadeo 42, 20133, Milan, Italy
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Urbano Chamorro I, de la Torre-Montero JC. Cancer-related fatigue and activities of daily living: lessons learned from the COVID-19 pandemic. BMC Palliat Care 2024; 23:110. [PMID: 38678234 PMCID: PMC11055275 DOI: 10.1186/s12904-024-01437-z] [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: 12/15/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cancer-related fatigue is a prevalent condition in all stages of oncologic disease that is poorly diagnosed, with a negative impact on physical function to perform activities of daily living. Fatigue is also one of the main manifestations in post-COVID-19 syndrome, and few studies have explored the functionality of cancer patients after infection by the new coronavirus. This study was designed to assess cancer-related fatigue symptoms and their implications on physical function and quality of life during the pandemic. METHODOLOGY An observational study with a cross-sectional survey in cancer patients ≥ 18 years of age was conducted. The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F), the perception of asthenia and performance status were evaluated, and the differences between groups according to the history of COVID-19 were calculated. RESULTS A total of 60 cancer patients had an average age of 33.5 ± 10.11 years, 73.3% were female, and 98.3% had an Eastern Cooperative Oncology Group-Performance Status level < 2. Severe fatigue was found in 43.3% of patients, and the average FACIT-F score was 33.5 ± 10.11. The proportion of coronavirus infection was 13,3%, and the performance of this group was worse on the scale compared to the group without infection (25 ± 10,40 vs. 34,81 ± 9,50 [p = 0,009]). There was a significant correlation between visual analog scale values and FACIT-F scale scores (Pearson's r = -0.76). CONCLUSION SARS-CoV-2 infection could increase cancer-related fatigue symptoms, limiting activities of daily living and impairing quality of life.
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Affiliation(s)
- Iveth Urbano Chamorro
- Universidad Pontificia Comillas, Health Sciences Department, Madrid, Spain.
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Julio C de la Torre-Montero
- Universidad Pontificia Comillas, Health Sciences Department, Madrid, Spain
- Fundación San Juan de Dios, Madrid, Spain
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Bravo L, Vizcarra K, Zavaleta J, Paez KJ, Morante Z, Limache-García A, Saravia CH. Impact of the COVID-19 Pandemic on the Treatment of Cancer Patients at a Hospital in Peru. Cancer Control 2024; 31:10732748241276616. [PMID: 39155527 PMCID: PMC11331466 DOI: 10.1177/10732748241276616] [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: 05/01/2024] [Revised: 07/25/2024] [Accepted: 08/02/2024] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND The appearance of the new coronavirus, SARS-CoV-2, in Wuhan - China, in 2019 led to the declaration of a COVID-19 pandemic by the World Health Organization. Peru confirmed its first case on March 6, 2020, prompting a significant change in medical care. PURPOSE Our objective was to determine the impact of the COVID-19 pandemic on cancer treatment in Peru. METHODS A retrospective analysis of hospital data from the National Institute of Neoplastic Diseases revealed substantial decreases in oncological treatments in 2020 compared to 2019. RESULTS Oncological treatments involving bone marrow transplantation had a greater impact between the months of April and September, at -100% (p=0.003). However, treatments involving surgery in April (-95% [p≤0.001]), radiotherapy in May (-76% [p=0.002]) and chemotherapy in June (-71% [p≤0.001]) also showed significant impacts. Comparative analysis with international data revealed similar trends in cancer care interruptions in different countries. However, variations in the magnitude of the impact were observed, influenced by regional health policies and the severity of the pandemic. CONCLUSIONS The findings underscore the challenges cancer care providers face during public health crises, requiring adaptive strategies to ensure continued access to essential treatments. Addressing these challenges requires comprehensive public health responses to mitigate the impact of future crises on cancer care systems.
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Affiliation(s)
- Leny Bravo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Karla Vizcarra
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Jenny Zavaleta
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Kevin J. Paez
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Perú
| | - Zaida Morante
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
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El-Warrak L, Nunes M, Luna G, Barbosa CE, Lyra A, Argôlo M, Lima Y, Salazar H, de Souza JM. Towards the Future of Public Health: Roadmapping Trends and Scenarios in the Post-COVID Healthcare Era. Healthcare (Basel) 2023; 11:3118. [PMID: 38132008 PMCID: PMC10743190 DOI: 10.3390/healthcare11243118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
The COVID-19 pandemic, a transformative event in modern society, has disrupted routine, work, behavior, and human relationships. Organizations, amidst the chaos, have innovatively adapted to the evolving situation. However, many countries were unprepared for the magnitude of the challenge, revealing the fragility of health responses due to inadequate leadership, insufficient resources, and poor information system integration. Structural changes in health systems are imperative, particularly in leadership, governance, human resources, financing, information systems, technology, and health service provision. This research utilizes the Technological Roadmapping method to analyze the health sector, focusing on public health, drawing on articles from SCOPUS and PubMed databases, and creating a roadmap extending to 2050. The research presents three long-term scenarios based on the literature-derived roadmap and explores various alternatives, including integrated care, telemedicine, Big Data utilization, nanotechnology, and Big Tech's AI services. The results underscore the anticipation of post-pandemic public health with high expectations, emphasizing the importance of integrating health history access, encouraging self-care, and leveraging technology for streamlined treatment. Practical implications include insights for decision makers and stakeholders to inform strategic planning and adapt to evolving industry demands, recognizing the significance of preventive services and the humanizing potential of technology.
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Affiliation(s)
- Leonardo El-Warrak
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
| | - Mariano Nunes
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
| | - Gabriel Luna
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
| | - Carlos Eduardo Barbosa
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
- Centro de Análises de Sistemas Navais, Rio de Janeiro 20091-000, Brazil
| | - Alan Lyra
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
| | - Matheus Argôlo
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
| | - Yuri Lima
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
| | - Herbert Salazar
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
| | - Jano Moreira de Souza
- Graduate School of Engineering (COPPE), Universidade Federal do Rio de Janeiro (UFRJ), Avenida Horácio Macedo 2030, Centro de Tecnologia, Bloco H, Rio de Janeiro 21941-972, Brazil; (L.E.-W.); (G.L.); (Y.L.); (H.S.)
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Mousavi SE, Ilaghi M, Aslani A, Yekta Z, Nejadghaderi SA. A population-based study on incidence trends of myeloma in the United States over 2000-2020. Sci Rep 2023; 13:20705. [PMID: 38001246 PMCID: PMC10673923 DOI: 10.1038/s41598-023-47906-y] [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: 07/28/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023] Open
Abstract
Myeloma is one of the most common types of haematological malignancies. We aimed to investigate the incidence rates of myeloma by sex, race, age, and histological subgroups in the United States (US) over 2000-2020. Data were retrieved from the the Surveillance, Epidemiology, and End Results (SEER) 22 database. The International Classification of Diseases for Oncology version 3 morphological codes 9731, 9732, and 9734 were assigned for solitary plasmacytoma of bone, plasma cell myeloma, and extraosseous plasmacytoma, respectively. Average annual percent change (AAPC) and the pairwise comparison with the parallelism and coincidence were reported. All estimates were reported as counts and age-adjusted incidence rates per 100,000 individuals. Over 2000-2019, most of myeloma cases were among those aged at least 55 years (85.51%), men (54.82%), and non-Hispanic Whites (66.67%). Among different subtypes, plasma cell myeloma with 193,530 cases had the highest frequency over the same period. Also, there was a significant decrease in the age-standardized incidence rate of myeloma across all races/ethnicities in both sexes within all age groups (AAPC: - 8.02; 95% confidence interval (CI): - 10.43 to - 5.61) and those aged < 55 (AAPC: - 8.64; 95% CI - 11.02 to - 6.25) from 2019 to November 2020. The overall trends of myeloma incidence rates were not parallel, nor identical. There was an increase in myeloma incidence in both sexes, with a highly increasing rate, particularly among younger Hispanic and non-Hispanic Black women over 2000-2019. However, a remarkable decline was observed in the incidence rates following the COVID-19 pandemic in 2020.
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Affiliation(s)
- Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Community Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mehran Ilaghi
- Institute of Neuropharmacology, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Armin Aslani
- Department of Community Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Yekta
- Calaveras Department of Public Health, Calaveras County, CA, USA
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Systematic Review and Meta‑analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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Sun H, Zhang T, Wang X, Wang C, Zhang M, Song H. The occupational burnout among medical staff with high workloads after the COVID-19 and its association with anxiety and depression. Front Public Health 2023; 11:1270634. [PMID: 37954047 PMCID: PMC10639132 DOI: 10.3389/fpubh.2023.1270634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Objective After the end of COVID-19, medical staff were immediately faced with a high workload, leading to widespread occupational burnout. This study aims to explore the level and influencing factors of burnout among medical staff during this period, as well as its relationship with anxiety and depression. Methods The participants' levels of burnout were assessed using Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the reliability and validity of the questionnaire were evaluated through Cronbach's α and Confirmatory Factor Analysis (CFA). Independent sample t-test, chi-square test, and Pearson analysis were employed to determine the correlation between two sets of variables. Univariate and multivariate logistic regression analyses were conducted to identify significant factors influencing burnout. Finally, nomograms were used to predict the probability of burnout occurrence. Results This study collected a total of 1,550 questionnaires, and after excluding 45 questionnaires that were duplicates or incomplete, a sample of 1,505 (97.1%) participants were included in the final statistical analysis. Both Cronbach's α and the fit indices of CFA demonstrated excellent adaptability of the Chinese version of MBI-HSS in this study. The overall prevalence rates for emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA) were 52.4, 55.3, and 30.6%, respectively. Obtaining psychological support, health condition, relationship with family members, and insufficient sleep were identified as common contributing factors to burnout among medical staff. Additionally, age and promotion pressure were also associated with burnout among doctors, and exceeding legal working hours was an important factor for nurse burnout. The C-index for the nomograms predicting burnout among doctors and nurses was 0.832 and 0.843, respectively. Furthermore, burnout exhibited a significant linear correlation with anxiety and depression. Conclusion After the end of COVID-19, medical staff in high workload environments were facing severe burnout, which might lead to anxiety and depression. The occupational burnout of medical staff needed to be taken seriously and actively intervened.
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Affiliation(s)
- Hao Sun
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Tengfei Zhang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xinyu Wang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Caixia Wang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Mengqiao Zhang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongjiang Song
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
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10
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Mazidimoradi A, Sabet Birjandi S, Salehiniya H. Effect of coronavirus disease 2019 on diagnosis and treatment of hepatocellular carcinoma: a systematic review. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2023; 4:1039-1058. [PMID: 38023991 PMCID: PMC10651356 DOI: 10.37349/etat.2023.00179] [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: 02/07/2023] [Accepted: 08/28/2023] [Indexed: 12/01/2023] Open
Abstract
Aim Changes in strategies in the coronavirus disease 2019 (COVID-19) crisis and the imposing of restrictions have isolated many vulnerable patients including those with hepatocellular carcinoma (HCC) from routine medical care. This study investigated how the COVID-19 pandemic is affecting the diagnosis and treatment of HCC. Methods An extensive search was conducted in the PubMed, Scopus, and Web of Science databases by using the appropriate keywords: COVID-19, hepatocellular carcinoma, hepatocellular cancer, and MeSH. Studies in English related to the purpose of the study were included in the analysis, and review studies, case reports, letters to editors, comments, and reports were excluded. The quality of the studies was assessed by the "Adapted Newcastle-Ottawa Quality Assessment Scales" checklist. The Endnote X7 software has been used for managing items. Results The final qualitative analysis consisted of 27 articles. During the COVID-19 crisis, HCC diagnosis decreased from 20% to 34.13% compared to pre-crisis. The impact of the COVID-19 pandemic on HCC treatment encompasses a wide range of aspects. Generally, delays in treatment for patients with HCC ranged from more than one month for 21.5% of patients in France, to two months for 26% of patients in Italy, up to 30% in Austria, and 66.7% in Asia-Pacific countries. Conclusions According to the findings, developing and implementing appropriate diagnostic and therapeutic strategies and developing low-cost and high-precision screening programs among high-risk populations seem to be effective in reducing the impact of the COVID-19 pandemic on HCC management.
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Affiliation(s)
- Afrooz Mazidimoradi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Samane Sabet Birjandi
- Department of Midwifery, Birjand Branch Islamic Azad University, Birjand 97178-11111, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand 97178-53577, Iran
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11
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Duarte-Díaz A, Aparicio Betancourt M, Seils L, Orrego C, Perestelo-Pérez L, Barrio-Cortes J, Beca-Martínez MT, Bermejo-Caja CJ, González-González AI. COVID-19 healthcare and social-related needs from the perspective of Spanish patients and healthcare providers: a qualitative analysis of responses to open-ended questions. Front Public Health 2023; 11:1166317. [PMID: 37780448 PMCID: PMC10538718 DOI: 10.3389/fpubh.2023.1166317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/17/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Identifying stakeholders' needs is crucial to informing decisions and policy development. This study aims to identify healthcare and social-related needs and effective strategies associated with COVID-19 from the first-person perspectives of patients and healthcare providers. Methods Cross-sectional online survey design including qualitative open-ended questions, conducted in primary care and hospital settings across Spain, with 12 out of 19 regions represented. Adults aged 18 years and older, who (a) resided in Spain and had a history of COVID-19 or (b) worked as healthcare providers delivering direct or indirect care for people with COVID-19 in Spanish primary care or hospitals during 2020 were eligible to participate. Recruitment was conducted via social-media networks (Twitter, LinkedIn, and WhatsApp) and communication channels of key organizations including patient and professional associations and groups. A total of 182 people were invited to complete the surveys and 76 people completed the surveys (71% women), of which 33 were home-isolated patients, 14 were hospitalized patients, 16 were primary care professionals, and 13 were hospital care professionals. Results A total of 327 needs and 86 effective strategies and positive aspects were identified across surveys and classified into the following overarching themes: (i) Accessibility, (ii) Basic needs, (iii) Clinical care, (iv) Person-and-family centered care, (v) Caring for the healthcare professional, (vi) Protocolization, information, health campaigns, and education, (vii) Resource availability, (viii) and Organizational needs/strategies. Discussion Findings indicate the Spanish health and social care systems were generally unprepared to combat COVID-19. Implications for research, practice, and policy focus on integrating first-person perspectives as best practice to identify, prioritize and address needs to increase health and social care systems capacity and preparedness, as well as providing well-co-coordinated responses across government, healthcare, and non-government sectors to promote and protect the physical and mental health of all.
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Affiliation(s)
- Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), El Rosario, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - Mariana Aparicio Betancourt
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Laura Seils
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | - Carola Orrego
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), El Rosario, Spain
| | - Jaime Barrio-Cortes
- Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
- Fundación Para la Investigación e Innovación Biosanitaria en Atención Primaria, Madrid, Spain
- Faculty of Health Sciences, Universidad Camilo José Cela, Madrid, Spain
| | | | - Carlos Jesús Bermejo-Caja
- Unidad de Apoyo Técnico Dirección Técnica de Sistemas de Información, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Nursing Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ana Isabel González-González
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
- Unidad de Innovación y Proyectos Internacionales, Subdirección General de Investigación Sanitaria y Documentación, Dirección General Investigación y Docencia, Consejería de Sanidad, Madrid, Spain
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12
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González-Martín AM, Aguilera-García I, Castellote-Caballero Y, Rivas-Campo Y, Bernal-Suárez A, Aibar-Almazán A. Effectiveness of Therapeutic Education in Patients with Cancer Pain: Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:4123. [PMID: 37627151 PMCID: PMC10452673 DOI: 10.3390/cancers15164123] [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: 07/10/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Objective: To review the existing evidence on pain education in patients with pain derived from an oncological process. (2) Methods: A systematic review was conducted using the databases Pubmed, Web of Science, PEDro, and Scopus. The selected studies had to incorporate instruction about the neurophysiology of pain into their educational program. The target population was cancer patients who had suffered pain for at least one month. The methodological quality of the articles collected was assessed using the PEDro scale. (3) Results: Some 698 studies were initially identified, of which 12 were included in this review. Four different models of pain education programs were found in the studies' interventions. Pain intensity, pain experience, quality of life, pain tolerance, and catastrophism were the variables that appeared most frequently. (4) Conclusions: This review demonstrates that pain education in patients with cancer pain may produce effects such as decreased pain intensity and catastrophism. Knowledge about pain also seems to increase. However, no benefit was reported for patients' overall quality of life. Therefore, more research is needed to clarify the effects of these interventions on the oncology population.
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Affiliation(s)
- Ana María González-Martín
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, 35017 Las Palmas de Gran Canaria, Spain
- Department of Psychology, Higher Education Center for Teaching and Educational Research, Plaza de San Martín 4, 28013 Madrid, Spain
| | - Iván Aguilera-García
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | | | - Yulieth Rivas-Campo
- Faculty of Human and Social Sciences, University of San Buenaventura-Cali, Santiago de Cali 760016, Colombia
| | - Antonio Bernal-Suárez
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, 35017 Las Palmas de Gran Canaria, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
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13
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Bermúdez Castellanos I, Saornil Álvarez MA, Almaraz Gómez A, Villoría Díaz S, García Álvarez C. Impact of COVID-19 on a rare disease (uveal melanoma) in a national reference unit of intraocular tumors in Spain. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:254-258. [PMID: 37075839 PMCID: PMC10110274 DOI: 10.1016/j.oftale.2023.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/31/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To analyze the impact of the COVID-19 pandemic on the diagnosis and management of uveal melanoma (a tumor included in the Orphanet catalog of rare diseases) in a Spanish national reference unit for intraocular tumors during the first year of the pandemic. METHOD An observational retrospective study of patients with uveal melanoma in the National Reference Unit for Adult Intraocular Tumors of the Hospital Clínico Universitario de Valladolid (Spain) was performed, analyzing the pre- and post-COVID-19 periods: from March 15, 2019 to March 15, 2020 and from March 16, 2020 to March 16, 2021. Demographic data, diagnostic delay, tumor size, extraocular extension, treatment and evolution were collected. A multivariable logistic regression model was used to identify factors that were associated with the variable: enucleation. RESULTS Eighty-two patients with uveal melanoma were included, of which 42(51.21%) belonged to the pre-COVID-19 period and 40(40.78%) to the post-COVID-19 period. An increase in tumor size at diagnosis and in the number of enucleations was observed during the post-COVID-19 period (p < 0.05). Multivariable logistic regression demonstrated that both medium-large tumor size and patients diagnosed in the post-COVID-19 period were independently related to an increased risk of enucleation (OR 250, 95%CI, 27.69-2256.37; p < 0.01 and OR 10; 95%CI, 1.10-90.25; p = 0.04, respectively). CONCLUSIONS The increase in tumor size observed in uveal melanomas diagnosed during the first year of the COVID-19 pandemic may have favored the increase in the number of enucleations performed during that period.
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Affiliation(s)
| | - M A Saornil Álvarez
- Servicio de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Almaraz Gómez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | - S Villoría Díaz
- Servicio de oftalmología, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | - C García Álvarez
- Servicio de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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Global Health System Resilience during Encounters with Stressors - Lessons Learnt from Cancer Services during the COVID-19 Pandemic. Clin Oncol (R Coll Radiol) 2023; 35:e289-e300. [PMID: 36764875 PMCID: PMC9842532 DOI: 10.1016/j.clon.2023.01.004] [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: 05/14/2022] [Revised: 10/04/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
AIMS The protracted COVID-19 pandemic has overwhelmed health systems globally, including many aspects of cancer control. This has underscored the multidimensional nature of cancer control, which requires a more comprehensive approach involving taking a wider perspective of health systems. Here, we investigated aspects of health system resilience in maintaining cancer services globally during the COVID-19 pandemic. This will allow for health systems to be resilient to different types of system stressors/shocks in the future, to allow cancer care to be maintained optimally. MATERIALS AND METHODS Using the World Health Organization health system framework (capturing aspects of service delivery, health workforce, information, medical products, vaccines and technologies, financing and governance and leadership), we carried out a comparative analysis of the impact of COVID-19 and the synthesis of the findings in responses in cancer care in 10 countries/jurisdictions across four continents comprising a wide diversity of health systems, geographical regions and socioeconomic status (China, Colombia, Egypt, Hong Kong SAR, Indonesia, India, Singapore, Sri Lanka, UK and Zambia). A combination of literature and document reviews and interviews with experts was used. RESULTS Our study revealed that: (i) underlying weaknesses of health systems before the pandemic were exacerbated by the pandemic (e.g. economic issues in low- and middle-income countries led to greater shortage of medication and resource constraints compounded by inadequacies of public financing and issues of engagement with stakeholders and leadership/governance); (ii) no universal adaptive strategies were applicable to all the systems, highlighting the need for health systems to design emergency plans based on local context; (iii) despite the many differences between health systems, common issues were identified, such as the lack of contingency plan for pandemics, inadequate financial policies for cancer patients and lack of evidence-based approaches for competing priorities of cancer care/pandemic control. CONCLUSION We identified four key points/recommendations to enhance the resilient capacity of cancer care during the COVID-19 pandemic and other system stressors: (i) effective pandemic control approaches in general are essential to maintain the continuity of cancer care during the emergency health crises; (ii) strong health systems (with sufficient cancer care resources, e.g. health workforce, and universal health coverage) are fundamental to maintain quality care; (iii) the ability to develop response strategies and adapt to evolving evidence/circumstances is critical for health system resilience (including introducing systematic, consistent and evidence-based changes, national support and guidance in policy development and implementation); (iv) preparedness and contingency plans for future public health emergencies, engaging the whole of society, to achieve health system resilience for future crises and to transform healthcare delivery beyond the pandemic.
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15
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Impact of the COVID-19 Pandemic on Cancer Diagnosis in Madrid (Spain) Based on the RTMAD Tumor Registry (2019–2021). Cancers (Basel) 2023; 15:cancers15061753. [PMID: 36980640 PMCID: PMC10046347 DOI: 10.3390/cancers15061753] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused a significant disruption to cancer diagnosis, treatment and prevention worldwide that could have serious consequences in the near future. We intend to evaluate the weight of this backlog on a community-wide scale in Madrid during the period 2020–2021, and whether a stage shift towards the advanced stage has occurred. Cancer diagnoses in the Madrid tumor registry (RTMAD) from 2019–2021 were evaluated. Absolute and percentage differences in annual volume and observed-to-expected (O/E) volume ratios were calculated. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated using the O/E ratio. The SIR for 2020–2021 compared to 2019 was 94.5% (95% CI 93.8–95.3), with unequal gender-specific cancer diagnosis recovery (88.5% for males and 102.1% for females). Most cancer types were underdiagnosed in 2020. The tendency worsened in 2021 for colorectal and prostate cancers (87.8%), but lung cancer recovered (102.1%) and breast cancer was over-diagnosed (114.4%) compared with reference pre-COVID-19 data. These changes have modified the ranking of the most frequent malignancies diagnosed in Madrid. Breast cancer has overtaken colorectal and prostate cancers, displaced to second and third position, respectively. Not only was colorectal cancer diagnosis affected more as a consequence of the COVID-19 pandemic but diagnosis of this malignancy at the advance stage also increased by 3.6% in 2020 and 4.2% in 2021 compared to the reference period of 2019. In summary, there is a large volume of undetected cancer in Madrid caused by the reduced access to care secondary to the COVID-19 pandemic, especially regarding colorectal and prostate cancer. Strategies are needed to recover the backlog of diagnoses and effectively treat these cases in the future and solve the negative impact that will be caused by the diagnostic delay. Analyzing the impact of new diagnoses suffered by each different malignancy and their recovery will help to understand how the future allocation of resources should look.
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16
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Frisardi V, Brunetti O, Abbinante V, Ardigò M, Caolo G, Di Turi A, Torsello A, Napoli C, Mancini R, Belleudi V, Addis A, Di Bella O, Ciliberto G, Neri A, Corsini R, Ruggieri P, Pollorsi C, Silvestris N. Impact of COVID-19 pandemic on outpatient visit volume in cancer patients: Results of COMETA multicenter retrospective observational study. Front Public Health 2023; 11:1077103. [PMID: 36866103 PMCID: PMC9971950 DOI: 10.3389/fpubh.2023.1077103] [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: 10/22/2022] [Accepted: 01/26/2023] [Indexed: 02/16/2023] Open
Abstract
Objective To evaluate the impact of the COVID-19 pandemic on first and follow-up visits for cancer outpatients. Methods This is a multicenter retrospective observational study involving three Comprehensive Cancer Care Centers (CCCCs): IFO, including IRE and ISG in Rome, AUSL-IRCCS of Reggio Emilia, and IRCCS Giovanni Paolo II in Bari) and one oncology department in a Community Hospital (Saint'Andrea Hospital, Rome). From 1 January 2020 and 31 December 2021, we evaluated the volume of outpatient consultations (first visits and follow-up), comparing them with the pre-pandemic year (2019). Results were analyzed by quarter according to the Rt (real-time indicator used to assess the evolution of the pandemic). IFO and IRCCS Giovanni Paolo II were "COVID-free" while AUSL-IRCCS RE was a "COVID-mixed" Institute. Depending on the Rt, Sain't Andrea Hospital experienced a "swinging" organizational pathway (COVID-free/ COVID-mixed). Results Regarding the "first appointments", in 2020 the healthcare facilities operating in the North and Center of Italy showed a downward trend. In 2021, only AUSL-IRCCS RE showed an upward trend. Regarding the "follow-up", only AUSL IRCCS RE showed a slight up-trend in 2020. In 2021, IFO showed an increasing trend, while S. Andrea Hospital showed a negative plateau. Surprisingly, IRCCS Giovanni Paolo II in Bari showed an uptrend for both first appointment and follow-ups during pandemic and late pandemic except for the fourth quarter of 2021. Conclusions During the first pandemic wave, no significant difference was observed amongst COVID-free and COVID-mixed Institutes and between CCCCs and a Community Hospital. In 2021 ("late pandemic year"), it has been more convenient to organize COVID-mixed pathway in the CCCCs rather than to keep the Institutions COVID-free. A swinging modality in the Community Hospital did not offer positive results in term of visit volumes. Our study about the impact of COVID-19 pandemic on visit volume in cancer outpatients may help health systems to optimize the post-pandemic use of resources and improve healthcare policies.
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Affiliation(s)
- Vincenza Frisardi
- Department of Neuromotor Diseases, Geriatric Unit, AUSL IRCCS of Reggio Emilia, Reggio Emilia, Italy,*Correspondence: Vincenza Frisardi ✉
| | - Oronzo Brunetti
- Istituto Tumori “Giovanni Paolo II” of Bari, IRCCS, Bari, Italy
| | | | - Marco Ardigò
- San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | | | | | - Christian Napoli
- Sapienza University of Rome, Saint'Andrea Hospital, Rome, Lazio, Italy
| | - Rita Mancini
- Sapienza University of Rome, Saint'Andrea Hospital, Rome, Lazio, Italy
| | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | | | - Antonino Neri
- Scientific Directorate, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Romina Corsini
- Scientific Directorate, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Patrizia Ruggieri
- Scientific Directorate, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Pollorsi
- Department of Neuromotor Diseases, Geriatric Unit, AUSL IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, Messina, Italy
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Kamecki H, Rajwa P, Przewor A, Sosnowski R. The impact of coronavirus disease 2019 (COVID-19) pandemic on urologic cancer care: did we throw the baby out with the bathwater? Transl Androl Urol 2023; 12:1-4. [PMID: 36760874 PMCID: PMC9906107 DOI: 10.21037/tau-22-796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- Hubert Kamecki
- Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Paweł Rajwa
- Department of Urology, Medical University of Silesia, Zabrze, Poland;,Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Artur Przewor
- Department of Urogenital Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Roman Sosnowski
- Department of Urogenital Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Mora N, Fina F, Méndez-Boo L, Cantenys R, Benítez M, Moreno N, Balló E, Hermosilla E, Fàbregas M, Guiriguet C, Cos X, Rodoreda S, Mas A, Lejardi Y, Coma E, Medina M. "Decline and uneven recovery from 7 common long-term conditions managed in the Catalan primary care after two pandemic years: an observational retrospective population-based study using primary care electronic health records". BMC PRIMARY CARE 2023; 24:9. [PMID: 36641483 PMCID: PMC9840158 DOI: 10.1186/s12875-022-01935-0] [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: 09/12/2022] [Accepted: 12/01/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND The incidence of chronic diseases during the COVID-19 pandemic has drastically been reduced worldwide due to disruptions in healthcare systems. The aim of our study is to analyse the trends in the incidence of 7 commonly managed primary care chronic diseases during the last 2 years of the COVID-19 pandemic in Catalonia. METHODS We performed an observational retrospective population-based study using data from primary care electronic health records from January 2018 to August 2022 (5.1 million people older than 14 years). We divided the study period into two: a pre-pandemic period (before 14 March 2020) and a pandemic period. We performed a segmented regression analysis of daily incidence rates per 100,000 inhabitants of 7 chronic diseases: type 2 diabetes mellitus (T2DM), asthma, chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD), heart failure (HF), hypertension and hypercholesterolemia. In addition, we compared annual incidence between pandemic years (2020, 2021 and 2022) and 2019. Associated incidence rate ratios (IRR) were also calculated. Finally, we estimated the number of expected diagnoses during the pandemic period using data from 2019 and we compared it with the observed data. RESULTS We analysed 740,820 new chronic diseases' diagnoses. Daily incidence rates of all 7 chronic diseases were drastically interrupted on 14 March 2020, and a general upward trend was observed during the following months. Reductions in 2020 were around 30% for all conditions except COPD which had greater reductions (IRR: 0.58 [95% CI: 0.57 to 0.6]) and HF with lesser drops (IRR: 0.86 [95% CI: 0.84 to 0.88]). Some of the chronic conditions have returned to pre-pandemic diagnosis levels, except asthma, COPD and IHD. The return to pre-pandemic diagnosis levels compensated for the drops in 2020 for T2DM and HF, but not for hypertension which presented an incomplete recovery. We also observed an excess of hypercholesterolemia diagnoses of 8.5% (95%CI: 1.81% to 16.15%). CONCLUSIONS Although primary care has recovered the pre-pandemic diagnosis levels for some chronic diseases, there are still missing diagnoses of asthma, COPD and IHD that should be addressed.
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Affiliation(s)
- Núria Mora
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Francesc Fina
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Leonardo Méndez-Boo
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Roser Cantenys
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Mència Benítez
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària de Gòtic, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Nemesio Moreno
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Elisabet Balló
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Eduardo Hermosilla
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
| | - Mireia Fàbregas
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Carolina Guiriguet
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària de Gòtic, Institut Català de la Salut (ICS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Xavier Cos
- Direcció Assistencial d'Atenció Primària i a la Comunitat, Institut Català de la Salut (ICS), Barcelona, Spain
- DAP_Cat Research Group, Gerència Territorial Barcelona Ciutat, Institut Català de la Salut, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBERDEM, ISCIII , Madrid, Spain
| | - Sara Rodoreda
- Direcció Assistencial d'Atenció Primària i a la Comunitat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Ariadna Mas
- Direcció Assistencial d'Atenció Primària i a la Comunitat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Yolanda Lejardi
- Direcció Assistencial d'Atenció Primària i a la Comunitat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Ermengol Coma
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain.
| | - Manuel Medina
- Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
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19
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Villén N, Roso-Llorach A, Gallego-Moll C, Danes-Castells M, Fernández-Bertolin S, Troncoso-Mariño A, Monteagudo M, Amado E, Violán C. Polypharmacy Patterns in Multimorbid Older People with Cardiovascular Disease: Longitudinal Study. Geriatrics (Basel) 2022; 7:141. [PMID: 36547277 PMCID: PMC9777651 DOI: 10.3390/geriatrics7060141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/01/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
(1) Introduction: Cardiovascular disease is associated with high mortality, especially in older people. This study aimed to characterize the evolution of combined multimorbidity and polypharmacy patterns in older people with different cardiovascular disease profiles. (2) Material and methods: This longitudinal study drew data from the Information System for Research in Primary Care in people aged 65 to 99 years with profiles of cardiovascular multimorbidity. Combined patterns of multimorbidity and polypharmacy were analysed using fuzzy c-means clustering techniques and hidden Markov models. The prevalence, observed/expected ratio, and exclusivity of chronic diseases and/or groups of these with the corresponding medication were described. (3) Results: The study included 114,516 people, mostly men (59.6%) with a mean age of 78.8 years and a high prevalence of polypharmacy (83.5%). The following patterns were identified: Mental, behavioural, digestive and cerebrovascular; Neuropathy, autoimmune and musculoskeletal; Musculoskeletal, mental, behavioural, genitourinary, digestive and dermatological; Non-specific; Multisystemic; Respiratory, cardiovascular, behavioural and genitourinary; Diabetes and ischemic cardiopathy; and Cardiac. The prevalence of overrepresented health problems and drugs remained stable over the years, although by study end, cohort survivors had more polypharmacy and multimorbidity. Most people followed the same pattern over time; the most frequent transitions were from Non-specific to Mental, behavioural, digestive and cerebrovascular and from Musculoskeletal, mental, behavioural, genitourinary, digestive and dermatological to Non-specific. (4) Conclusions: Eight combined multimorbidity and polypharmacy patterns, differentiated by sex, remained stable over follow-up. Understanding the behaviour of different diseases and drugs can help design individualised interventions in populations with clinical complexity.
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Affiliation(s)
- Noemí Villén
- Medicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, Spain
- Department of Pediatrics, Obstetrics, Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain
| | - Albert Roso-Llorach
- Department of Pediatrics, Obstetrics, Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain
- IDIAP Research Institute, 08007 Barcelona, Spain
| | | | - Marc Danes-Castells
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- Sant Quirze del Vallès Primary Health Care Center Av. d′Ègara, s/n, Sant Quirze del Vallès, 08192 Barcelona, Spain
| | | | - Amelia Troncoso-Mariño
- Medicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, Spain
| | | | - Ester Amado
- Medicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, Spain
| | - Concepción Violán
- Department of Pediatrics, Obstetrics, Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- North Metropolitan Research Support Unit, IDIAP Research Institute, Mataró, 08303 Barcelona, Spain
- North Metropolitan Primary Health Care Administration, Institut Català de Salut, Ctra. de Barcelona, 473, Sabadell, 08204 Barcelona, Spain
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20
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Garlasco J, Canepari A, Giacobone G, Funicelli G, Kozel D, Bernini L, Cotroneo A. Impact of COVID-19 on healthcare waste generation: Correlations and trends from a tertiary hospital of a developed country. WASTE MANAGEMENT & RESEARCH : THE JOURNAL OF THE INTERNATIONAL SOLID WASTES AND PUBLIC CLEANSING ASSOCIATION, ISWA 2022; 40:1450-1457. [PMID: 35088653 DOI: 10.1177/0734242x221074195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The SARS-CoV-2 (COVID-19) coronavirus pandemic has represented an emergency not only from a clinical point of view, but also for the environment due to the largely increased waste disposal. This study aimed at estimating, in the context of current trends, the increase in healthcare waste (HW) generation during the outbreak, based on data from a tertiary hospital. From the purveying office statements of 'SS Antonio e Biagio e Cesare Arrigo' Hospital of Alessandria (Italy), monthly HW generation data from January 2015 to March 2021 were retrospectively retrieved. Trends and COVID's impact were evaluated by Interrupted Time Series (ITS) design with linear regression models. Locally Weighted Scatterplot Smoothing was used to model the relation between infectious HW generation and proportion of COVID-related bed days. HW generation rose from 35.9 ± 3.8 tonnes month-1 (2.4 ± 0.2 kg per patient-day, kg PD-1) in 2015-2019, to 46.3 ± 6.0 tonnes month-1 (3.3 ± 0.7 kg PD-1) during the outbreak. The increasing trend was not appreciably modified as for its slope (p = 0.363), while a significant level change was found between baseline and outbreak (+ 0.72 kg PD-1, p < 0.001). The proportion of COVID-related bed days non-linearly affected the infectious HW generated per patient-day, with steeper increases for proportions above 20%. The study showed a significant rise in HW generation in 2020-2021, reasonably due to the COVID outbreak; in addition, the generally increasing trend was not affected. Therefore, urgent measures are needed to conciliate safety requirements with HW generation issues.
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Affiliation(s)
- Jacopo Garlasco
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Alessandro Canepari
- Medical Direction Department, 'SS. Antonio e Biagio e Cesare Arrigo' Hospital, Alessandria, Italy
| | - Gilda Giacobone
- Logistics and Purveying Office, 'SS. Antonio e Biagio e Cesare Arrigo' Hospital, Alessandria, Italy
| | - Gemma Funicelli
- Medical Direction Department, 'SS. Antonio e Biagio e Cesare Arrigo' Hospital, Alessandria, Italy
- Forensic Medicine Unit, 'ATS Milano' Local Health Authority, Milan, Italy
| | - Daniela Kozel
- Medical Direction Department, 'SS. Antonio e Biagio e Cesare Arrigo' Hospital, Alessandria, Italy
- Medical Direction Department, 'Maggiore della Carità' University Hospital, Novara, Italy
| | - Luciano Bernini
- Medical Direction Department, 'SS. Antonio e Biagio e Cesare Arrigo' Hospital, Alessandria, Italy
| | - Alida Cotroneo
- Medical Direction Department, 'SS. Antonio e Biagio e Cesare Arrigo' Hospital, Alessandria, Italy
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21
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[What have we missed because of COVID-19? Missed diagnoses and delayed follow-ups. SESPAS Report 2022]. GACETA SANITARIA 2022; 36 Suppl 1:S36-S43. [PMID: 35781146 PMCID: PMC9244613 DOI: 10.1016/j.gaceta.2022.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022]
Abstract
La pandemia de COVID-19 y la emergencia de salud pública asociada han afectado a los/las pacientes y a los servicios de salud en lo que respecta a las patologías no relacionadas con la COVID-19. Diversos estudios han evidenciado su desvinculación con los servicios sanitarios, con disminución de las consultas a los servicios de urgencias, de los ingresos hospitalarios de patologías no COVID-19, así como de la incidencia semanal notificada de enfermedades agudas y nuevos diagnósticos en atención primaria. Paralelamente, la pandemia ha tenido efectos directos e indirectos en las personas con enfermedades crónicas; las dificultades de acceso a los servicios sanitarios, la interrupción de la atención, la saturación del propio sistema y su reorientación hacia formatos no presenciales ha reducido la capacidad de prevenir o controlar las enfermedades crónicas, impactando además en los diferentes ámbitos de la vida de las personas, creando nuevas dificultades sociales y económicas, o agravando las preexistentes antes de la pandemia. Todas estas circunstancias se han ido modificando con cada una de las olas epidémicas. Se presenta una revisión de los estudios más relevantes que han ido analizando este problema y se incorporan como estudio de caso los resultados de un estudio observacional retrospectivo realizado en atención primaria en Madrid, que da cobertura sanitaria a una población de más de 6 millones de personas, y cuyo objetivo ha sido analizar la pérdida de nuevos diagnósticos en las patologías más prevalentes, como los problemas comunes de salud mental, enfermedades cardiovasculares y cerebrovasculares, diabetes tipo 2, enfermedad pulmonar obstructiva crónica y tumores de mama y de colon, en la primera y la segunda olas. Se calcularon las tasas de incidencia anual con su intervalo de confianza para cada patología y se comparó la frecuencia mensual de los nuevos códigos registrados entre el 1 de enero y el 31 de diciembre de 2020 con la media mensual de los recuentos observados para los mismos meses en 2016-2019. La tasa de incidencia anual para todos los procesos estudiados disminuyó en 2020, excepto para los trastornos de ansiedad. En relación con la recuperación de los diagnósticos perdidos, la insuficiencia cardiaca es el único diagnóstico que presenta una recuperación por encima de la media después de la primera ola. Para volver a los niveles prepandémicos de diagnóstico y seguimiento de la patología no COVID-19, el sistema sanitario debe reorganizarse y contemplar acciones específicas para los grupos de mayor riesgo.
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22
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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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23
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Lee DH, Chung SW, Lee JH, Kim HY, Chung GE, Kim MS, Yang BR, Nam JY, Lee YB, Kim YJ, Yoon JH. Association of Chronic Hepatitis B Infection and Antiviral Treatment With the Development of the Extrahepatic Malignancies: A Nationwide Cohort Study. J Clin Oncol 2022; 40:3394-3405. [PMID: 35561284 DOI: 10.1200/jco.21.01285] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Epidemiologic studies suggest that chronic hepatitis B (CHB) is a risk factor for various primary extrahepatic malignancies. Our aim was to evaluate the associations of CHB and nucleos(t)ide analog (NA) treatment with the risk of the development of extrahepatic malignancies. PATIENTS AND METHODS We conducted an 18-month landmark analysis using nationwide claims data from the National Health Insurance Service of South Korea. Patients newly diagnosed with CHB in 2012-2014 (n = 90,944) and matched-controls (n = 685,436) were included. Patients with CHB were further classified as the NA-treated (CHB+/NA+, n = 6,539) or the NA-untreated (CHB+/NA-, n = 84,405) group. Inverse probability of treatment weighting analysis was applied to balance the treatment groups. Time-varying Cox analysis was performed to evaluate time-varying effect of NA treatment. The primary outcome was the development of any primary extrahepatic malignancy. Development of intrahepatic malignancy and death were considered as competing events. RESULTS During the study period (median = 47.4 months), 30,413 patients (3.9%) developed any extrahepatic malignancy. The CHB+/NA- group had a higher overall risk of extrahepatic malignancy than the CHB+/NA+ group (adjusted subdistribution hazard ratio [aSHR] = 1.28; 95% CI, 1.12 to 1.45; P < .001) or controls (aSHR = 1.22; 95% CI, 1.18 to 1.26; P < .001). There was no difference in the risk of extrahepatic malignancy between the CHB+/NA+ group and the controls (CHB+/NA+ v control: aSHR = 0.96; 95% CI, 0.84 to 1.08; P = .48). In time-varying Cox analysis, the CHB+/NA- patients were associated with a higher risk of extrahepatic malignancy than the CHB+/NA+ patients (aSHR = 1.37; 95% CI, 1.23 to 1.52; P < .001). CONCLUSION Patients with CHB have an elevated risk of developing primary extrahepatic malignancy. Long-term NA treatment was associated with a lower risk of extrahepatic malignancy development among patients with CHB.
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Affiliation(s)
- Dong Hyeon Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.,Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sung Won Chung
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Jeong-Hoon Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Hwi Young Kim
- Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Goh Eun Chung
- Department of Internal Medicine, Healthcare System Gangnam Center Seoul National University Hospital, Seoul, South Korea
| | - Mi-Sook Kim
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South Korea
| | - Bo Ram Yang
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South Korea.,College of Pharmacy, Chungnam National University, Daejeon, South Korea
| | - Joon Yeul Nam
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Yun Bin Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Yoon Jun Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung-Hwan Yoon
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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24
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Ribes J, Pareja L, Sanz X, Mosteiro S, Escribà JM, Esteban L, Gálvez J, Osca G, Rodenas P, Pérez-Sust P, Borràs JM. Cancer diagnosis in Catalonia (Spain) after two years of COVID-19 pandemic: an incomplete recovery. ESMO Open 2022; 7:100486. [PMID: 35714476 PMCID: PMC9197337 DOI: 10.1016/j.esmoop.2022.100486] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- J Ribes
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain; Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain.
| | - L Pareja
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - X Sanz
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain
| | - S Mosteiro
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - J M Escribà
- Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain; Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - L Esteban
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain
| | - J Gálvez
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - G Osca
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - P Rodenas
- Catalan Electronic Health Record, EHealth Office, Health/Catalan Health Service, Department of Health of Catalonia, Barcelona, Spain
| | - P Pérez-Sust
- CatSalut Information Systems and Health Department ICT Unit, Barcelona, Spain
| | - J M Borràs
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain
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25
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Carretero-Barrio I, Lop-Gros J, Iglesias M, Martínez C, Matias-Guiu X, Pérez-Mies B, Palacios J. Impact of the COVID-19 pandemic on pathology training: a survey among Spanish residents. Virchows Arch 2022; 481:505-509. [PMID: 35352148 PMCID: PMC8964236 DOI: 10.1007/s00428-022-03303-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/17/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
Abstract
This study aimed to assess the impact of the COVID-19 pandemic on the training of Spanish pathology residents by conducting an online survey. It was distributed among the pathologists who had been residents during the pandemic and consisted of 31 questions about the demographics and the impact of the pandemic on their pathology training. In total, 114 residents completed the survey; they reported a decrease in the number of biopsies, cytology samples, autopsies, research activities, sessions, case corrections, and courses, as well as the detrimental effect this had on their training. Half of the residents had to cancel rotations and 32% were redeployed to other departments. The COVID-19 pandemic has affected pathology training, and our results can be used to understand the challenges residents have faced and mitigate their impact.
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26
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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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Covid-19's impact on radiotherapy in the Republic of Srpska. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp211018024k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. The aim of this epidemiological study was to investigate the
impact of the Covid-19 pandemic on the weekly number of external beam
radiotherapy (EBRT) fractions and monthly brachytherapy (BT) applications,
without intentional hypofractionation. We also investigated how the pandemic
affected the number of EBRT patients younger and older than 70 years.
Methods. The Affidea Radiotherapy Center, Banja Luka (BL), provides
radiotherapy (RT) to the population (1.15 million) of the Republic of Srpska
(Bosnia and Herzegovina). We analyzed the period of 14 months before the
onset and the same period during the Covid-19. Results. The average weekly
number of EBRT fractions from January 2019 to the end of February 2020, was
680.5 (SD 67.4), and from March 2020 to the end of April 2021, it was 617.1
(SD 96.4). During April 2020, the weekly number of the EBRT decreased by
67.9 % compared to the same period in 2019, while in March 2021 it fell by
42.4 %. Paired samples T-test showed that the occurrence of the Covid-19
pandemic had a statistically significant effect t(60)=4.627, p<0.05, on the
reduction in the number of weekly EBRT fractions in BL RT center. When
comparing EBRT patients over 70 years old to those fewer than 70 years old,
the decrease was 16.3 % vs. 1.6 %, respectively. The Wilcoxon signed-rank
test revealed that the Covid-19 pandemic had a statistically significant
effect (Z=-2.42, p=0.016) on reducing the number of monthly BT applications.
Conclusion. A statistically significant decline in EBRT and BT was observed
in BL RT Centre for the first fourteen months of the pandemic. The "waves"
of the pandemic "closed" the medical wards needed for the diagnosis and
therapy of oncology patients and converted them into Covid-19. Therefore,
some oncology patients who would have had indication for RT never received
it.
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Martínez MT, Moragon S, Ortega-Morillo B, Montón-Bueno J, Simon S, Roselló S, Insa A, Viala A, Navarro J, Sanmartín A, Fluixá C, Julve A, Soriano D, Buch E, Peña A, Franco J, Martínez-Jabaloyas J, Marco J, Forner MJ, Cano A, Silvestre A, Teruel A, Bermejo B, Cervantes A, Chirivella Gonzalez I. Impact of the COVID-19 Pandemic on a Cancer Fast-Track Programme. Cancer Control 2022; 29:10732748221131000. [DOI: 10.1177/10732748221131000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly regarding early cancer diagnosis, sparking public health concerns that possible delays could increase the proportion of patients diagnosed at advanced stages. In 2009, a cancer fast-track program (CFP) was implemented at the Clinico-Malvarrosa Health Department in Valencia, Spain with the aim of shortening waiting times between suspected cancer symptoms, diagnosis and therapy initiation. Objectives The study aimed to explore the effects of the COVID-19 pandemic on our cancer diagnosis fast-track program. Methods The program workflow (patients included and time periods) was analysed from the beginning of the state of alarm on March 16th, 2020 until March 15th, 2021. Data was compared with data from the same period of time from the year before (2019). Results During the pandemic year, 975 suspected cancer cases were submitted to the CFP. The number of submissions only decreased during times of highest COVID-19 incidence and stricter lockdown, and overall, referrals were slightly higher than in the previous 2 years. Cancer diagnosis was confirmed in 197 (24.1%) cases, among which 33% were urological, 23% breast, 16% gastrointestinal and 9% lung cancer. The median time from referral to specialist appointment was 13 days and diagnosis was reached at a median of 18 days. In confirmed cancer cases, treatment was started at around 30 days from time of diagnosis. In total, 61% of cancer disease was detected at early stage, 20% at locally advanced stage, and 19% at advanced stage, displaying time frames and case proportions similar to pre-pandemic years. Conclusions Our program has been able to maintain normal flow and efficacy despite the challenges of the current pandemic, and has proven a reliable tool to help primary care physicians referring suspected cancer patients.
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Affiliation(s)
- M. T. Martínez
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - S. Moragon
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - B. Ortega-Morillo
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - J. Montón-Bueno
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - S. Simon
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - S. Roselló
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
- Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
| | - A. Insa
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - A. Viala
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - J. Navarro
- Management Department, Hospital Clinico Universitario de Valencia, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
- CIBERESP (CIBER de Epidemiología y Salud Pública), Centro Nacional de Epidemiología Del Instituto de Salud Carlos III, Madrid, Spain
| | - A. Sanmartín
- Management Department, Hospital Clinico Universitario de Valencia, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - C. Fluixá
- Alfahuir Primare Care Center, Valencia, Spain
| | - A. Julve
- Department of Radiodiagnosis, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - D. Soriano
- Department of Radiodiagnosis, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - E. Buch
- Department of Surgery, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - A. Peña
- Department of Medicine Digestive, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - J. Franco
- Department of Pneumology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - J. Martínez-Jabaloyas
- Department of Urology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - J. Marco
- Department of Otolaryngology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - M. J. Forner
- Department of Internal Medicine, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - A. Cano
- Department of Gynaecology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - A. Silvestre
- Department of Traumatology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - A Teruel
- Department of Haematology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - B. Bermejo
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
- Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
| | - A. Cervantes
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
- Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
| | - I. Chirivella Gonzalez
- Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
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Differences in the Impact of COVID-19 on Pathology Laboratories and Cancer Diagnosis in Girona. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413269. [PMID: 34948878 PMCID: PMC8701849 DOI: 10.3390/ijerph182413269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/18/2022]
Abstract
Introduction: The recent COVID-19 pandemic has compromised socio-health care, with consequences for the diagnosis and follow-up of other pathologies. The aim of this study was to evaluate the impact of COVID-19 on cancer diagnosis in Girona, Spain. Methodology: Observational study of samples received in two pathology laboratories during 2019–2020 (tertiary hospital in Girona and county hospital in Figueres). Date, sample type, and location and morphology were available. Samples were recoded to determine malignancy and grouped by location. Comparisons were made by calendar year and period of exposure to COVID-19. Results: 102,360 samples were included: 80,517 from Girona and 21,843 from Figueres. The reduction in activity in the pathology laboratories in 2020 compared to the previous year was 25.4% in Girona and 27.5% in Figueres. The reduction in cancer diagnoses in 2020 compared to 2019 was 6.8% in Girona and 21% in Figueres. In both laboratories, a decrease was observed in the diagnoses of neoplasms of the lip, oral cavity and pharynx, larynx, colon, rectum and anus, kidney and urinary system, melanoma, and central nervous system. A statistically significant higher probability of a sample received in the pathology laboratory displaying malignancy during COVID-19 was found (Girona: OR = 1.28, 95% CI: 1.23–1.34; Figueres: OR = 1.10, 95% CI: 1.01–1.20) with respect to the COVID-19-free period. Conclusions: The COVID-19 pandemic has resulted in a reduction in cancer diagnoses by pathology departments that varies according to tumor location and type of hospital. Despite this, the optimization of care resources and the recovery effort have partially reduced the impact of the pandemic in certain neoplasms.
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30
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Martinez-Lopez J, Hernandez-Ibarburu G, Alonso R, Sanchez-Pina JM, Zamanillo I, Lopez-Muñoz N, Iñiguez R, Cuellar C, Calbacho M, Paciello ML, Ayala R, García-Barrio N, Perez-Rey D, Meloni L, Cruz J, Pedrera-Jiménez M, Serrano-Balazote P, de la Cruz J. Impact of COVID-19 in patients with multiple myeloma based on a global data network. Blood Cancer J 2021; 11:198. [PMID: 34893583 PMCID: PMC8661359 DOI: 10.1038/s41408-021-00588-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic has represented a major cause of morbidity/mortality worldwide, overstressing health systems. Multiple myeloma (MM) patients show an increased risk for infections and they are expected to be particularly vulnerable to SARS-CoV-2 infection. Here we have obtained a comprehensive picture of the impact of COVID-19 in MM patients on a local and a global scale using a federated data research network (TriNetX) that provided access to Electronic Medical Records (EMR) from Health Care Organizations (HCO) all over the world. Through propensity score matched analyses we found that the number of new diagnoses of MM was reduced in 2020 compared to 2019 (RR 0.86, 95%CI 0.76-0.96) and the survival of newly diagnosed MM cases decreased similarly (HR 0.61, 0.38-0.81). MM patients showed higher risk of SARS-CoV-2 infection (RR 2.09, 1.58-2.76) and a higher excess mortality in 2020 (difference in excess mortality 9%, 4.4-13.2) than non-MM patients. By interrogating large EMR datasets from HCO in Europe and globally, we confirmed that MM patients have been more severely impacted by COVID-19 pandemic than non-MM patients. This study highlights the necessity of extending preventive measures worlwide to protect vulnerable patients from SARS-CoV-2 infection by promoting social distancing and an intensive vaccination strategies.
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Affiliation(s)
- J Martinez-Lopez
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain.
| | | | - R Alonso
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - J M Sanchez-Pina
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - I Zamanillo
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - N Lopez-Muñoz
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - Rodrigo Iñiguez
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - C Cuellar
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - M Calbacho
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - M L Paciello
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | - R Ayala
- Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain
| | | | - D Perez-Rey
- Biomedical Informatics Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - L Meloni
- TriNetX, LLC, Cambridge, MA, USA
| | - J Cruz
- Data Science Group, Hospital 12 de Octubre, Madrid, Spain
| | | | | | - J de la Cruz
- Research Institute imas12, Hospital 12 de Octubre, Madrid, Spain
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Mazidimoradi A, Hadavandsiri F, Momenimovahed Z, Salehiniya H. Impact of the COVID-19 Pandemic on Colorectal Cancer Diagnosis and Treatment: a Systematic Review. J Gastrointest Cancer 2021; 54:171-187. [PMID: 34843058 PMCID: PMC8628028 DOI: 10.1007/s12029-021-00752-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 02/06/2023]
Abstract
Background Following the official announcement of the COVID-19 pandemic by the World Health Organization (WHO) in March 2020 and decreased activity of healthcare systems, relocation of resources, and the possible reluctance of patients to seek medical help, colorectal cancer patients were exposed to significant risks. Given that colon cancer is the third most common cancer and the second deadliest cancer in the world, its timely diagnosis and treatment are necessary to reduce costs and improve quality of life and patient survival. The aim of this study was to investigate the effects of COVID-19 pandemic on the diagnosis and treatment of colorectal cancer. Methods and Materials A comprehensive search performed on June 2021 in various databases, including Medline, Web of Science, and Scopus. Keywords such as “diagnosis,” “treatment,” “coronavirus disease-19,” “COVID-19,” “coronavirus disease,” “SARS-CoV-2 infection,” “SARS-CoV-2,” “2019-nCoV,” “coronavirus, 2019 novel,” “SARS-CoV-2 virus,” severe acute respiratory syndrome coronavirus 2,” “COVID-19,” “COVID-19, coronavirus disease 19,” “SARS coronavirus 2,” “colorectal neoplasm,” and “colorectal cancer “ was used individually or a combination of these words. All retrieved articles were entered into a database on EndNote X7. Then, studies were first selected by title and then by abstract, and at the end, full texts were investigated. Results Of the 850 studies, 43 were identified as eligible. According to studies, the diagnosis of colorectal cancer and the number of diagnostic procedures have decreased. Emergency visits due to obstruction or perforation of the large intestine or in advanced stages of cancer have increased, and a delay in the diagnosis of colorectal cancer has reported from 5.4 to 26%. Treatment of colorectal cancer has also decreased significantly or has been delayed, interrupted, or stopped. This reduction and delay have been observed in all treatments, including surgery, chemotherapy, and long-term radiation therapy; only cases of emergency surgery and short-term radiotherapy has increased. The waiting time for hospitalization and the length of hospital stay after surgery has been reported to be higher. Changes in patients’ treatment plans and complete to partial cessation of hospitals activities—that provided treatment services—were reported. Conclusion According to the reduction in the diagnosis and treatment of colorectal cancer due to the COVID-19 pandemic, compensating for the reduction and preventing the continuation of this declining trend, requires serious and effective interventions to prevent its subsequent consequences, including referrals of people with advanced stages and emergency conditions, increasing treatment costs and reducing the quality of life and patients survival.
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Affiliation(s)
| | - Fatemeh Hadavandsiri
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.
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Marzo-Castillejo M, Guiriguet Capdevila C, Coma Redon E. [The impact of COVID-19 on cancer diagnosis delay: possible consequences]. Aten Primaria 2021; 53:102142. [PMID: 34547579 PMCID: PMC8206581 DOI: 10.1016/j.aprim.2021.102142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Mercè Marzo-Castillejo
- Unitat de Suport a la Recerca Costa de Ponent, IDIAP Jordi Gol, Institut Català de la Salut (ICS), Cornellà de Llobregat, Barcelona, España.
| | - Carolina Guiriguet Capdevila
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, España
| | - Ermengol Coma Redon
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, España
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33
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Significant Decrease in Annual Cancer Diagnoses in Spain during the COVID-19 Pandemic: A Real-Data Study. Cancers (Basel) 2021; 13:cancers13133215. [PMID: 34203185 PMCID: PMC8267675 DOI: 10.3390/cancers13133215] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/20/2021] [Accepted: 06/25/2021] [Indexed: 01/09/2023] Open
Abstract
The COVID-19 pandemic has caused a profound change in health organizations at both the primary and hospital care levels. This cross-sectional study aims to investigate the impact of the COVID-19 pandemic in the annual rate of new cancer diagnosis in two university-affiliated hospitals. This study includes all the patients with a pathological diagnosis of cancer attended in two hospitals in Málaga (Spain) during the first year of pandemic. This study population was compared with the patients diagnosed during the previous year 2019. To analyze whether the possible differences in the annual rate of diagnoses were due to the pandemic or to other causes, the patients diagnosed during 2018 and 2017 were also compared. There were 2340 new cancer diagnosis compared to 2825 patients in 2019 which represented a decrease of -17.2% (p = 0.0001). Differences in the number of cancer patients diagnosed between 2018 and 2019 (2840 new cases; 0.5% increase) or 2017 and 2019 (2909 new cases; 3% increase) were not statistically significant. The highest number of patients lost from diagnosis in 2020 was in breast cancer (-26.1%), colorectal neoplasms (-16.9%), and head and neck tumors (-19.8%). The study of incidence rates throughout the first year of the COVID-19 pandemic shows that the diagnosis of new cancer patients has been significantly impaired. Health systems must take the necessary measures to restore pre-pandemic diagnostic procedures and to recover lost patients who have not been diagnosed.
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