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O’Driscoll J, Mooney T, Kearney P, Williams Y, Lynch S, Connors A, Larke A, McNally S, O’Doherty A, Murphy L, Bennett KE, Fitzpatrick P, Mullooly M, Flanagan F. Examining the impact of COVID-19 disruptions on population-based breast cancer screening in Ireland. J Med Screen 2024; 31:182-190. [PMID: 38509806 PMCID: PMC11330080 DOI: 10.1177/09691413241232899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/08/2023] [Accepted: 01/23/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Many population-based breast screening programmes temporarily suspended routine screening following the COVID-19 pandemic onset. This study aimed to describe screening mammography utilisation and the pattern of screen-detected breast cancer diagnoses following COVID-19-related screening disruptions in Ireland. METHODS Using anonymous aggregate data from women invited for routine screening, three time periods were examined: (1) January-December 2019, (2) January-December 2020, and (3) January-December 2021. Descriptive statistics were conducted and comparisons between groups were performed using chi-square tests. RESULTS In 2020, screening mammography capacity fell by 67.1% compared to 2019; recovering to 75% of mammograms performed in 2019, during 2021. Compared to 2019, for screen-detected invasive breast cancers, a reduction in Grade 1 (14.2% vs. 17.2%) and Grade 2 tumours (53.4% vs. 58.0%) and an increase in Grade 3 tumours (32.4% vs. 24.8%) was observed in 2020 (p = 0.03); whereas an increase in Grade 2 tumours (63.3% vs. 58.0%) and a reduction in Grade 3 tumours (19.6% vs. 24.8%) was found in 2021 (p = 0.02). No changes in oestrogen receptor-positive or nodal-positive diagnoses were observed; however the proportion of oestrogen/progesterone receptor-positive breast cancers significantly increased in 2020 (76.2%; p < 0.01) and 2021 (78.7%; p < 0.001) compared to 2019 (67.8%). CONCLUSION These findings demonstrate signs of a grade change for screen-detected invasive breast cancers early in the pandemic, with recovery evident in 2021, and without an increase in nodal positivity. Future studies are needed to determine the COVID-19 impact on long-term breast cancer outcomes including mortality.
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Affiliation(s)
- Jessica O’Driscoll
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | | | | | | | - Aideen Larke
- BreastCheck, National Screening Service, Ireland
| | | | | | - Laura Murphy
- BreastCheck, National Screening Service, Ireland
| | - Kathleen E. Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Patricia Fitzpatrick
- National Screening Service, Dublin, Ireland
- School of Public Health, Physiotherapy & Sports Science, University College Dublin, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Stephanopoli JP, Bouazzi L, Guerbaz-Sommi M, Graesslin O, Hurtaud A, Ilardo S, Chrusciel J, Barbaret C, Bertrand C, Sanchez S. Factors associated with deferral or non-performance of an organized breast cancer screening program during the COVID-19 pandemic in France. Cancer Med 2024; 13:e7444. [PMID: 39192606 DOI: 10.1002/cam4.7444] [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: 02/11/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Delays in detection and treatment of breast cancer can lead to increased mortality. To date, participation in organized breast cancer screenings (OBCS) has been suboptimal worldwide. The objective of this study was to investigate the factors associated with deferral or non-performance of mammography during the COVID-19 pandemic for women who had previously participated in OBCS. METHODS A retrospective observational study was conducted on a cohort of 6282 women from the Aube Department of France, who were invited to an OBCS in 2020. Participants were divided into women who promptly underwent screening after receiving an invitation (between 22 and 25 months elapsed since the last mammogram), women who underwent late screening (≥26 months since the last mammogram), and those who were never screened. Data were collected from a self-reported questionnaire. Comparative and multivariable analyses modeling the probability of each type of attendance were performed using these data. RESULTS In total, 2301 women (aged 50-74 years) returned a valid questionnaire. Compared to women who promptly underwent mammography, non- and late-screening participants were younger, had less frequent gynecological follow-up and a less frequent history of colorectal cancer screening. Women with higher education status and those residing in socially disadvantaged areas were more likely to attend late. CONCLUSION The absence of regular gynecological follow-up and the absence of colorectal cancer screening were significant factors associated with deferral of or non-attendance at OBCS.
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Affiliation(s)
- Jean Papadacci Stephanopoli
- Department of General Medicine, Université de Reims Champagne-Ardenne, Reims, Marne, France
- Médecine générale, Maison de Santé Pluriprofessionnelle de la Forêt d'Orient, Piney, Aube, France
| | - Leila Bouazzi
- Comité Universitaire de Ressources pour la Recherche en Santé,, Université de Reims Champagne-Ardenne, Reims, Marne, France
| | - Myriam Guerbaz-Sommi
- CRCDC, Centre Régional de Coordination des Dépistages des Cancers du Grand Est, Troyes, Aube, France
| | - Olivier Graesslin
- Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, Marne, France
| | - Aline Hurtaud
- Department of General Medicine, Université de Reims Champagne-Ardenne, Reims, Marne, France
| | - Salvatore Ilardo
- Médecine générale, Maison de Santé Pluriprofessionnelle de la Forêt d'Orient, Piney, Aube, France
| | - Jan Chrusciel
- Department of Public Health and Performance, Centre Hospitalier de Troyes, Troyes, France
| | - Cécile Barbaret
- Univ. Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble Institute of Engineering, TIMC-IMAG,, Univ. Grenoble Alpes,, Grenoble, isère, France
| | - Camille Bertrand
- CRCDC, Centre Régional de Coordination des Dépistages des Cancers du Grand Est, Troyes, Aube, France
| | - Stéphane Sanchez
- Comité Universitaire de Ressources pour la Recherche en Santé,, Université de Reims Champagne-Ardenne, Reims, Marne, France
- Department of Public Health and Performance, Centre Hospitalier de Troyes, Troyes, France
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da Silva AG, Silva TPRD, Vasconcelos NMD, Santos FMD, Oliveira GDC, Malta DC. Time trend analysis and impacts of the COVID-19 pandemic on mammography and Papanicolaou test coverage in Brazilian state capitals. BMC Womens Health 2024; 24:436. [PMID: 39085895 PMCID: PMC11290149 DOI: 10.1186/s12905-024-03278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Breast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic. METHODS A time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student's t-test was employed to compare the prevalence rates between 2019 and 2023. RESULTS Between 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests. CONCLUSIONS Over the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups.
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Affiliation(s)
- Alanna Gomes da Silva
- School of Nursing, Graduate Program in Nursing, Department of Maternal-Child and Public Health Nursing, Federal University of Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
| | - Thales Philipe Rodrigues da Silva
- Women's Health Nursing Department, Paulista School of Nursing, Federal University of São Paulo (Unifesp), Rua Napoleão de Barros,754, Vila Clementino, São Paulo, 04023-062, Brazil
| | - Nádia Machado de Vasconcelos
- Graduate Program in Public Health at the Medical School, Federal University of Minas Gerais (UFMG), 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Filipe Malta Dos Santos
- Faculty of Medical Sciences of Minas Gerais (CMMG), Alameda Ezequiel Dias, 275, Centro, Belo Horizonte, 30130-110, Minas Gerais, Brazil
| | - Greice de Campos Oliveira
- Sofia Feldman Hospital, Rua Antônio Bandeira 1060, Tupi, Belo Horizonte, 31844-130, Minas Gerais, Brazil
| | - Deborah Carvalho Malta
- School of Nursing, Graduate Program in Nursing, Department of Maternal-Child and Public Health Nursing, Federal University of Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil
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Klamminger GG, Bitterlich A, Nigdelis MP, Schnöder L, Hamoud BH, Solomayer EF, Wagner M. Impact of the COVID-19 Pandemic on Tumor Stage and Pathohistological Parameters of Vulvar Cancer. J Clin Med 2024; 13:4058. [PMID: 39064099 PMCID: PMC11277637 DOI: 10.3390/jcm13144058] [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: 06/04/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Vulvar cancer (VC) comprises a small fraction of female neoplasms with notable high-incidence clusters among German regions. Despite a proposed impact of nationwide lockdowns in response to the COVID-19 pandemic on oncological diseases, the effect on VC staging and tumor characteristics remains yet to be resolved; therefore, analyzing pathological data from patients with squamous cell VC pre-, during, and post-COVID in a high-incidence region may offer insights into potential epidemiological and clinical trends. Methods: We identified a total of 90 patients who were diagnosed at the Institute of Pathology, University Hospital Saarland, between 2018 and 2023, and defined three distinct cohorts: a pre-COVID cohort (2018-2019), a COVID cohort (2020-2021), and a post-COVID cohort (2022-2023). Histomorphological data were collected from the individual patient reports and statistically analyzed using Fisher's exact test or the Kruskal-Wallis test. Results: Although we found no statistically significant differences in age, T-stage, perineural infiltration, blood vessel infiltration, resection status, grading, or resection margin between our three cohorts, surprisingly, we determined a greater extent of lymphovascular infiltration (Fisher's exact test; p = 0.041), as well as deeper tumor infiltration depth (Kruskal-Wallis test; p < 0.001) before the COVID-19 pandemic. Furthermore, we did not identify any soft indications of abnormalities in patient care within our center (unchanged status of the resection margins across all three cohorts). Conclusions: Our results clearly do not support a negative affection of clinical or pathobiological characteristics of VC during or after the pandemic. However, final assessments regarding the pandemic's effect on VC require additional study approaches in various regions, preferably with future extended timeframes of a longer follow-up.
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Affiliation(s)
- Gilbert Georg Klamminger
- Department of General and Special Pathology, Saarland University (USAAR), 66424 Homburg, Germany
- Department of General and Special Pathology, Saarland University Medical Center (UKS), 66424 Homburg, Germany
| | - Annick Bitterlich
- Department of General and Special Pathology, Saarland University (USAAR), 66424 Homburg, Germany
- Department of General and Special Pathology, Saarland University Medical Center (UKS), 66424 Homburg, Germany
| | - Meletios P. Nigdelis
- Department of Gynecology and Obstetrics, Saarland University Medical Center (UKS), 66424 Homburg, Germany
| | - Laura Schnöder
- Saarland University Medical Center for Tumor Diseases (UTS), Saarland University (USAAR), 66424 Homburg, Germany
| | - Bashar Haj Hamoud
- Department of Gynecology and Obstetrics, Saarland University Medical Center (UKS), 66424 Homburg, Germany
| | - Erich-Franz Solomayer
- Department of Gynecology and Obstetrics, Saarland University Medical Center (UKS), 66424 Homburg, Germany
- Saarland University Medical Center for Tumor Diseases (UTS), Saarland University (USAAR), 66424 Homburg, Germany
| | - Mathias Wagner
- Department of General and Special Pathology, Saarland University (USAAR), 66424 Homburg, Germany
- Department of General and Special Pathology, Saarland University Medical Center (UKS), 66424 Homburg, Germany
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Wilpert C, Wenkel E, Baltzer PAT, Fallenberg EM, Preibsch H, Sauer ST, Siegmann-Luz K, Weigel S, Wunderlich P, Wessling D. Vaccine-associated axillary lymphadenopathy with a focus on COVID-19 vaccines. ROFO-FORTSCHR RONTG 2024. [PMID: 38906159 DOI: 10.1055/a-2328-7536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
Axillary lymphadenopathy (LA) after COVID-19 vaccination is now known to be a common side effect. In these cases, malignancy cannot always be excluded on the basis of morphological imaging criteria.Narrative review for decision-making regarding control and follow-up intervals for axillary LA according to currently published research. This article provides a practical overview of the management of vaccine-associated LA using image examples and a flowchart and provides recommendations for follow-up intervals. A particular focus is on patients presenting for diagnostic breast imaging. The diagnostic criteria for pathological lymph nodes (LN) are explained.Axillary LA is a common adverse effect after COVID-19 vaccination (0.3-53%). The average duration of LA is more than 100 days. LA is also known to occur after other vaccinations, such as the seasonal influenza vaccine. Systematic studies on this topic are missing. Other causes of LA after vaccination (infections, autoimmune diseases, malignancies) should be considered for the differential diagnosis. If the LA persists for more than 3 months after COVID-19 vaccination, a primarily sonographic follow-up examination is recommended after another 3 months. A minimally invasive biopsy of the LA is recommended if a clinically suspicious LN persists or progresses. In the case of histologically confirmed breast cancer, a core biopsy without a follow-up interval is recommended regardless of the vaccination, as treatment appropriate to the stage should not be influenced by follow-up intervals. For follow-up after breast cancer, the procedure depends on the duration of the LA and the woman's individual risk of recurrence.Vaccination history should be well documented and taken into account when evaluating suspicious LN. Biopsy of abnormal, persistent, or progressive LNs is recommended. Preoperative staging of breast cancer should not be delayed by follow-up. The risk of false-positive findings is accepted, and the suspicious LNs are histologically examined in a minimally invasive procedure. · The vaccination history must be documented (vaccine, date, place of application).. · If axillary LA persists for more than 3 months after vaccination, a sonographic follow-up examination is recommended after 3 months.. · Enlarged LNs that are persistent, progressive in size, or are suspicious on control sonography should be biopsied.. · Suspicious LNs should be clarified before starting oncological therapy, irrespective of the vaccination status, according to the guidelines and without delaying therapy.. · Wilpert C, Wenkel E, Baltzer PA et al. Vaccine-associated axillary lymphadenopathy with a focus on COVID-19 vaccines. Fortschr Röntgenstr 2024; DOI 10.1055/a-2328-7536.
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Affiliation(s)
- Caroline Wilpert
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Evelyn Wenkel
- Radiology, Radiologie München, Munich, Germany
- Medical Faculty, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Pascal Andreas Thomas Baltzer
- Unit of General Radiology and Paediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Heike Preibsch
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Stephanie Tina Sauer
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | | | - Stefanie Weigel
- Department of Clinical Radiology and Reference Center for Mammography, University Hospital Muenster, Muenster, Germany
| | | | - Daniel Wessling
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
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Chung A, Chen Q, Curry W, Felix T, Tuan WJ. Breast Cancer Screening During the COVID-19 Pandemic in the United States: Results From Real-World Health Records Data. Ann Fam Med 2024; 22:208-214. [PMID: 38806260 PMCID: PMC11237221 DOI: 10.1370/afm.3098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/24/2024] [Accepted: 01/31/2024] [Indexed: 05/30/2024] Open
Abstract
PURPOSE The COVID-19 pandemic abruptly interrupted breast cancer screening, an essential preventive service in primary care. We aimed to evaluate the pandemic's impact on overall and follow-up breast cancer screening using real-world health records data. METHODS We retrospectively analyzed a cohort of women eligible for breast cancer screening through the study period from January 1, 2017 to February 28, 2022 using TriNetX Research Network data. We examined the temporal trend of monthly screening volume throughout the study period and compared the rate of adherence to follow-up screening within 24 months after the previous screening when the follow-up screening was due in the pre-COVID period vs the COVID period. To account for multiple screenings in the longitudinal data, we applied a logistic regression model using generalized estimating equations with adjustment for individual-level covariates. RESULTS Among 1,186,669 screening-eligible women, the monthly screening volume temporarily decreased by 80.6% from February to April 2020 and then rebounded to close to pre-COVID levels by June 2020. Yet, the follow-up screening rate decreased from 78.9% (95% CI, 78.8%-79.0%) in the pre-COVID period to 77.7% (95% CI, 77.6%-77.8%) in the COVID period. Multivariate regression analysis also showed a lower adherence to follow-up screening during the COVID period (odds ratio = 0.86; 0.86-0.87) and a greater pandemic impact among women aged 65 years and older and women of non-Hispanic "other" race (Asian, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander). CONCLUSIONS The COVID-19 pandemic had a transient negative effect on breast cancer screening overall and a prolonged negative effect on follow-up screening. It also exacerbated gaps in adherence to follow-up screening, especially among certain vulnerable groups, requiring innovative strategies to address potential health disparities in primary care.
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Affiliation(s)
- Andrew Chung
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, Pennsylvania
| | - Qiushi Chen
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, Pennsylvania
| | - William Curry
- Department of Family and Community Medicine, The Pennsylvania State University, Hershey, Pennsylvania
| | - Todd Felix
- Department of Family and Community Medicine, The Pennsylvania State University, Hershey, Pennsylvania
| | - Wen-Jan Tuan
- Department of Family and Community Medicine, The Pennsylvania State University, Hershey, Pennsylvania
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Nyante SJ, Deal AM, Heiling HM, Kim KS, Kuzmiak CM, Calhoun BC, Ray EM. Trends in breast, colon, pancreatic, and uterine cancers in women during the COVID-19 pandemic in North Carolina. Cancer Med 2024; 13:e7156. [PMID: 38572934 PMCID: PMC10993709 DOI: 10.1002/cam4.7156] [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: 10/27/2023] [Revised: 03/03/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024] Open
Abstract
IMPORTANCE The COVID-19 pandemic led to reductions in primary care and cancer screening visits, which may delay detection of some cancers. The impact on incidence has not been fully quantified. We examined change in cancer incidence to determine how the COVID-19 pandemic may have altered the characteristics of cancers diagnosed among women. METHODS This study included female patients aged ≥18 years and diagnosed with breast (n = 9489), colon (n = 958), pancreatic (n = 669), or uterine (n = 1991) cancer at three hospitals in North Carolina. Using interrupted time series, we compared incidence of cancers diagnosed between March 2020 and November 2020 (during pandemic) with cancers diagnosed between January 2016 and February 2020 (pre-pandemic). RESULTS During the pandemic, incidence of breast and uterine cancers was significantly lower than expected compared to pre-pandemic (breast-18%, p = 0.03; uterine -20%, p = 0.05). Proportions of advanced pathologic stage and hormone receptor-negative breast cancers, and advanced clinical stage and large size uterine cancers were more prevalent during the pandemic. No significant changes in incidence were detected for pancreatic (-20%, p = 0.08) or colon (+14%, p = 0.30) cancers. CONCLUSION AND RELEVANCE In women, the COVID-19 pandemic resulted in a significant reduction in the incidence of breast and uterine cancers, but not colon or pancreatic cancers. A change in the proportion of poor prognosis breast and uterine cancers suggests that some cancers that otherwise would have been diagnosed at an earlier stage will be detected in later years. Continued analysis of long-term trends is needed to understand the full impact of the pandemic on cancer incidence and outcomes.
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Affiliation(s)
- Sarah J. Nyante
- Department of RadiologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Allison M. Deal
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hillary M. Heiling
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Kyung Su Kim
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Cherie M. Kuzmiak
- Department of RadiologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Benjamin C. Calhoun
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Pathology and Laboratory MedicineUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Emily M. Ray
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Division of Oncology, Department of MedicineUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Youn HM, Zhang Y, Liu A, Ng CS, Liang J, Lau GKK, Lee SF, Lok J, Lam CLK, Wan EYF, Quan J. Decline in Cancer Diagnoses during the 'Zero COVID' Policy in Hong Kong: Indirect Spillover Impact of the COVID-19 Pandemic. Clin Oncol (R Coll Radiol) 2024; 36:157-164. [PMID: 38262779 DOI: 10.1016/j.clon.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/26/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
AIMS Despite a largely successful 'zero COVID' policy in 2020, the COVID-19 pandemic disrupted routine cancer services in the city of Hong Kong. The aims of this study were to examine the trends in cancer incidence before and during the COVID-19 pandemic and estimate missed cancer diagnoses. MATERIALS AND METHODS We used population-based data from the Hong Kong Cancer Registry 1983-2020 to examine the trends of age- and sex-standardised cancer incidence before and during the COVID-19 pandemic. We applied: (i) the annual average percentage change (AAPC) calculated using the Joinpoint regression model and (ii) the autoregressive integrated moving average (ARIMA) model to forecast cancer incidence rates in 2020. Missed cancer diagnoses in 2020 were estimated by comparing forecasted incidence rates to reported rates. A subgroup analysis was conducted by sex, age and cancer site. RESULTS The cancer incidence in Hong Kong declined by 4.4% from 2019 to 2020 (male 8.1%; female 1.1%) compared with the long-term AAPC of 0.5% from 2005 to 2019 (95% confidence interval 0.3, 0.7). The gap between the reported and forecasted incidence for 2020 ranged from 5.1 to 5.7% (male 8.5%, 9.8%; female 2.3%, 3.5%). We estimated 1525-1596 missed cancer diagnoses (ARIMA estimate -98, 3148; AAPC 514, 1729) in 2020. Most missed diagnoses were in males (ARIMA 1361 [327, 2394]; AAPC 1401 [1353, 1460]), with an estimated 479-557 missed cases of colorectal cancer (ARIMA 112, 837; AAPC 518, 597) and 256-352 missed cases of prostate cancer (AAPC 231, 280; ARIMA 110, 594). CONCLUSION The incidence of new cancer diagnoses declined in 2020 contrary to the long-term increase over the previous decades. Significantly lower diagnoses than expected were observed in males, particularly for colorectal and prostate cancers. Fewer reported cancer cases indicate missed diagnoses and could lead to delayed treatment that could impact future health outcomes.
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Affiliation(s)
- H M Youn
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Y Zhang
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - A Liu
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - C S Ng
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - J Liang
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - G K K Lau
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - S F Lee
- Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - J Lok
- Department of Pathology, United Christian Hospital, Hong Kong SAR, China
| | - C L K Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - E Y F Wan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China
| | - J Quan
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; HKU Business School, University of Hong Kong, Hong Kong SAR, China.
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Duffy SW, de Jonge L, Duffy TE. Effects on Cancer Prevention from the COVID-19 Pandemic. Annu Rev Med 2024; 75:1-11. [PMID: 37625124 DOI: 10.1146/annurev-med-051022-122257] [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] [Indexed: 08/27/2023]
Abstract
The COVID-19 pandemic led to disruption of health services around the world, including cancer services. We carried out a narrative review of the effect of the pandemic on cancer prevention services, including screening. Services were severely affected in the early months of the pandemic, and in some areas are still recovering. Large numbers of additional cancers or additional late-stage cancers have been predicted to arise over the coming years as a result of this disruption. To minimize the effects on cancer outcomes, it is necessary to return as quickly as possible to prepandemic levels of screening and prevention activity or indeed to exceed these levels. The recovery of services should address health inequalities.
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Affiliation(s)
- Stephen W Duffy
- Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom;
| | - Lucie de Jonge
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands;
| | - Thomas E Duffy
- Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom;
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Navarro-Sabate A, Font R, Martínez-Soler F, Solà J, Tortosa A, Ribes J, Benito-Aracil L, Espinas JA, Borras JM. The Impact of the COVID-19 Pandemic on Adherence to Endocrine Therapy for Breast Cancer in Catalonia (Spain). Cancers (Basel) 2024; 16:426. [PMID: 38275867 PMCID: PMC10814820 DOI: 10.3390/cancers16020426] [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: 12/18/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Purpose. To assess the impact of the COVID-19 pandemic on adherence to oral endocrine therapy in patients diagnosed with breast cancer in the public healthcare system in Catalonia (Spain). Methods. Retrospective cohort study in patients starting endocrine therapy from 2017 to 2021. Adherence was measured during the first year of treatment, and the impact of the pandemic was calculated according to the calendar year and whether the first year of treatment included the peak period of the pandemic in our setting (March-September 2020). Analyses were performed using a chi-square test and multivariable logistic regression, with results stratified by year, age group, and drug type. Results. Mean overall adherence during the first year of treatment was 89.6% from 2017 to 2021. In contrast, the patients who started treatment in 2019 and 2020 and whose treatment included the peak pandemic period presented an adherence of 87.0% and 86.5%, respectively. Young age and tamoxifen or combination therapy were predictors of low adherence. An increase in neoadjuvant therapy was also observed in 2020. Conclusions. The COVID-19 pandemic had only a modest impact on adherence to endocrine therapy (≈3%), despite the enormous disruptions for patients, the healthcare system in general, and cancer care in particular that were occurring in that period.
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Affiliation(s)
- Aurea Navarro-Sabate
- Fundamental Care and Clinical Nursing Department, Nursing Faculty, University of Barcelona, 08007 Barcelona, Spain; (A.N.-S.); (F.M.-S.); (A.T.); (L.B.-A.)
| | - Rebeca Font
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
| | - Fina Martínez-Soler
- Fundamental Care and Clinical Nursing Department, Nursing Faculty, University of Barcelona, 08007 Barcelona, Spain; (A.N.-S.); (F.M.-S.); (A.T.); (L.B.-A.)
| | - Judit Solà
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
| | - Avelina Tortosa
- Fundamental Care and Clinical Nursing Department, Nursing Faculty, University of Barcelona, 08007 Barcelona, Spain; (A.N.-S.); (F.M.-S.); (A.T.); (L.B.-A.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
| | - Josepa Ribes
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
- Clinical Sciences Department, University of Barcelona, 08907 Barcelona, Spain
| | - Llúcia Benito-Aracil
- Fundamental Care and Clinical Nursing Department, Nursing Faculty, University of Barcelona, 08007 Barcelona, Spain; (A.N.-S.); (F.M.-S.); (A.T.); (L.B.-A.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
| | - Josep Alfons Espinas
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
- Clinical Sciences Department, University of Barcelona, 08907 Barcelona, Spain
| | - Josep Maria Borras
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
- Clinical Sciences Department, University of Barcelona, 08907 Barcelona, Spain
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11
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Wu Y, Liu X, Maculaitis MC, Li B, Berk A, Massa A, Weiss MC, McRoy L. Financial Toxicity among Patients with Breast Cancer during the COVID-19 Pandemic in the United States. Cancers (Basel) 2023; 16:62. [PMID: 38201491 PMCID: PMC10778054 DOI: 10.3390/cancers16010062] [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: 11/09/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
This study reported the prevalence of financial distress (financial toxicity (FT)) and COVID-19-related economic stress in patients with breast cancer (BC). Patients with BC were recruited from the Ciitizen platform, Breastcancer.org, and patient advocacy groups between 30 March and 6 July 2021. FT was assessed with the COmprehensive Score for financial Toxicity (COST) instrument. COVID-19-related economic stress was assessed with the COVID-19 Stress Scale. Among the 669 patients, the mean age was 51.6 years; 9.4% reported a COVID-19 diagnosis. The prevalence rates of mild and moderate/severe FT were 36.8% and 22.4%, respectively. FT was more prevalent in patients with metastatic versus early BC (p < 0.001). The factors associated with FT included income ≤ USD 49,999 (adjusted odds ratio (adj OR) 6.271, p < 0.0001) and USD 50,000-USD 149,999 (adj OR 2.722, p < 0.0001); aged <50 years (adj OR 3.061, p = 0.0012) and 50-64 years (adj OR 3.444, p = 0.0002); living alone (adj OR 1.603, p = 0.0476); and greater depression severity (adj OR 1.155, p < 0.0001). Black patients (adj OR 2.165, p = 0.0133), patients with income ≤ USD 49,999 (adj OR 1.921, p = 0.0432), or greater depression severity (adj OR 1.090, p < 0.0001) were more likely to experience COVID-19-related economic stress. FT was common in patients with BC, particularly metastatic disease, during COVID-19. Multiple factors, especially lower income and greater depression severity were associated with financial difficulties during COVID-19.
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Affiliation(s)
- Yan Wu
- Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 07103, USA;
- Pfizer Inc., New York, NY 10001, USA; (B.L.); (L.M.)
| | - Xianchen Liu
- Pfizer Inc., New York, NY 10001, USA; (B.L.); (L.M.)
| | | | - Benjamin Li
- Pfizer Inc., New York, NY 10001, USA; (B.L.); (L.M.)
| | - Alexandra Berk
- Invitae Corporation, San Francisco, CA 94103, USA; (A.B.); (A.M.)
| | - Angelina Massa
- Invitae Corporation, San Francisco, CA 94103, USA; (A.B.); (A.M.)
| | | | - Lynn McRoy
- Pfizer Inc., New York, NY 10001, USA; (B.L.); (L.M.)
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12
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Ibfelt EH, Jensen H, Vrou Offersen B, Bang Hansen M, Møller H, Christiansen P, Bech Olesen T. Diagnosis and treatment of breast cancer in Denmark during the COVID-19 pandemic: a nationwide population-based study. Acta Oncol 2023; 62:1749-1756. [PMID: 37750293 DOI: 10.1080/0284186x.2023.2259598] [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: 07/07/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic was a global health crisis with population-wide behavioural restrictions imposed worldwide to reduce transmission of infection and to limit the potential burden on the healthcare systems. We examined whether there was any change in the diagnosis or treatment of breast cancer during the pandemic as compared to previous years. MATERIAL AND METHODS The study population comprised all women aged ≥18 years diagnosed with breast cancer in 2015-2021 with data obtained from the clinical quality registry of the Danish Breast Cancer Cooperative Group (DBCG). Data on socioeconomic factors were retrieved from Statistics Denmark. Prevalence ratios (PR) with 95% confidence intervals (CI) were estimated from a generalised linear model (GLM) with a log link for the Poisson family with robust standard errors (SE) of each outcome, using the COVID-19 pandemic period in Denmark as the exposure of interest. RESULTS In total, 30,598 breast cancers were diagnosed during the study period. There was a small decrease (4.5%) in the total number of breast cancer cases in 2020 compared with previous years. During the pandemic, a lower proportion of the patients diagnosed with breast cancer had a short educational level (28.5 vs. 26.9%; PR = 0.91; 95% CI: 0.88-0.95), a low income (20.5 vs. 19.0%; PR = 0.90; 0.85-0.95) and fewer than expected in the age group 60-69 years (27.8 vs. 25.3; PR = 0.90; 0.86-0.94) were diagnosed, as compared with the pre-pandemic period. No difference in type of surgery or tumour size was observed. A higher proportion of patients received neo-adjuvant chemotherapy (49.0 vs 55.0%; PR = 1.15; 1.06-1.24), whereas a lower proportion received adjuvant chemotherapy (93.5 vs 85.6%; PR = 0.92; 0.90-0.93) during the pandemic, compared with the pre-pandemic period. CONCLUSIONS During the pandemic, a small decrease in the number of breast cancer diagnoses was observed particularly among socially disadvantaged groups. Overall, the quality of breast cancer treatment was maintained.
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Affiliation(s)
- Else Helene Ibfelt
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Copenhagen, Denmark
| | - Henry Jensen
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Copenhagen, Denmark
| | - Birgitte Vrou Offersen
- Department of Experimental Clinical Oncology, Aarhus University Hospital - Aarhus University, Aarhus, Denmark
| | - Maiken Bang Hansen
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Copenhagen, Denmark
- Palliative Care Research Department, Bispebjerg Hospital, Kobenhavn, Denmark
| | - Henrik Møller
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Copenhagen, Denmark
- Danish Centre for Health Service Research, Aalborg University, Aalborg, Denmark
| | - Peer Christiansen
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
- Danish Breast Cancer Cooperative Group - DBCG, Denmark
| | - Tina Bech Olesen
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Copenhagen, Denmark
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13
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Plotti F, Silvagni A, Montera R, De Cicco Nardone C, Luvero D, Ficarola F, Cundari GB, Branda F, Angioli R, Terranova C. Impact of COVID-19 Pandemic on the Diagnostic and Therapeutic Management of Endometrial Cancer: A Monocentric Retrospective Comparative Study. J Clin Med 2023; 12:7016. [PMID: 38002630 PMCID: PMC10671930 DOI: 10.3390/jcm12227016] [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: 10/08/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Endometrial cancer represents an ideal target to evaluate the impact of COVID-19 being the most frequent gynecological malignancy in Italy, generally detected at early stages and correlated with favorable oncological outcomes. The present comparative retrospective study carried out at Campus Bio-medico University Foundation in Rome aims to evaluate the impact of the COVID-19 pandemic on the presentation, diagnosis and treatment of EC. All women with a histological diagnosis of non-endometrioid and endometrioid endometrial cancer between 1 March 2018 and 31 October 2022 were included. The number of cases was higher in period 2 (95 vs. 64 cases). Time to diagnosis did not show statistically significant differences but in period 2, 92.06% of the diagnoses were made following abnormal uterine bleeding, while in period 1, only 67.02% were. The waiting time for the intervention was significantly shorter in period 2. Definitive histology, FIGO staging, surgical technique and adjuvant therapy did not show significant differences between the two periods. The study demonstrates that the impact of the COVID-19 pandemic did not have a direct effect on the diagnostic delay, tumor staging and type of therapy but rather on the presentation pattern of endometrial cancer.
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Affiliation(s)
- Francesco Plotti
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Adele Silvagni
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Roberto Montera
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Carlo De Cicco Nardone
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Daniela Luvero
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Fernando Ficarola
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Gianna Barbara Cundari
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Francesco Branda
- Unit of Medical Statistics and Molecular Epidemiology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Roberto Angioli
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Corrado Terranova
- Unit of Gynecology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
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14
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Guével E, Priou S, Lamé G, Wassermann J, Bey R, Uzan C, Chatellier G, Belkacemi Y, Tannier X, Guillerm S, Flicoteaux R, Gligorov J, Cohen A, Benderra M, Teixeira L, Daniel C, Hersant B, Tournigand C, Kempf E. Impact of the COVID-19 pandemic on clinical presentation, treatments, and outcomes of new breast cancer patients: A retrospective multicenter cohort study. Cancer Med 2023; 12:20918-20929. [PMID: 37909210 PMCID: PMC10709737 DOI: 10.1002/cam4.6637] [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: 07/18/2023] [Revised: 09/14/2023] [Accepted: 10/04/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND The SARS CoV-2 pandemic disrupted healthcare systems. We compared the cancer stage for new breast cancers (BCs) before and during the pandemic. METHODS We performed a retrospective multicenter cohort study on the data warehouse of Greater Paris University Hospitals (AP-HP). We identified all female patients newly referred with a BC in 2019 and 2020. We assessed the timeline of their care trajectories, initial tumor stage, and treatment received: BC resection, exclusive systemic therapy, exclusive radiation therapy, or exclusive best supportive care (BSC). We calculated patients' 1-year overall survival (OS) and compared indicators in 2019 and 2020. RESULTS In 2019 and 2020, 2055 and 1988, new BC patients underwent cancer treatment, and during the two lockdowns, the BC diagnoses varied by -18% and by +23% compared to 2019. De novo metastatic tumors (15% and 15%, p = 0.95), pTNM and ypTNM distributions of 1332 cases with upfront resection and of 296 cases with neoadjuvant therapy did not differ (p = 0.37, p = 0.3). The median times from first multidisciplinary meeting and from diagnosis to treatment of 19 days (interquartile 11-39 days) and 35 days (interquartile 22-65 days) did not differ. Access to plastic surgery (15% and 17%, p = 0.08) and to treatment categories did not vary: tumor resection (73% and 72%), exclusive systemic therapy (13% and 14%), exclusive radiation therapy (9% and 9%), exclusive BSC (5% and 5%) (p = 0.8). Among resected patients, the neoadjuvant therapy rate was lower in 2019 (16%) versus 2020 (20%) (p = 0.02). One-year OS rates were 99.3% versus 98.9% (HR = 0.96; 95% CI, 0.77-1.2), 72.6% versus 76.6% (HR = 1.28; 95% CI, 0.95-1.72), 96.6% versus 97.8% (HR = 1.09; 95% CI, 0.61-1.94), and 15.5% versus 15.1% (HR = 0.99; 95% CI, 0.72-1.37), in the treatment groups. CONCLUSIONS Despite a decrease in the number of new BCs, there was no tumor stage shift, and OS did not vary.
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Affiliation(s)
- Etienne Guével
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
| | - Sonia Priou
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
- CentraleSupélec, Laboratoire Génie IndustrielUniversité Paris‐SaclayGif‐sur‐YvetteFrance
| | - Guillaume Lamé
- CentraleSupélec, Laboratoire Génie IndustrielUniversité Paris‐SaclayGif‐sur‐YvetteFrance
| | - Johanna Wassermann
- Assistance Publique–Hôpitaux de Paris, Department of medical oncology, Pitié Salpétrière University HospitalSorbonne UniversitéParisFrance
- Assistance Publique–Hôpitaux de Paris, Institut Universitaire de cancérologieSorbonne UniversitéParisFrance
| | - Romain Bey
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
| | - Catherine Uzan
- Assistance Publique–Hôpitaux de Paris, Institut Universitaire de cancérologieSorbonne UniversitéParisFrance
- Assistance Publique–Hôpitaux de Paris, Department of gynecology, Pitié Salpétrière University HospitalSorbonne UniversitéParisFrance
| | - Gilles Chatellier
- Department of medical informatics, Assistance Publique Hôpitaux de Paris, Centre‐Université de Paris (APHP‐CUP)Université Paris CItéParisFrance
| | - Yazid Belkacemi
- Assistance Publique–Hôpitaux de Paris, Department of Radiation Oncology and Henri Mondor Breast Center, Henri Mondor and Albert Chenevier University HospitalUniversité Paris Est CréteilCréteilFrance
| | - Xavier Tannier
- Sorbonne University Inserm, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e‐Santé, LIMICSParisFrance
| | - Sophie Guillerm
- Assistance Publique–Hôpitaux de Paris, Department of radiation therapy, Saint Louis University HospitalUniversité Paris CitéCréteilFrance
| | - Rémi Flicoteaux
- Assistance Publique–Hôpitaux de ParisDepartment of medical informationParisFrance
| | - Joseph Gligorov
- Assistance Publique–Hôpitaux de Paris, Institut Universitaire de cancérologieSorbonne UniversitéParisFrance
- Assistance Publique–Hôpitaux de Paris, Department of medical oncology, Tenon University HospitalSorbonne UniversitéParisFrance
| | - Ariel Cohen
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
| | - Marc‐Antoine Benderra
- Assistance Publique–Hôpitaux de Paris, Institut Universitaire de cancérologieSorbonne UniversitéParisFrance
- Assistance Publique–Hôpitaux de Paris, Department of medical oncology, Tenon University HospitalSorbonne UniversitéParisFrance
| | - Luis Teixeira
- Assistance Publique–Hôpitaux de Paris, Department of senology, Saint Louis Teaching HospitalUniversité Paris CitéParisFrance
| | - Christel Daniel
- Assistance Publique–Hôpitaux de Paris, Innovation and Data, IT DepartmentParisFrance
- Sorbonne University Inserm, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e‐Santé, LIMICSParisFrance
| | - Barbara Hersant
- Assistance Publique – Hôpitaux de Paris, Department of plastic surgery, Henri Mondor and Albert Chenevier University HospitalUniversité Paris Est CréteilCréteilFrance
| | - Christophe Tournigand
- Assistance Publique – Hôpitaux de Paris, Department of medical oncology, Henri Mondor and Albert Chenevier University HospitalUniversité Paris Est CréteilCréteilFrance
| | - Emmanuelle Kempf
- Sorbonne University Inserm, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances pour la e‐Santé, LIMICSParisFrance
- Assistance Publique – Hôpitaux de Paris, Department of medical oncology, Henri Mondor and Albert Chenevier University HospitalUniversité Paris Est CréteilCréteilFrance
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15
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Olesen TB, Jensen H, Møller H, Jensen JW, Andersen B, Vejborg I, Njor SH. Nationwide mammography screening participation in Denmark during the COVID-19 pandemic: An observational study. eLife 2023; 12:e83541. [PMID: 37589381 PMCID: PMC10513477 DOI: 10.7554/elife.83541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 07/27/2023] [Indexed: 08/18/2023] Open
Abstract
Background In most of the world, the mammography screening programmes were paused at the start of the pandemic, whilst mammography screening continued in Denmark. We examined the mammography screening participation during the COVID-19 pandemic in Denmark. Methods The study population comprised all women aged 50-69 years old invited to participate in mammography screening from 2016 to 2021 in Denmark based on data from the Danish Quality Database for Mammography Screening in combination with population-based registries. Using a generalised linear model, we estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) of mammography screening participation within 90, 180, and 365 d since invitation during the pandemic in comparison with the previous years adjusting for age, year and month of invitation. Results The study comprised 1,828,791 invitations among 847,766 women. Before the pandemic, 80.2% of invitations resulted in participation in mammography screening within 90 d, 82.7% within 180 d, and 83.1% within 365 d. At the start of the pandemic, the participation in screening within 90 d was reduced to 69.9% for those invited in pre-lockdown and to 76.5% for those invited in first lockdown. Extending the length of follow-up time to 365 d only a minor overall reduction was observed (PR = 0.94; 95% CI: 0.93-0.95 in pre-lockdown and PR = 0.97; 95% CI: 0.96-0.97 in first lockdown). A lower participation was, however, seen among immigrants and among women with a low income. Conclusions The short-term participation in mammography screening was reduced at the start of the pandemic, whilst only a minor reduction in the overall participation was observed with longer follow-up time, indicating that women postponed screening. Some groups of women, nonetheless, had a lower participation, indicating that the social inequity in screening participation was exacerbated during the pandemic. Funding The study was funded by the Danish Cancer Society Scientific Committee (grant number R321-A17417) and the Danish regions.
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Affiliation(s)
- Tina Bech Olesen
- The Danish Clinical Quality Program – National Clinical Registries (RKKP)Aarhus NDenmark
| | - Henry Jensen
- The Danish Clinical Quality Program – National Clinical Registries (RKKP)Aarhus NDenmark
| | - Henrik Møller
- The Danish Clinical Quality Program – National Clinical Registries (RKKP)Aarhus NDenmark
| | - Jens Winther Jensen
- The Danish Clinical Quality Program – National Clinical Registries (RKKP)Aarhus NDenmark
| | - Berit Andersen
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional HospitalRandersDenmark
- Department of Clinical Medicine, Aarhus UniversityAarhusDenmark
| | - Ilse Vejborg
- Department of Breast Examinations, Copenhagen University HospitalCopenhagenDenmark
| | - Sisse H Njor
- The Danish Clinical Quality Program – National Clinical Registries (RKKP)Aarhus NDenmark
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional HospitalRandersDenmark
- Department of Clinical Medicine, Aarhus UniversityAarhusDenmark
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16
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Schiaffino S, Pinker K, Cozzi A, Magni V, Athanasiou A, Baltzer PAT, Camps Herrero J, Clauser P, Fallenberg EM, Forrai G, Fuchsjäger MH, Gilbert FJ, Helbich T, Kilburn-Toppin F, Kuhl CK, Lesaru M, Mann RM, Panizza P, Pediconi F, Sardanelli F, Sella T, Thomassin-Naggara I, Zackrisson S, Pijnappel RM. European Society of Breast Imaging (EUSOBI) guidelines on the management of axillary lymphadenopathy after COVID-19 vaccination: 2023 revision. Insights Imaging 2023; 14:126. [PMID: 37466753 DOI: 10.1186/s13244-023-01453-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/14/2023] [Indexed: 07/20/2023] Open
Abstract
Axillary lymphadenopathy is a common side effect of COVID-19 vaccination, leading to increased imaging-detected asymptomatic and symptomatic unilateral axillary lymphadenopathy. This has threatened to negatively impact the workflow of breast imaging services, leading to the release of ten recommendations by the European Society of Breast Imaging (EUSOBI) in August 2021. Considering the rapidly changing scenario and data scarcity, these initial recommendations kept a highly conservative approach. As of 2023, according to newly acquired evidence, EUSOBI proposes the following updates, in order to reduce unnecessary examinations and avoid delaying necessary examinations. First, recommendation n. 3 has been revised to state that breast examinations should not be delayed or rescheduled because of COVID-19 vaccination, as evidence from the first pandemic waves highlights how delayed or missed screening tests have a negative effect on breast cancer morbidity and mortality, and that there is a near-zero risk of subsequent malignant findings in asymptomatic patients who have unilateral lymphadenopathy and no suspicious breast findings. Second, recommendation n. 7 has been revised to simplify follow-up strategies: in patients without breast cancer history and no imaging findings suspicious for cancer, symptomatic and asymptomatic imaging-detected unilateral lymphadenopathy on the same side of recent COVID-19 vaccination (within 12 weeks) should be classified as a benign finding (BI-RADS 2) and no further work-up should be pursued. All other recommendations issued by EUSOBI in 2021 remain valid.
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Affiliation(s)
- Simone Schiaffino
- Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Katja Pinker
- Division of General and Paediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Andrea Cozzi
- Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | - Pascal A T Baltzer
- Division of General and Paediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Paola Clauser
- Division of General and Paediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Eva M Fallenberg
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Gabor Forrai
- Department of Radiology, Duna Medical Center, Budapest, Hungary
| | - Michael H Fuchsjäger
- Division of General Radiology, Department of Radiology, Medical University Graz, Graz, Austria
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Thomas Helbich
- Division of General and Paediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Christiane K Kuhl
- University Hospital of Aachen, Rheinisch-Westfälische Technische Hochschule, Aachen, Germany
| | - Mihai Lesaru
- Radiology and Imaging Laboratory, Fundeni Institute, Bucharest, Romania
| | - Ritse M Mann
- Department of Radiology, Radboud University Medical Centre, Nijmegen, The Netherlands
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Pietro Panizza
- Breast Imaging Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federica Pediconi
- Department of Radiological, Oncological and Pathological Sciences, Università degli Studi di Roma "La Sapienza", Rome, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Tamar Sella
- Department of Diagnostic Imaging, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | | | - Sophia Zackrisson
- Diagnostic Radiology, Department of Translational Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ruud M Pijnappel
- Department of Imaging, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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17
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Bharwani A, Li D, Vermund SH. A Review of the Effect of COVID-19-Related Lockdowns on Global Cancer Screening. Cureus 2023; 15:e40268. [PMID: 37448422 PMCID: PMC10336183 DOI: 10.7759/cureus.40268] [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] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
COVID-19 lockdowns have led to significant disruptions in preventative health services worldwide. This review aims to assess the impact of COVID-19 lockdowns on worldwide preventive cancer screening participation. Major medical databases were searched using the keywords 'lockdown,' 'cancer,' and 'screening or diagnosis,' and relevant articles were evaluated against inclusion and exclusion criteria. The final review consisted of 38 studies. The impact of COVID-19 on screening uptake was categorized based on cancer type. All types of screening had decreased participation during or around the lockdown period. Racial and socioeconomic disparities, provider-related barriers, and patient attitudes about service disruptions during the pandemic were also highlighted in this review. Future research should focus on data from low- and middle-income countries to obtain a more comprehensive picture of the problem. Policy interventions that adopt self-screening or different screening intervals can also be considered to reduce impacts in future crises. Insights from existing studies and future research will allow for more proactive measures to manage future disruptions.
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Affiliation(s)
| | - Dan Li
- Public Health, Yale University, New Haven, USA
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18
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Medas F, Dobrinja C, Al-Suhaimi EA, Altmeier J, Anajar S, Arikan AE, Azaryan I, Bains L, Basili G, Bolukbasi H, Bononi M, Borumandi F, Bozan MB, Brenta G, Brunaud L, Brunner M, Buemi A, Canu GL, Cappellacci F, Cartwright SB, Castells Fusté I, Cavalheiro B, Cavallaro G, Chala A, Chan SYB, Chaplin J, Cheema MS, Chiapponi C, Chiofalo MG, Chrysos E, D'Amore A, de Cillia M, De Crea C, de Manzini N, de Matos LL, De Pasquale L, Del Rio P, Demarchi MS, Dhiwakar M, Donatini G, Dora JM, D'Orazi V, Doulatram Gamgaram VK, Eismontas V, Kabiri EH, El Malki HO, Elzahaby I, Enciu O, Eskander A, Feroci F, Figueroa-Bohorquez D, Filis D, François G, Frías-Fernández P, Gamboa-Dominguez A, Genc V, Giordano D, Gómez-Pedraza A, Graceffa G, Griffin J, Guerreiro SC, Gupta K, Gupta KK, Gurrado A, Hajiioannou J, Hakala T, Harahap WA, Hargitai L, Hartl D, Hellmann A, Hlozek J, Hoang VT, Iacobone M, Innaro N, Ioannidis O, Jang JHI, Xavier-Junior JC, Jovanovic M, Kaderli RM, Kakamad F, Kaliszewski K, Karamanliev M, Katoh H, Košec A, Kovacevic B, Kowalski LP, Králik R, Yadav SK, Kumorová A, Lampridis S, Lasithiotakis K, Leclere JC, Leong EKF, Leow MKS, Lim JY, Lino-Silva LS, Liu SYW, Llorach NP, Lombardi CP, López-Gómez J, Lori E, Quintanilla-Dieck L, Lucchini R, Madani A, Manatakis D, Markovic I, Materazzi G, Mazeh H, Mercante G, Meyer-Rochow GY, Mihaljevic O, Miller JA, Minuto M, Monacelli M, Mulita F, Mullineris B, Muñoz-de-Nova JL, Muradás Girardi F, Nader S, Napadon T, Nastos C, Offi C, Ronen O, Oragano L, Orois A, Pan Y, Panagiotidis E, Panchangam RB, Papavramidis T, Parida PK, Paspala A, Pérez ÒV, Petrovic S, Raffaelli M, Ramacciotti CF, Ratia Gimenez T, Rivo Vázquez Á, Roh JL, Rossi L, Sanabria A, Santeerapharp A, Semenov A, Seneviratne S, Serdar A, Sheahan P, Sheppard SC, Slotcavage RL, Smaxwil C, Kim SY, Sorrenti S, Spartalis E, Sriphrapradang C, Testini M, Turk Y, Tzikos G, Vabalayte K, Vargas-Osorio K, Vázquez Rentería RS, Velázquez-Fernández D, Vithana SMP, Yücel L, Yulian ED, Zahradnikova P, Zarogoulidis P, Ziablitskaia E, Zolotoukho A, Calò PG. Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study. Lancet Diabetes Endocrinol 2023; 11:402-413. [PMID: 37127041 PMCID: PMC10147315 DOI: 10.1016/s2213-8587(23)00094-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours. METHODS In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186. FINDINGS Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78·6%] female patients and 4922 [21·4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1·4 [IQR 0·6-3·4]) compared with the prepandemic phase (2·0 [0·9-3·7]; p<0·0001) and pandemic decrease phase (2·3 [1·0-5·0]; p<0·0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69·0%] of 3704 vs 1515 [71·5%] of 2119; OR 1·1 [95% CI 1·0-1·3]; p=0·042), lymph node metastases (343 [9·3%] vs 264 [12·5%]; OR 1·4 [1·2-1·7]; p=0·0001), and tumours at high risk of structural disease recurrence (203 [5·7%] of 3584 vs 155 [7·7%] of 2006; OR 1·4 [1·1-1·7]; p=0·0039). INTERPRETATION Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation. FUNDING None.
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Affiliation(s)
- Fabio Medas
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
| | - Chiara Dobrinja
- Department of Medical and Surgical Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste, Italy
| | - Ebtesam Abdullah Al-Suhaimi
- Biology Department, College of Science, Institute for Research and Medical Consultations, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Julia Altmeier
- Endocrine Surgery, Diakonie-Klinikum Stuttgart, Stuttgart, Germany
| | - Said Anajar
- Department of Otolaryngology-Head and Neck Surgery, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Akif Enes Arikan
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Türkiye
| | - Irina Azaryan
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lovenish Bains
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
| | - Giancarlo Basili
- Azienda USL Toscana Nord-Ovest, UOSD Chirurgia della Tiroide, Toscana, Italy
| | - Hakan Bolukbasi
- General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Türkiye
| | - Marco Bononi
- Dipartimento di Chirurgia Pietro Valdoni, Policlinico Umberto I Sapienza, Rome, Italy
| | - Farzad Borumandi
- Department of Oral and Maxillofacial Surgery, University Hospitals Sussex NHS Foundation Trust, St Richard's Hospital, Chichester and Worthing Hospital, Worthing, UK
| | - Mehmet Buğra Bozan
- General Surgery, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Türkiye
| | - Gabriela Brenta
- Endocrinology Department, Unidad Asistencial Dr César Milstein, Buenos Aires, Argentina
| | - Laurent Brunaud
- Department of Surgery CVMC, CHU Nancy-Brabois, Université de Lorraine, Nancy, France
| | - Maximilian Brunner
- Department of General and Visceral Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Antoine Buemi
- Department of Surgery, Cliniques Universitaires Saint Luc, Bruxelles, Belgium
| | - Gian Luigi Canu
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | | | | | | | - Beatriz Cavalheiro
- Departamento de Cirurgia de Cabeça e Pescoço, Hospital São Camilo Oncologia-Instituto Brasileiro de Controle do Câncer, São Paulo, Brazil
| | | | - Andres Chala
- Head and Neck Department Oncologos del Occidente, Universidad de Caldas, Manizales, Colombia
| | - Shun Yan Bryant Chan
- Department of Surgery, Tseung Kwan O Hospital, Hong Kong Special Administrative Region, China
| | - John Chaplin
- Department of Otolaryngology Head and Neck Surgery, Auckland City Hospital, Auckland, New Zealand
| | | | - Costanza Chiapponi
- Department of General, Visceral, Cancer and Transplant Surgery, University Hospital Cologne, Cologne, Germany; Department of Endocrine Surgery, Evangelisches Klinikum Cologne Weyertal, Cologne, Germany
| | - Maria Grazia Chiofalo
- Head and Neck Cancer Medical Oncology Department, Istituto Nazionale Tumori, IRCCS Fondazione G Pascale, Napoli, Italy
| | - Emmanuel Chrysos
- Department of Surgery, University Hospital of Heraklion, Medical School, University of Crete, Crete, Greece
| | - Annamaria D'Amore
- Division of Endocrine Surgery, Department of Gastroenterologic, Endocrine-Metabolic and Nephro-Urologic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Michael de Cillia
- Department of Surgery, Saint John of God Hospital, Salzburg, Austria
| | - Carmela De Crea
- UOC Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Nicolò de Manzini
- Department of Medical and Surgical Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste, Italy
| | - Leandro Luongo de Matos
- Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Loredana De Pasquale
- Thyroid and Parathyroid Surgery Unit-Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Paolo Del Rio
- General Surgery Unit, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Marco Stefano Demarchi
- Department of Thoracic and Endocrine Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Muthuswamy Dhiwakar
- Department of Otolaryngology-Head and Neck Surgery, Kovai Medical Center and Hospital, Coimbatore, India
| | | | - Jose Miguel Dora
- Thyroid Unit, Hospital de Clínicas de Porto Alegre and Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Valerio D'Orazi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy; Division of General Surgery-Section of Endocrine and Diabetic Foot Surgery, "Fabia Mater" Hospital, Rome, Italy
| | | | - Vitalijus Eismontas
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania; Health Research and Innovation Science Center, Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - El Hassane Kabiri
- Department of Thoracic Surgery, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Hadj Omar El Malki
- Surgery Department 'A', Ibn Sina Hospital, Medical School, Mohammed V University, Rabat, Morocco
| | | | - Octavian Enciu
- Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Francesco Feroci
- Department of Surgery, General Surgery Unit, S Stefano Hospital, Prato, Italy
| | | | - Dimitrios Filis
- Department of Surgery, Saint Andrew Hospital of Patras, Patras, Greece
| | - Gorostidi François
- Otolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | - Armando Gamboa-Dominguez
- Departamento de Patología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Volkan Genc
- Department of Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Davide Giordano
- Otorhinolaryngology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Giuseppa Graceffa
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - James Griffin
- Otolaryngology, Midlands Regional Hospital Tullamore, Tullamore, Ireland
| | - Sofia Cuco Guerreiro
- Endocrine Surgery, University Hospital Center of Central Lisbon, Hospital Curry Cabral, Lisboa, Portugal
| | - Karan Gupta
- Department of Head and Neck Surgery, Medanta, Gurugram, India
| | - Keshav Kumar Gupta
- Department of ENT, University Hospitals Birmingham NHS Trust, Birmingham, UK
| | - Angela Gurrado
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy
| | | | - Tommi Hakala
- Department of Surgery, Tampere University Hospital, Tampere, Finland
| | - Wirsma Arif Harahap
- Department of Surgery, Faculty of Medicine, Universitas Andalas, Padang City, Indonesia
| | - Lindsay Hargitai
- Department of General Surgery, Division of Visceral Surgery, Medical University Vienna, Vienna, Austria
| | - Dana Hartl
- Department of Surgery, Anesthesia and Interventional Radiology, Head and Neck Oncology Service, Thyroid Surgery Unit, Gustave Roussy, Villejuif, France
| | - Andrzej Hellmann
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Jiri Hlozek
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, Prague, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Van Trung Hoang
- Department of Radiology, Thien Hanh Hospital, Buon Ma Thuot, Vietnam
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Nadia Innaro
- Unit of Endocrine Surgery, AOU Mater Domini, Catanzaro, Italy
| | - Orestis Ioannidis
- Fourth Department of Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital "Georgios Papanikolaou", Thessaloniki, Greece
| | - J H Isabelle Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore
| | | | - Milan Jovanovic
- Clinic for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, Belgrade, Serbia
| | - Reto Martin Kaderli
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fahmi Kakamad
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Iraq
| | - Krzysztof Kaliszewski
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Martin Karamanliev
- Department of Surgical Oncology, University Hospital "Georgi Stranski", Faculty of Medicine, Medical University of Pleven, Pleven, Bulgaria
| | - Hiroshi Katoh
- Department of Breast and Endocrine Surgery, Kitasato University Hospital, Sagamihara, Japan
| | - Andro Košec
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Bozidar Kovacevic
- Institute of Pathology and Forensic Medicine, Medical Military Academy, Belgrade, Serbia
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgry and Otorhinolaryngology, AC Camargo Cancer Center, São Paulo, Brazil
| | - Robert Králik
- Department of Surgical Oncology, St Elisabeth Cancer Institute, Medical Faculty of Comenius University, Bratislava, Slovakia
| | | | - Adriána Kumorová
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Central Military Hospital Ružomberok, Ružomberok, Slovakia
| | - Savvas Lampridis
- Department of Thoracic Surgery, 424 General Military Hospital, Thessaloniki, Greece
| | - Konstantinos Lasithiotakis
- Department of Surgery, University Hospital of Heraklion, Medical School, University of Crete, Crete, Greece
| | | | | | | | - James Y Lim
- Department of Surgery and Otolaryngology, Oregon Health and Science University, Portland, OR, USA
| | | | - Shirley Yuk Wah Liu
- Department of Surgery, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Núria Perucho Llorach
- Unit of Endocrine Surgery Head and Neck Parc Tauli, Hospital Universitari, Sabadell, Spain
| | - Celestino Pio Lombardi
- Division of Endocrine Surgery, Department of Gastroenterologic, Endocrine-Metabolic and Nephro-Urologic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Javier López-Gómez
- Head and Neck Department, Hospital de Oncología Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | - Eleonora Lori
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Lourdes Quintanilla-Dieck
- Department of Pediatric Otolaryngology, Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Roberta Lucchini
- Endocrine Surgery Unit, University of Perugia, Santa Maria Hospital, Terni, Italy
| | - Amin Madani
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Dimitrios Manatakis
- Second Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
| | - Ivan Markovic
- Clinic for Surgical Oncology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | | | - Haggi Mazeh
- Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | | | - Olgica Mihaljevic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Julie A Miller
- The Royal Melbourne Hospital and Epworth Hospital, Melbourne, VIC, Australia
| | - Michele Minuto
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genova, Italy
| | | | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Barbara Mullineris
- Department of General, Emergency and New Technologies, University Hospital of Modena, Baggiovara Civil Hospital, Modena, Italy
| | - José Luis Muñoz-de-Nova
- Department of General and Digestive Surgery, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Saki Nader
- Otolaryngology Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Chiara Offi
- Department of Endocrine and Ultrasound-Guided Surgery, Ospedale del Mare, ASl Napoli 1 Centro, Naples, Italy
| | - Ohad Ronen
- Galilee Medical Center, Azrieli Faculty of Medicine Bar Ilan University, Safed, Israel
| | | | - Aida Orois
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Yongqin Pan
- Department of Thyroid Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Emmanouil Panagiotidis
- Department of Nuclear Medicine/PET CT, Theageneio Cancer Hospital of Thessaloniki, Thessaloniki, Greece
| | | | - Theodosios Papavramidis
- First Propedeutic Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Pradipta Kumar Parida
- Department of ENT-Head and Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Anna Paspala
- Department of Surgery, Eugenideio Hospital, Athens, Greece
| | - Òscar Vidal Pérez
- General Surgery Department, Universitat de Barcelona, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Marco Raffaelli
- UOC Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | | | - Tomas Ratia Gimenez
- General Surgery, Hospital Universitario Principe de Asturias, Alcala de Henares, Spain
| | - Ángel Rivo Vázquez
- Department of General and Digestive Surgery, Division of Endocrine Surgery, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Jong-Lyel Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Leonardo Rossi
- Endocrine Surgery Unit, University Hospital of Pisa, Pisa, Italy
| | - Alvaro Sanabria
- Department of Surgery, Universidad de Antioquia, CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia
| | - Alena Santeerapharp
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Arseny Semenov
- Endocrine Surgery Department, Saint Petersburg State University Hospital, Saint Petersburg, Russia
| | | | - Altinay Serdar
- Department of Endocrin Pathology Unit, University of Health Sciences, Faculty of Medicine, Bakırköy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | | | - Sean C Sheppard
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Rachel L Slotcavage
- Department of Surgery and Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Soo Young Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, South Korea
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Chutintorn Sriphrapradang
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Mario Testini
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy
| | - Yigit Turk
- Division of Endocrine Surgery, General Surgery Department, Ege University Hospital, Izmir, Turkey
| | - George Tzikos
- First Propedeutic Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Kristina Vabalayte
- Endocrine Surgery Department, Saint Petersburg State University Hospital, Saint Petersburg, Russia
| | - Kelly Vargas-Osorio
- Clinical University Hospital Santiago de Compostela University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - David Velázquez-Fernández
- Endocrine Surgery Unit, Department of Surgery, National Institute for Medical Sciences and Nutrition, Mexico City, Mexico
| | | | - Levent Yücel
- Department of Otorhinolaryngology, University of Health Sciences, Gülhane Research and Training Hospital, Ankara, Turkey
| | - Erwin Danil Yulian
- Division of Surgical Oncology, Department of Surgery, Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Petra Zahradnikova
- Department of Paediatric Surgery, Medical Faculty of Comenius University, National Institute of Children's Diseases, Bratislava, Slovakia
| | - Paul Zarogoulidis
- Third Surgery Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evgeniia Ziablitskaia
- Central Research Laboratory, Clinical Medical Multidisciplinary Center of St Luke VI Vernadsky Crimean Federal University, Simferopol, Russia
| | - Anna Zolotoukho
- Endocrine Surgery Department, Saint Petersburg State University Hospital, Saint Petersburg, Russia
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Anedda G, Cappellacci F, Canu GL, Farris S, Calò PG, Dessena M, Medas F. Axillary Treatment Management in Breast Cancer during COVID-19 Pandemic (Association between ACOSOG Z0011 Criteria and OSNA Test). J Pers Med 2023; 13:jpm13020241. [PMID: 36836475 PMCID: PMC9960710 DOI: 10.3390/jpm13020241] [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: 12/20/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The outbreak of the SARS-COVID-2 pandemic (COVID-19) had a significant effect on the organisation of healthcare systems. Surgical units saw a significant reduction in the volume of surgical procedures performed, with lengthening waiting lists as a consequence. We assessed the surgical activity in relation to breast cancer that took place at the University Hospital of Cagliari, Italy, from February 2018 to March 2022. Two phases were identified based on the epidemiological circumstances: Phase 1-February 2018 to February 2020; Phase 2-March 2020 to March 2022. The surgery performed in the two phases was then compared. All the patients in our sample underwent a breast surgical procedure involving a lymph node biopsy using OSNA associated with the ACOSOG Z0011 criteria. In the study period overall at our facility, there were 4214 procedures, 417 of which involved breast surgery. In Phase 2, 91 procedures were performed using the OSNA method and ACOSOG Z0011 criteria, enabling the intraoperative staging of axillary nodes. Axillary treatment in breast cancer using this approach resulted in a significant reduction in the number of reoperations for the radicalisation of metastatic sentinel lymph nodes.
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Affiliation(s)
- Giacomo Anedda
- Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
- Correspondence: ; Tel.: +39-3335351390
| | | | - Gian Luigi Canu
- Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Stefania Farris
- Polispecialistyc Surgery Unit, Policlinico Universitario “Duilio Casula”, 09042 Cagliari, Italy
| | - Pietro Giorgio Calò
- Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Massimo Dessena
- Polispecialistyc Surgery Unit, Policlinico Universitario “Duilio Casula”, 09042 Cagliari, Italy
| | - Fabio Medas
- Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
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Kamiński M, Skrzypczak P, Staszewski R, Roszak M. Effects of the COVID-19 Pandemic on the Interest of Google Queries in Cancer Screening and Cancers: A Retrospective Study. Cancers (Basel) 2023; 15:cancers15030617. [PMID: 36765582 PMCID: PMC9913796 DOI: 10.3390/cancers15030617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
The COVID-19 pandemic disrupted cancer screening programs and care for individuals with malignancies. We aimed to analyze the effects of the COVID-19 pandemic on the interest of Google users in cancers and their screenings. We collected data from Google Trends (GT) from 1 January 2015 to 31 December 2021 worldwide for nine topics representing cancer screening and the HPV vaccine and for 33 topics representing malignancies. We performed a secular analysis comparing the prepandemic (2015-2019) and pandemic (2020-2021) period. We performed forecasting analysis on the prepandemic timeline to assess interest in the analyzed topics if the pandemic hadnot occurred.The actual interest in most of the analyzed topics was significantly lower than in the forecasted trend. Interest in 6 of the 9 topics representing cancer screening and 3 of the 33 topics representing cancer was higher during the pandemic than in the prepandemic period. The interest of Google users in cancer screenings increased in 2020-2021 compared to 2015-2019, but the growth was less dynamic than expected. The interest in many cancers during the pandemic was significantly lower than in the prepandemic period, especially during March and April 2020. The lower interest in cancers and their screenings may delay the diagnosis and worsen the long-term outcomes.
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Affiliation(s)
- Mikołaj Kamiński
- District Hospital in Kościan, Department of Rheumatology, 64-000 Kościan, Poland
- Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, 60-569 Poznań, Poland
| | - Piotr Skrzypczak
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego St. 62, 60-569 Poznań, Poland
- Correspondence: ; Tel.: +48-661-962-498
| | - Rafał Staszewski
- Department of Hypertension, Angiology and Internal Diseases, Poznan University of Medical Sciences, 61-848 Poznań, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Rokietnicka St. 7, 60-806 Poznań, Poland
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