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Balan L, Secosan C, Sorop VB, Pirtea M, Cimpean AM, Chiriac D, Balan C, Borsi E, Iorga A, Pirtea L. Impact of SARS-CoV-2 Pandemic on the Diagnosis of Cervical Cancer and Precursor Lesions-A Single-Center Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:909. [PMID: 38929526 PMCID: PMC11206154 DOI: 10.3390/medicina60060909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/19/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Our aim was to perform a retrospective analysis of the volume of cervical screening tests, the number of patients treated with an excision method, and the incidence of invasive and non-invasive cervical during a pandemic and pre-pandemic period of 24 months. Materials and Methods: The study compared 404 patients who underwent cervical cone biopsy for cervical cancer. The study examined patients' specimens based on histopathological characteristics and categorized cervical lesions based on pap smear. Results: There was a statistically significant age difference between the two study periods. The mean difference was 32 years before the pandemic and 35 years during the pandemic (p-value > 0.05). The biggest patient loss ratio identified by age group was in the 50-59-year group, with a 14.53% loss in the pre-pandemic period and a 9.1% loss in the pandemic period. In the pandemic period, patients from rural areas presented in the clinical trial with a lower rate of 39.52% (83 patients) vs. 60.47% (127 patients) in urban areas. A higher percentage of patients experiencing cervicorrhagia as a clinical manifestation in the pandemic period vs. the pre-pandemic period, with an increase in more severe lesions in the pandemic period, had a statistical significance of 8% more newly diagnosed compared to the pre-pandemic period. Conclusions: The addressability of the patients during the COVID period was not affected in a drastic way in our study. We encountered a decrease in appointments in the age group of 50-59 years and a decrease in patients with rural residence. In our study, we found an increase in cervical bleeding as a reason for consultation in the pandemic period with a higher lesion degree, both on a pap smear and on a cervical biopsy.
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Affiliation(s)
- Lavinia Balan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Cristina Secosan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Virgiliu-Bogdan Sorop
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Marilena Pirtea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Anca Maria Cimpean
- Department of Microscopic Morphology/Histology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Daniela Chiriac
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
| | - Catalin Balan
- Department of Cell and Molecular Biology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Ema Borsi
- Department of Internal Medicine, Discipline of Hematology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Ariana Iorga
- Clinical Hospital of Infectious Diseases and Pulmonology “Dr. Victor Babes”, 300310 Timisoara, Romania;
| | - Laurentiu Pirtea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.B.); (V.-B.S.); (M.P.); (D.C.); (L.P.)
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Simelane SM, Munyakazi JB, Dlamini PG, Egbelowo OF. Projections of human papillomavirus vaccination and its impact on cervical cancer using the Caputo fractional derivative. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:11605-11626. [PMID: 37501411 DOI: 10.3934/mbe.2023515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
We propose a fractional order model for human papillomavirus (HPV) dynamics, including the effects of vaccination and public health education on developing cervical cancer. First, we discuss the general structure of Caputo fractional derivatives and integrals. Next, we define the fractional HPV model using Caputo derivatives. The model equilibrium quantities, with their stability, are discussed based on the magnitude of the reproduction number. We compute and simulate numerical solutions of the presented fractional model using the Adams-Bashforth-Moulton scheme. Meanwhile, real data sourced from reports from the World Health Organization is used to establish the parameters and compute the basic reproduction number. We present figures of state variables for different fractional orders and the classical integer order. The impacts of vaccination and public health education are discussed through numerical simulations. From the results, we observe that an increase in both vaccination rates and public health education increases the quality of life, and thus, reduces disease burden and suffering in communities. The results also confirm that modeling HPV transmission dynamics using fractional derivatives includes history effects in the model, making the model further insightful and appropriate for studying HPV dynamics.
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Affiliation(s)
- Simphiwe M Simelane
- Department of Mathematics and Applied Mathematics, University of Johannesburg, Doornfontein, 2028, South Africa
| | - Justin B Munyakazi
- Department of Mathematics and Applied Mathematics, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa
| | - Phumlani G Dlamini
- Department of Mathematics and Applied Mathematics, University of Johannesburg, Doornfontein, 2028, South Africa
| | - Oluwaseun F Egbelowo
- Department of Mathematics and Applied Mathematics, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa
- DSI-NRF Centre of Excellence in Mathematical and Statistical Sciences (CoE-MaSS), South Africa
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McMullan JC, Rainey L, Morgan D, Johnston L. The effect of COVID-19 on the cervical screening programme within a Northern Irish Health and Social care trust. THE ULSTER MEDICAL JOURNAL 2023; 92:84-88. [PMID: 37649920 PMCID: PMC10464633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Precis COVID-19 has had a significant impact on the waiting times for cervical screening and colposcopy but no impact on the severity of disease outcomes. Abstract Objectives/Purposes of the study:: To assess the impact of the COVID-19 pandemic on the cervical screening programme and colposcopy services in Northern Ireland.Methods: All new patients referred to colposcopy following an abnormal cervical smear result from September to November 2019 and 2020 were included. Review patients and those referred to colposcopy for another indication in the same time frame were excluded. Data collected included the presenting smear result and the time to report, time interval to colposcopy review, cervical biopsy method, result and the time to report. Statistical analysis was performed using JASP (JASP V.0.16.1, 2022) and included Shapiro-Wilk normality test and Mann-Whitney U test to compare means.Results: There was an 11% reduction in the number of presenting cervical smears (7155 vs 6379) in 2020 with a 46% reduction (158 vs 85) in the number of colposcopy referrals. In 2020 there was a mean increase of 6 days to report the presenting smear (P<0.01), mean decrease of 49 days to attend colposcopy (P<0.01) and a mean decrease of 36 days to report the cervical biopsy result (P<0.01). An increase of 14 days (P= 0.01) and 15 days (P=0.01) respectively to attend colposcopy for moderate and severe dyskaryosis in 2020. No statistical difference was seen in the frequency of presenting smear results, method of cervical biopsy and cervical biopsy results in 2020.Conclusion: COVID-19 has had a significant impact on the number of patients referred to colposcopy and the time intervals in cervical screening but no significant short term impact on the severity of disease outcomes.
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Affiliation(s)
- Josh Courtney McMullan
- Dr. Josh Courtney McMullan, MBBch MRCOG, Northern Ireland Medical & Dental Training Agency (NIMDTA), Northern Ireland
| | - Laura Rainey
- Dr. Laura Rainey, MBBch, NIMDTA, Northern Ireland
| | - David Morgan
- Dr. David Morgan, MBBCH MRCOG, Antrim Area Hospital, Northern Health & Social Care Trust (NHSCT), Northern Ireland
| | - Lorraine Johnston
- Dr. Lorraine Johnston, MBBCH MRCOG, Causeway Hospital, NHSCT, Northern Ireland
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Ramírez-Soto MC, Salazar-Peña M, Vargas-Herrera J. Estimating Excess Mortality Due to Prostate, Breast, and Uterus Cancer during the COVID-19 Pandemic in Peru: A Time Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5156. [PMID: 36982065 PMCID: PMC10049374 DOI: 10.3390/ijerph20065156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
During the COVID-19 pandemic, most of the deaths in Peru were related to COVID-19; however, cancer deaths have also been exacerbated in the first months of the pandemic. Despite this, excess mortalities of prostate, breast, and uterus cancer are not available by age group and region from January to December 2020. Therefore, we estimated the excess deaths and excess death rates (per 100,000 habitants) due to prostate, breast, and uterus cancer in 25 Peruvian regions. We did a time series analysis. Prostate, breast, and uterus cancer death data for 25 Peruvian regions were retrieved during the COVID-19 pandemic in 2020, as well as data for up to 3 years prior (2017-2019) from the Sistema Informatico Nacional de Defunciones at the Ministry of Health of Peru. Deaths in 2020 were defined as observed deaths. The expected deaths (in 2020) were estimated using the average deaths over 3 preceding years (2017, 2018 and 2019). Excess mortality was calculated as the difference between observed mortality and expected mortality in 2020. We estimated that the number of excess deaths and the excess death rates due to prostate, breast, and uterus cancer were 610 deaths (55%; 12.8 deaths per 100,000 men), 443 deaths (43%; 6 deaths per 100,000 women), and 154 deaths (25%; 2 deaths per 100,000 women), respectively. Excess numbers of deaths and excess death rates due to prostate and breast cancer increased with age. These excess deaths were higher in men aged ≥ 80 years (596 deaths (64%) and 150 deaths per 100,000 men) and women aged 70-79 years (229 deaths (58%) and 15 deaths per 100,000 women), respectively. In summary, during the COVID-19 pandemic, there were excess prostate and breast cancer mortalities in 2020 in Peru, while excess uterus cancer mortalities were low. Age-stratified excess death rates for prostate cancer and breast cancer were higher in men ≥ 80 years and in women ≥ 70 years, respectively.
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Affiliation(s)
| | | | - Javier Vargas-Herrera
- Unidad de Telemedicina, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima 15001, Peru;
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Chopra S, Mulani J, Mittal P, Singh M, Shinde A, Gurram L, Scaria L, Aravindakshan D, Kohle S, Rane P, Ghadi Y, Rath S, Ghosh J, Gulia S, Gupta S, Kinhikar R, Laskar S, Agarwal JP. Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic. Brachytherapy 2023; 22:125-131. [PMID: 36585283 PMCID: PMC9626438 DOI: 10.1016/j.brachy.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Brachytherapy (BT) for cervix cancer was listed as a level I priority and reduced number of implants and multiple fractions were recommended during COVID-19 pandemic. We present early clinical outcome of this approach. METHODS AND MATERIALS Patients treated with (chemo)radiotherapy and BT with single implant and multiple fractions BT were included. Treatment protocol included 3-5 fractions of 5-8.5 Gy with an aim to achieve point A dose of 70 Gy EQD210Gy (or HRCTV dose of >80 Gy EQD210Gy) in those undergoing intracavitary (IC) and HRCTV dose >85 Gy EQD2 10Gy in patients undergoing Intracavitary-Interstitial (IC/IS) whereas maintaining bladder (B2cc), rectum (R2cc), sigmoid (S 2cc) doses of 90, 75, and 75 Gy EQD23Gy. Time to event analysis was used to report oncological endpoints. Toxicity was reported using crude proportions. RESULTS From April 2020 to March, 2021, 64 patients with stage IB2-IV received single implant and multi-fraction BT after external radiation of 45 Gy/25 fractions/5 weeks. Only 76.7% (n = 49) received concurrent chemotherapy. Median overall treatment time (OTT) was 56 days (38-131 days). Overall, 62.5% (n = 40) patients received IC and 37.5% (n = 24) received IC+IS. The median HRCTV was 34.7 cc (IQR 25-41). Median (IQR) point A dose, HRCTV D90, B2cc, R2cc, and S2cc for those undergoing IC was 74 Gy (71-78), 80 Gy (73-84), 86 Gy (82-89), 70 Gy (65-74), 65 Gy (59-73) respectively. For the IC+IS cohort, HRCTV D90, B2cc, R2cc, and S2cc was 84 Gy (78-89 Gy), 89 Gy (86-92), 70 Gy (67-74), 68 Gy (59-76). At a median follow-up of 16 months (5-27) the 2-year local control, pelvic control, cause specific and overall survival was 88%, 85.3%, 92.2%, and 81.3% respectively. Late gastrointestinal and genitourinary grade ≥III toxicities were 14% and 1.5% each. CONCLUSIONS Abbreviated BT outcomes are encouraging for oncological outcomes despite delays in overall treatment time and omission of chemotherapy. Further mature follow up is needed.
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Affiliation(s)
- Supriya Chopra
- Department of Radiation Oncology, Advanced Centre For Treatment, Research and Education in Cancer(ACTREC), Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India.
| | - Jaahid Mulani
- Department of Radiation Oncology, Advanced Centre For Treatment, Research and Education in Cancer(ACTREC), Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
| | - Prachi Mittal
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Maneesh Singh
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Amruta Shinde
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Lavanya Gurram
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Libin Scaria
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Dheera Aravindakshan
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Satish Kohle
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Priyanka Rane
- Department of Radiation Oncology, Advanced Centre For Treatment, Research and Education in Cancer(ACTREC), Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
| | - Yogesh Ghadi
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sushmita Rath
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Jaya Ghosh
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Seema Gulia
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Rajesh Kinhikar
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sarbani Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Jai Prakash Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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van Vliet ED, Eijkelboom AH, van Giessen A, Siesling S, de Wit GA. Physical and mental health outcomes of COVID-19 induced delay in oncological care: A systematic review. Front Oncol 2023; 13:998940. [PMID: 36776332 PMCID: PMC9911660 DOI: 10.3389/fonc.2023.998940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/16/2023] [Indexed: 01/29/2023] Open
Abstract
Background During the COVID-19 pandemic cancer patients might have experienced delays in screening, diagnosis and/or treatment. A systematic review was conducted to give an overview of the effects of COVID-19 induced delays in oncological care on the physical and mental health outcomes of cancer patients. Methods MEDLINE and EMBASE databases were searched for articles on the effects of COVID-19 induced delays on physical and mental health outcomes. Results Out of 1333 papers, eighteen observational, and twelve modelling studies were included. In approximately half of the studies, tumor stage distribution differed during the pandemic compared to before the pandemic. Modelling studies predicted that the estimated increase in the number of deaths ranged from -0.04 to 30%, and the estimated reduction in survival ranged from 0.4 to 35%. Varying results on the impact on mental health, e.g. anxiety and depression, were seen. Conclusions Due to large methodological discrepancies between the studies and the varying results, the effect of COVID-19 induced delays on the physical and mental health outcomes of cancer patients remains uncertain. While modelling studies estimated an increase in mortality, observational studies suggest that mortality might not increase to a large extent. More longitudinal observational data from the pandemic period is needed for more conclusive results.
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Affiliation(s)
- Ella D. van Vliet
- Center for Health Protection, National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands,*Correspondence: Ella D. van Vliet,
| | - Anouk H. Eijkelboom
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands,Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Anoukh van Giessen
- Center for Nutrition, Prevention and Healthcare, National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands,Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - G. Ardine de Wit
- Center for Nutrition, Prevention and Healthcare, National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands,Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam & Amsterdam Health Research Institute, Amsterdam, Netherlands
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Ananthakrishnan A, Luz ACG, KC S, Ong L, Oh C, Isaranuwatchai W, Dabak SV, Teerawattananon Y, Turner HC. How can health technology assessment support our response to public health emergencies? Health Res Policy Syst 2022; 20:124. [PMID: 36333759 PMCID: PMC9636714 DOI: 10.1186/s12961-022-00925-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Public health emergencies (PHEs), such as the COVID-19 crisis, are threats to global health and public order. We recommend that countries bolster their PHE responses by investing in health technology assessment (HTA), defined as a systematic process of gathering pertinent information on and evaluating health technologies from a medical, economic, social and ethical standpoint. We present examples of how HTA organizations in low- and middle-income countries have adapted to supporting PHE-related decisions during COVID-19 and describe the ways HTA can help the response to a PHE. In turn, we advocate for HTA capacity to be further developed globally and for increased institutional acceptance of these methods as a building block for preparedness and response to future PHEs. Finally, the long-term potential of HTA in strengthening health systems and embedding confidence and transparency into scientific policy should be recognized.
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Affiliation(s)
- Aparna Ananthakrishnan
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Alia Cynthia Gonzales Luz
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Sarin KC
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Leslie Ong
- Access and Delivery Partnership, United Nations Development Programme (UNDP), Bangkok, Thailand
| | - Cecilia Oh
- Access and Delivery Partnership, United Nations Development Programme (UNDP), Bangkok, Thailand
| | - Wanrudee Isaranuwatchai
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand ,grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON Canada
| | - Saudamini Vishwanath Dabak
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Yot Teerawattananon
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand ,grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hugo C. Turner
- grid.7445.20000 0001 2113 8111MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
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Soni K, Neville JF, Purwar R, Kumar T, Yadav G, Verma N, Pandey M. Cancer surgery during COVID increased the patient mortality and the transmission risk to healthcare workers: results from a retrospective cohort study (NCT05240378). World J Surg Oncol 2022; 20:302. [PMID: 36127678 PMCID: PMC9485781 DOI: 10.1186/s12957-022-02761-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND India encountered two waves of COVID-19 pandemic with variability in its characteristics and severity. Concerns were raised over the safety of treatment, and higher morbidity was predicted for oncological surgery. The present study was conducted to evaluate and compare the rate of morbidity and mortality in patients undergoing curative surgery for cancer before and during the COVID-19 pandemic. METHOD The prospectively obtained clinical data of 1576 patients treated between April 2019 and May 2021 was reviewed; of these, 959 patients were operated before COVID-19 and 617 during the pandemic. The data on complications, deaths, confirmed or suspected COVID-19 cases, and COVID-19 infection among health workers (HCW) was extracted. RESULTS A 35% fall in number of surgeries was seen during the COVID period; significant fall was seen in genital and esophageal cancer. There was no difference in postoperative complication; however, the postoperative mortality was significantly higher. A total of 71 patients had COVID-19, of which 62 were preoperative and 9 postoperative, while 30/38 healthcare workers contracted COVID-19, of which 7 had the infection twice and 3 were infected after two doses of vaccination; there was no mortality in healthcare workers. CONCLUSION The present study demonstrates higher mortality rates after surgery in cancer patients, with no significant change in morbidity rates. A substantial proportion of HCWs were also infected though there was no mortality among this group. The results suggest higher mortality in cancer patients despite following the guidelines and protocols.
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Affiliation(s)
- Kishan Soni
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - J F Neville
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Roli Purwar
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Tarun Kumar
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Ghanshyam Yadav
- Department of Anesthesia, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Nimisha Verma
- Department of Anesthesia, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Manoj Pandey
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
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Poniewierza P, Panek G. Cervical Cancer Prophylaxis—State-of-the-Art and Perspectives. Healthcare (Basel) 2022; 10:healthcare10071325. [PMID: 35885852 PMCID: PMC9319342 DOI: 10.3390/healthcare10071325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/28/2022] [Accepted: 07/12/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Each year 604,127 new cases of cervical cancer (CC) are diagnosed, and 341,831 individuals die from the disease. It is the fourth most common cancer among women and the fourth most common cause of death from female cancers worldwide. The pathogenesis of CC is associated with human papillomavirus (HPV) infections and consists of several steps involving cell proliferation outside the human body’s control mechanisms. Strategies to prevent CC are based on screening and vaccination. Scope of the Review: The aim of this paper was to collect and analyze the available literature on the issue of CC prevention and the impact of the COVID-19 pandemic on its implementation. For this purpose, PubMed and Google Scholar databases were searched using keywords, such as “cervical cancer”; “HPV”; “prevention”; “prophylaxis”; “vaccination”; “screening” and “COVID-19” in different variations. Only articles published since 2018 were included in the study. Conclusions: Selected European countries have different CC prevention programs funded by national budgets. This translates into observed differences in the risk of death from CC (age-standardized rate Malta = 1.1, Poland = 5.9). COVID-19 pandemic due to disruption of CC screening may exacerbate these differences in the future. To improve the situation, new screening methods, such as p16/Ki67, HPV self-testing, and the use of artificial intelligence in colposcopic assessment, should be disseminated, as well as free HPV vaccination programs implemented in all countries. The search for new solutions is not without significance and entails ultra-sensitive screening tests for risk groups (mRNA E6/E7, SOX1/SOX14), HPV vaccines with shorter dosing schedules, and new therapeutic pathways using nanotheranostics.
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Affiliation(s)
- Patryk Poniewierza
- Medicover SP ZOO Company, Aleje Jerozolimskie 96, 00-807 Warsaw, Poland
- Correspondence:
| | - Grzegorz Panek
- Department of Oncologic Gynecology and Obstetrics, The Center of Postgraduate Medical Education, 00-416 Warsaw, Poland;
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Jardim BC, Migowski A, Corrêa FDM, Silva GAE. Covid-19 in Brazil in 2020: impact on deaths from cancer and cardiovascular diseases. Rev Saude Publica 2022; 56:22. [PMID: 35476100 PMCID: PMC9004704 DOI: 10.11606/s1518-8787.2022056004040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/20/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To analyze the impact of the covid-19 pandemic on mortality from cancer and cardiovascular diseases (CVD) as underlying cause and comorbidity in Brazil and Brazilian regions in 2020. METHODS We used the 2019 and 2020 databases of the Mortality Information System (SIM) to analyze deaths occurring between March and December of each year that had cancer or CVD as the underlying cause or comorbidity. Deaths from covid-19 in 2020 were also analyzed. To estimate the Standardized Mortality Ratio (SMR) and the excess of deaths, 2019 data were considered as standard. RESULTS Between March and December 2020, there were 181,377 deaths from cancer and 291,375 deaths from cardiovascular diseases in Brazil, indicating reduction rates of 9.7% and 8.8%, respectively, compared to the same period of the previous year. The pattern was maintained in the five Brazilian regions, with lower variation for cancer (-8.4% in the South to -10.9% in the Midwest). For CVD, the variation was greater, from -2.2% in the North to -10.5 in the Southeast and South. In the same period of 2020, these diseases were classified as comorbidities in 18,133 deaths from cancer and 188,204 deaths from cardiovascular diseases, indicating a proportional excess compared to data from 2019, of 82.1% and 77.9%, respectively. This excess was most significant in the Northern Region, with a ratio of 2.5 between observed and expected deaths for the two conditions studied. CONCLUSIONS Excess deaths from cancer and CVD as comorbidities in 2020 may indicate that covid-19 had an important impact among patients with these conditions.
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Affiliation(s)
- Beatriz Cordeiro Jardim
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hésio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hésio Cordeiro. Rio de Janeiro, RJ, Brasil
| | - Arn Migowski
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
- Instituto Nacional de CardiologiaCoordenação de Ensino e PesquisaNúcleo de EpidemiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia. Coordenação de Ensino e Pesquisa. Núcleo de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Flávia de Miranda Corrêa
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
| | - Gulnar Azevedo e Silva
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hésio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hésio Cordeiro. Rio de Janeiro, RJ, Brasil
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11
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Popescu A, Craina M, Pantea S, Pirvu C, Chiriac VD, Marincu I, Bratosin F, Bogdan I, Hosin S, Citu C, Bernad E, Neamtu R, Dumitru C, Mocanu AG, Avram C, Gluhovschi A. COVID-19 Pandemic Effects on Cervical Cancer Diagnosis and Management: A Population-Based Study in Romania. Diagnostics (Basel) 2022; 12:diagnostics12040907. [PMID: 35453955 PMCID: PMC9031697 DOI: 10.3390/diagnostics12040907] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
The Pap test plays a significant role worldwide in the early diagnosis of and high curability rates for cervical cancer. However, the coronavirus disease 2019 (COVID-19) pandemic necessitated the use of multiple drastic measures to stop the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, limiting women’s access to essential invasive and non-invasive investigations for cervical cancer diagnosis. Therefore, we aimed to determine the impact the COVID-19 pandemic had on cancer diagnosis and management in western Romania. A retrospective study design allowed us to compare the last 24 months of the pre-pandemic period with the first 24 months of the COVID-19 pandemic to determine the change in volume of cervical screening tests, the number of newly diagnosed cases and their severity, and the access to cancer care. A drastic 75.5% decrease in the volume of tests was observed in April 2020 during the first lockdown, after which the volume of cases decreased by up to 36.1% in December 2021. The total volume loss of tests during the first 24 months of the pandemic was 49.9%. The percentage of late-stage cervical cancers (III–IV) rose by 17%, while the number of newly diagnosed cancers in our outpatient clinic was significantly lower than the baseline, with a 45% drop. The access to cancer care was negatively influenced, with 9.2% more patients waiting longer to receive test results over four weeks, while taking longer to seek cancer care after diagnosis (6.4 months vs. 4.1 months pre-pandemic) and missing significantly more appointments. The COVID-19 pandemic had a significantly negative impact on cervical cancer diagnosis and management during the first 24 months compared with the same period before the pandemic. Although the numbers are now recovering, there is still a big gap, meaning that many cervical cancer cases were potentially missed. We recommend further interventions to reduce the gap between the pre-pandemic and pandemic period.
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Affiliation(s)
- Alin Popescu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
| | - Stelian Pantea
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Correspondence: ; Tel.: +40-722-356-233
| | - Catalin Pirvu
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Veronica Daniela Chiriac
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
| | - Iosif Marincu
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.M.); (F.B.); (I.B.)
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.M.); (F.B.); (I.B.)
| | - Iulia Bogdan
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.M.); (F.B.); (I.B.)
| | - Samer Hosin
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
| | - Elena Bernad
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
| | - Adelina Geanina Mocanu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
| | - Claudiu Avram
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Adrian Gluhovschi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (M.C.); (V.D.C.); (C.C.); (E.B.); (R.N.); (C.D.); (A.G.M.); (A.G.)
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12
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COVID-19 Pandemic Impact on Surgical Treatment Methods for Early-Stage Cervical Cancer: A Population-Based Study in Romania. Healthcare (Basel) 2022; 10:healthcare10040639. [PMID: 35455816 PMCID: PMC9024750 DOI: 10.3390/healthcare10040639] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/22/2022] [Accepted: 03/27/2022] [Indexed: 12/30/2022] Open
Abstract
Being one of the most common malignancies in young women, cervical cancer is frequently successfully screened around the world. Early detection enables for an important number of curative options that allow for more than 90% of patients to survive more than three years without cancer relapse. Unfortunately, the COVID-19 pandemic put tremendous pressure on healthcare systems and access to cancer care, determining us to develop a study on the influence the pandemic had on surgical care of cervical cancer, and to assess changes in its management and outcomes. A retrospective study design allowed us to compare cervical cancer trends of the last 48 months of the pre-pandemic period with the first 24 months during the COVID-19 pandemic, using the database from the Timis County Emergency Clinical Hospital. New cases of cervical cancer presented to our clinic in more advanced stages (34.6% cases of FIGO stage III during the pandemic vs. 22.4% before the pandemic, p-value = 0.047). These patients faced significantly more changes in treatment plans, postponed surgeries, and postponed radio-chemotherapy treatment. From the full cohort of cervical cancer patients, 160 were early stages eligible for curative intervention who completed a three-year follow-up period. The disease-free survival and overall survival were not influenced by the surgical treatment of choice, or by the SARS-CoV-2 infection (log-rank p-value = 0.449, respectively log-rank p-value = 0.608). The individual risk factors identified for the three-year mortality risk were independent of the SARS-CoV-2 infection and treatment changes during the COVID-19 pandemic. We observed significantly fewer cases of cervical cancer diagnosed per year during the first 24 months of the COVID-19 pandemic, blaming the changes in healthcare system regulations that failed to offer the same conditions as before the pandemic. Even though we did not observe significant changes in disease-free survival of early-stage cervical cancers, we expect the excess of cases diagnosed in later stages to have lower survival rates, imposing the healthcare systems to consider different strategies for these patients while the pandemic is still ongoing.
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13
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Gupta N, Nehra P, Chauhan AS, Mehra N, Singh A, Krishnamurthy MN, Rajsekhar K, Kalaiyarasi JP, Roy PS, Malik PS, Mathew A, Malhotra P, Kataki AC, Dixit J, Gupta S, Kumar L, Prinja S. Cost Effectiveness of Bevacizumab Plus Chemotherapy for the Treatment of Advanced and Metastatic Cervical Cancer in India-A Model-Based Economic Analysis. JCO Glob Oncol 2022; 8:e2100355. [PMID: 35286136 PMCID: PMC8932481 DOI: 10.1200/go.21.00355] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Patients with advanced and metastatic cervical cancer have a poor prognosis with a 1-year survival rate of 10%-15%. Recently, an antiangiogenic humanized monoclonal antibody bevacizumab has shown to improve the survival of these patients. This study was designed to assess the cost effectiveness of incorporating bevacizumab with standard chemotherapy for the treatment of patients with advanced and metastatic cervical cancer in India.
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Affiliation(s)
- Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Prerika Nehra
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Akashdeep Singh Chauhan
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nikita Mehra
- Department of Medical Oncology, Adyar Cancer Institute, Chennai, India
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College, Vellore, India
| | | | - Kavitha Rajsekhar
- Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
| | | | - Partha Sarathi Roy
- Department of Medical Oncology, Dr B. Booroah Cancer Institute, Guwahati, India
| | - Prabhat Singh Malik
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Anisha Mathew
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Pankaj Malhotra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amal Chandra Kataki
- Department of Gynaecologic Oncology, Dr B. Booroah Cancer Institute, Guwahati, India
| | - Jyoti Dixit
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Lalit Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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14
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Why cervical self-sampling can aid radiotherapy in India in the COVID-19 era. J Cancer Policy 2022; 32:100330. [PMID: 35560267 PMCID: PMC8917643 DOI: 10.1016/j.jcpo.2022.100330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/09/2022] [Accepted: 03/11/2022] [Indexed: 11/21/2022]
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15
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Venkatasai J, John C, Kondavetti SS, Appasamy M, Parasuraman L, Ambalathandi R, Masilamani H. Impact of COVID-19 Pandemic on Patterns of Care and Outcome of Head and Neck Cancer: Real-World Experience From a Tertiary Care Cancer Center in India. JCO Glob Oncol 2022; 8:e2100339. [PMID: 35213235 PMCID: PMC8887950 DOI: 10.1200/go.21.00339] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic has caused unprecedented health, social, and economic unrest globally, particularly affecting resource-limited low-middle–income countries. The resultant curfew had made the access to and delivery of cancer care services an arduous task. We have reported the patterns of care and 1-year outcome of head and neck squamous cell carcinoma (HNSCC) treatment before and during COVID-19 lockdown at our institution. COVID-19 restrictions can have adverse impact on the access to and delivery of RT #HNCSM #COVID19![]()
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Affiliation(s)
- Jeyaanth Venkatasai
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Christopher John
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Satish Srinivas Kondavetti
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Mallika Appasamy
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | | | - Ravichandran Ambalathandi
- Department of Medical Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Hemavathi Masilamani
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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16
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Aydın R, Bostan FS, Kabukcuoğlu K. Two wars on one front: Experiences of gynaecological cancer patients in the COVID-19 pandemic. Eur J Cancer Care (Engl) 2022; 31:e13562. [PMID: 35170125 PMCID: PMC9111480 DOI: 10.1111/ecc.13562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/21/2021] [Accepted: 01/26/2022] [Indexed: 11/28/2022]
Abstract
Objective The aim of this study is to explore the experiences of gynaecological cancer patients during the COVID‐19 pandemic from their own perspectives. Methods The study is a descriptive study with a qualitative design based on thematic analysis. We conducted the study with 17 women with gynaecological cancer and receiving chemotherapy in the Medical Oncology and Chemotherapy Unit of Kütahya Training and Research Hospital. The data were collected between April 2021 and May 2021 via an in‐depth individual interview form. The COREQ checklist was followed in the study. Results As a result of the interviews, we identified four main themes: the impacts of COVID‐19 on life, the impact of COVID‐19 on cancer treatment, the biggest fear during the COVID‐19 pandemic and the metaphors of struggling with cancer during the COVID‐19 pandemic. Conclusion The disruption of treatment services during the COVID‐19 pandemic and women's fear of infection by the virus led to delays in cancer diagnosis and treatment. This situation caused the women's state of health to deteriorate, and the resultant regret and sadness that they experienced had an adverse effect on their mental health. Furthermore, women's self‐isolation due to the fear of infection by the virus had a negative effect on their psychosocial health. Telehealth services should be provided for cancer patients to obtain accurate information and to easily access information about treatment processes during the pandemic, and telepsychological hotlines and peer support groups should be established to improve the psychosocial health of patients.
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Affiliation(s)
- Ruveyde Aydın
- Health Sciences Faculty, Karadeniz Technical University, Trabzon, Turkey
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17
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Joseph A, Olatosi B, Haider MR, Adegboyega BC, Lasebikan NN, Aliyu UM, Ali-Gombe M, Jimoh MA, Biyi-Olutunde OA, Awofeso O, Fatiregun OA, Oboh EO, Nwachukwu E, Zubairu IH, Otene SA, Iyare OI, Andero T, Musbau AB, Ajose A, Onitilo AA. Patient's Perspective on the Impact of COVID-19 on Cancer Treatment in Nigeria. JCO Glob Oncol 2022; 8:e2100244. [PMID: 35157511 PMCID: PMC8853626 DOI: 10.1200/go.21.00244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Because of the global COVID-19 pandemic, health care organizations introduced guidelines for modifications to health and cancer medical care delivery to mitigate transmission and ensure quality health outcomes. To examine the extent and impact of these modifications on oncology service disruptions in Nigeria, we surveyed oncology patients across selected public and private cancer treatment centers. Service interruptions because of the COVID-19 pandemic—Nigerian cancer patients' experience.![]()
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Affiliation(s)
- Adedayo Joseph
- NSIA-LUTH Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Bankole Olatosi
- Health Services, Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA
| | | | | | - Usman M Aliyu
- Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | - Mutiu A Jimoh
- University College Hospital, Ibadan, Oyo, Nigeria.,Lakeshore Cancer Center, Lagos, Nigeria
| | | | - Opeyemi Awofeso
- Lagos University Teaching Hospital, Idiaraba, Lagos, Nigeria
| | | | | | | | | | | | | | | | | | - Azeezat Ajose
- Lagos University Teaching Hospital, Idiaraba, Lagos, Nigeria
| | - Adedayo A Onitilo
- Department of Oncology, Marshfield Clinic Health System, Marshfield, WI
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18
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Gangopadhyay A. Elimination of cervical cancer as a public health problem-how shorter brachytherapy could make a difference during COVID-19. Ecancermedicalscience 2022; 16:1352. [PMID: 35510136 PMCID: PMC9023303 DOI: 10.3332/ecancer.2022.1352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Indexed: 01/09/2023] Open
Abstract
The World Health Organization has called for elimination of cervical cancer as a public health problem and has adopted strategies in this regard. However, the estimates for achieving the goals depend on the ability to provide timely treatment in a certain proportion of cases. The coronavirus disease 2019 pandemic has had a serious impact on healthcare delivery in many low and middle income countries (LMICs) with the highest burden of cervical cancer; funds and infrastructure are being reallocated to deal with the emergency, and cancer care has been seriously affected. In the absence of clear and reliable estimates, the exact extent of disruption remains unclear. It is, therefore, essential that pragmatic approaches are adopted to save lives. There has been considerable debate regarding the use of the 9 Gy × 2 fractions high dose rate brachytherapy schedule for the treatment of locally advanced cervical carcinoma. However, in LMICs with the highest global burden of locally advanced cervical cancer cases, radiation facilities have been using this fractionation schedule in many cases to deal with the overwhelming number of patients, who would have otherwise been denied timely treatment. In view of the current pandemic, and the difficulties in accessing and delivering timely healthcare, mortality owing to delayed treatment cannot be denied in LMICs, which already have underequipped healthcare facilities. Use of the shortest available fractionation schedule to provide timely treatment would serve to save more lives in regions with high incidence and mortality from the disease.
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19
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Singh N, Mishra N, Jayraj AS, Ghatage P. Management of Gynecologic Cancer During COVID-19 Pandemic: South Asian Perspective. Cancer Control 2022; 29:10732748221119349. [PMID: 36036360 PMCID: PMC9420651 DOI: 10.1177/10732748221119349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Management of gynecological cancers has suffered during the pandemic, partly due to lockdown and partly due to directing resources to manage COVID-19 patients. Modification of gynecological cancer management during this pandemic is recommended. Cervical cancer patients who present with stage IA1 disease can have a delay of up to 8 weeks for surgical treatment, considering the slow tumor growth rate. Women with stages IA2, IB1, IB2, IIA1 must undergo radical hysterectomy and lymphadenectomy within 6 to 8 weeks. In areas where surgical treatment is not available, patients should be referred for radiation therapy/areas with adequate surgical expertise. The surgical option is attractive for early cancers during the COVID era, as it involves a single visit compared to the multiple visits required for chemoradiation. The value of lymph node staging needs to be reconsidered. Neoadjuvant chemotherapy should be given preference over primary cytoreductive surgery for advanced ovarian cancers. Surgeries, which demand extended surgical time such as Hyperthermic Intraperitoneal Chemotherapy and pelvic exenterations, should be avoided during this pandemic. For patients scheduled for interval surgery after two or three neoadjuvant cycles, six cycles of chemotherapy should be considered before surgery is performed. For early-stage, low-grade endometrial cancer, consideration should be given to medical management until surgery is possible. The above recommendations have been made keeping in mind the geography, patient load, and availability of resources available to health care providers from southeast Asia. They might not be applicable globally and every practitioner should take call regarding patient's management as per availability of resources and loco-regional circumstances. The implementation of recommended international guidelines for the management of gynecologic cancers should take precedence. Each modification to the standard approach should be approved by a multidisciplinary team depending on the condition of the patients and the locoregional circumstances.
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Affiliation(s)
- Nilanchali Singh
- Department of Obstetrics and Gynaecology, 28730AIIMS, New Delhi, India.,Department of Gynaecologic Oncology, Tom Baker Cancer Centre, 2125University of Calgary, Calgary, AB, Canada
| | - Neha Mishra
- Department of Obstetrics and Gynaecology, 28730AIIMS, New Delhi, India.,Department of Obstetrics and Gynaecology, 517234GIMS, Uttar Pradesh, India
| | | | - Prafull Ghatage
- Department of Gynaecologic Oncology, Tom Baker Cancer Centre, 2125University of Calgary, Calgary, AB, Canada
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20
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Goenka L, Anandaradje A, Nakka T, Kayal S, Dubashi B, Chaturvedula L, Veena P, Durairaj J, Penumadu P, Ganesan P. The "collateral damage" of the war on COVID-19: impact of the pandemic on the care of epithelial ovarian cancer. Med Oncol 2021; 38:137. [PMID: 34581889 PMCID: PMC8476977 DOI: 10.1007/s12032-021-01588-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/19/2021] [Indexed: 12/23/2022]
Abstract
The covid-19 pandemic has impacted the management of non-covid-19 illnesses. Epithelial ovarian cancer (EOC) requires long-duration multidisciplinary treatment. Teleconsultation and shared care are suggested solutions to mitigate the consequences of the pandemic. However, these may be challenging to implement among patients who come from the lower economic strata. We report the disastrous impact of the pandemic on the care of EOC by comparing patients who were treated during the pandemic with those treated in the previous year. We collected the following data from newly diagnosed patients with EOC: time from diagnosis to treatment, time for completion of planned chemotherapy, and proportion of patients completing various components of therapy (surgery and chemotherapy). Patients treated between January 2019 and September 2019 (Group 1: Pre-covid) were compared with those treated between January 2020 and December 2020 (Group 2: During covid pandemic). A total of 82 patients were registered [Group 1: 43(51%) Group 2: 39(49)]. The median time from diagnosis to start of treatment was longer in group 2 when compared to group 1 [31(23–58) days versus 17(11–30) days (p = 0.03)]. The proportion of patients who had surgery in group 2 was lower in comparison to group 1 [33(77%) versus 21(54%) (p = 0.02)]. Proportion of patients who underwent neoadjuvant (NACT) and surgery were fewer in group 2 in comparison to group 1 [9(33%) versus 18(64%) p = 0.002]. Among patients planned for adjuvant chemotherapy, the median time from diagnosis to treatment was longer in group 2 [28(17–45) days, group 1 versus 49(26–78) days, group 2 (p = 0.04)]. The treatment of patients with EOC was adversely impacted due to the COVID-19 pandemic. There was a compromise in the proportion of patients completing planned therapy. Even among those who completed the treatment, there were considerable delays when compared with the pre-covid period. The impact of these compromises on the outcomes will be known with longer follow-up.
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Affiliation(s)
- Luxitaa Goenka
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India
| | | | - Tejaeswar Nakka
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India
| | - Smita Kayal
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India
| | - Biswajit Dubashi
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India
| | | | - Pampapati Veena
- Department of Obstetrics & Gynecology, JIPMER, Puducherry, India
| | | | | | - Prasanth Ganesan
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India.
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