The effect of the pandemic on colorectal cancer in the United States: An increased disease burden

Tommaso Violante , Davide Ferrari , Courtney N. Day , Kellie L. Mathis , Eric J. Dozois , David W. Larson
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Abstract

Background

The COVID-19 pandemic posed an unprecedented global threat to healthcare systems, causing delays in colorectal cancer (CRC) diagnoses. This study aims to assess the impact of COVID-19 on the presentation of cancer stages in the U.S.

Methods

Data from the national cancer database (2015–2020) were analyzed, categorizing patients into pre-COVID (2015–2019) and COVID (2020) groups for evaluation.

Results

In the COVID group, patients with colon cancer had a notably higher prevalence of Clinical stage IV disease at diagnosis, accompanied by an increased incidence of metastatic disease (Clinical stage IV C, 12.9% vs. 4.5%, p < 0.001). Similar trends were observed for rectal cancer (Clinical stage IV C, 2.2% vs. 0.8%, p < 0.001). Black patients, those with specific insurance status (Medicaid or not insured vs. private insurance), and patients in the COVID cohort were significantly associated with worse clinical stages in both colon and rectal cancer on multivariable analysis.

Conclusion

The impact of COVID-19 has led to a notable surge in advanced-stage colorectal cancer diagnoses, with ongoing repercussions anticipated. Colorectal surgeons should devise strategies to address this issue and establish pandemic preparedness measures for future healthcare crises.

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大流行病对美国结直肠癌的影响:疾病负担加重
背景COVID-19大流行对医疗保健系统构成了前所未有的全球性威胁,导致结直肠癌(CRC)诊断延误。本研究旨在评估 COVID-19 对美国癌症分期的影响。结果在 COVID 组中,结肠癌患者在诊断时临床 IV 期疾病的患病率明显较高,同时转移性疾病的发生率也有所增加(临床 IV 期 C,12.9% 对 4.5%,p < 0.001)。直肠癌也出现了类似的趋势(临床 IV 期 C,2.2% 对 0.8%,p <0.001)。在多变量分析中,黑人患者、特定保险状况(医疗补助或无保险与私人保险)患者以及 COVID 队列中的患者与结肠癌和直肠癌较差的临床分期显著相关。结直肠外科医生应制定策略解决这一问题,并为未来的医疗危机制定流行病防备措施。
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