Impact of COVID-19 on lung cancer care in New South Wales, Australia: real-world data from the EnRICH Program.

IF 2.5 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Public Health Research & Practice Pub Date : 2024-10-23 DOI:10.17061/phrp3432423
Bea Brown, Jane Young, Kirsty Galpin, Michael Boyer, Venessa Chin, Chris Brown, Robert Simes
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Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare systems worldwide, causing substantial changes to routine healthcare delivery. National and international modelling studies have predicted adverse impacts of this disruption. This study aimed to assess the real-world impact of the COVID-19 pandemic on quality of care and outcomes for patients with lung cancer in New South Wales (NSW).

Study type: Pre-post observational cohort study using data prospectively collected for the Embedding Research (and Evidence) in Cancer Healthcare (EnRICH) Program.

Methods: The study population comprised 2000 patients with lung cancer from six specialist cancer centres in metropolitan and regional NSW. We split this population into two cohorts: the pre-COVID-19 cohort (1143 patients diagnosed from 8 September 2016 to 10 March 2020) and the post-COVID-19 cohort (857 patients diagnosed from 11 March 2020 to 28 October 2021). The main outcome measures were lung cancer clinical quality indicators, 1-year and 2-year overall survival, and patient-reported health-related quality of life and psychological distress.

Results: Patient and disease characteristics (e.g. age, gender, cancer stage) were similar for the pre-and post-COVID-19 cohorts, except for histology (non-small cell lung cancer (NSCLC) 88% in the pre-COVID-19 cohort and 84% in the post-COVID-19 cohort; p = 0.008) and region of residence (62% and 55%, respectively, lived in metropolitan areas; p = 0.002). Compared to the pre-COVID-19 cohort, fewer patients in the post-COVID-19 cohort received a diagnosis within 28 days of the first investigation of symptoms (clinical diagnosis: 77% compared with 72%; p = 0.017, pathological diagnosis: 60% compared with 53%; p = 0.005). However, the median time from the first investigation of symptoms to treatment initiation did not differ. One- and 2-year overall survival, quality of life and psychological distress did not differ between cohorts.

Conclusions: This analysis found that the COVID-19 pandemic did not significantly adversely affect quality of care and outcomes for patients with lung cancer in NSW. Reassuringly, these results suggest that prioritising urgent health services, such as cancer care and implementing protective mitigation measures were effective in avoiding the predicted adverse outcomes of healthcare service disruption.

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COVID-19 对澳大利亚新南威尔士州肺癌治疗的影响:来自 EnRICH 计划的真实数据。
目标:2019 年冠状病毒病(COVID-19)大流行扰乱了全球的医疗保健系统,使常规医疗保健服务发生了重大变化。国内和国际模型研究预测了这一破坏所带来的不利影响。本研究旨在评估COVID-19大流行对新南威尔士州(NSW)肺癌患者的医疗质量和治疗效果的实际影响:研究类型:前-后观察性队列研究,使用为癌症医疗保健中嵌入研究(和证据)计划(EnRICH)前瞻性收集的数据:研究对象包括来自新南威尔士州大都市和地区六家癌症专科中心的 2000 名肺癌患者。我们将这些患者分为两个队列:COVID-19 前队列(2016 年 9 月 8 日至 2020 年 3 月 10 日确诊的 1143 名患者)和 COVID-19 后队列(2020 年 3 月 11 日至 2021 年 10 月 28 日确诊的 857 名患者)。主要结局指标为肺癌临床质量指标、1年和2年总生存率以及患者报告的健康相关生活质量和心理困扰:COVID-19前后队列的患者和疾病特征(如年龄、性别、癌症分期)相似,但组织学特征(COVID-19前队列中88%为非小细胞肺癌(NSCLC),COVID-19后队列中84%为非小细胞肺癌(NSCLC);P = 0.008)和居住地区特征(居住在大都市地区的患者分别占62%和55%;P = 0.002)除外。与 COVID-19 前队列相比,COVID-19 后队列中在首次检查症状后 28 天内获得诊断的患者人数较少(临床诊断:77% 对 72%;p = 0.017;病理诊断:60% 对 53%;p = 0.005)。不过,从首次发现症状到开始治疗的中位时间并无差异。各组间的一年和两年总生存率、生活质量和心理压力没有差异:这项分析发现,COVID-19 大流行并未对新南威尔士州肺癌患者的护理质量和治疗效果产生重大不利影响。令人欣慰的是,这些结果表明,优先提供紧急医疗服务(如癌症护理)和实施保护性缓解措施可有效避免医疗服务中断带来的预期不良后果。
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来源期刊
Public Health Research & Practice
Public Health Research & Practice PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.70
自引率
0.00%
发文量
51
审稿时长
20 weeks
期刊介绍: Public Health Research & Practice is an open-access, quarterly, online journal with a strong focus on the connection between research, policy and practice. It publishes innovative, high-quality papers that inform public health policy and practice, paying particular attention to innovations, data and perspectives from policy and practice. The journal is published by the Sax Institute, a national leader in promoting the use of research evidence in health policy. Formerly known as The NSW Public Health Bulletin, the journal has a long history. It was published by the NSW Ministry of Health for nearly a quarter of a century. Responsibility for its publication transferred to the Sax Institute in 2014, and the journal receives guidance from an expert editorial board.
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