COVID-19 Incidence and Mortality in Patients Operated on for Breast Cancer. Comparison with the General Population.

BACKGROUND: Breast Cancer (BC) remains the most diagnosed malignancy and the most common cause of cancer-related mortality in women worldwide. Covid-19 mortality in BC patients has been linked to comorbid conditions rather than to cancer treatment itself, although this was not confirmed by a meta-analysis. Also, during Covid-19 outbreaks, a great deal of health care resources is reassigned to critical Covid-19 patients. PATIENTS AND METHODS: During 5 consecutive trimesters (from 1/12/2020 to 31/3/2021) 2511 BC patients older than 20 years from our institution were surveyed. 1043 of them had received a Covid test and these made our study group, which was conveniently compared with the Covid-19 tested background feminine Catalan population. RESULTS: 13.1% of our patients presented with a positive Covid-19 test, whereas confirmed COVID-19 infection amounted to 7.1% of the feminine Catalan tested population. The COVID-19-specific mortality rate was 11.7% (16/137) in the study group, which compares with a 4.7% rate for the overall population. Most deaths occurred in patients over 70. CONCLUSION: Three clinical factors were significantly associated with Covid-19 mortality in BC, namely lack of hormone therapy, distant metastases, and BC dwelling in nursing homes. BC patients are at a higher risk of Covid-19 infection and mortality in comparison with the reference group without BC.

Short-term impact of the COVID-19 pandemic on a population-based screening program for colorectal cancer in Catalonia (Spain).

The COVID-19 pandemic caused the suspension at all levels of the Catalan FIT-based CRC screening program on March 12, 2020. Screening invitations to FIT were resumed on September 1, 2020. We aimed to assess the short-term impact of the pandemic and describe strategies implemented to minimize harm by the disruption of the FIT-based CRC screening in the Metropolitan Area of Barcelona. We analyzed participation rate, colonoscopy adherence, time intervals to colonoscopy, detection rates, and advanced-stage cancers in 2019 and 2020. To identify perceived distress levels during the suspension of the screening we conducted a phone interview. As a result of the suspension, 43% of the individuals due for screening did not receive their invitation by December 31, 2020. A percent decrease of 5.1% in participation and of 8.9% in colonoscopy adherence among invitees between January-March was observed, with a recovery to 2019 levels when the screening activities were restarted. The time interval between a positive test to colonoscopy was longer in 2020 than in 2019. A decrease in advanced neoplasia rate and an increase in later stages of CRC were also observed. Individuals with a positive test did not report higher levels of perceived distress compared to those with a negative test. Although the disruption of screening had a temporary impact on participation and colonoscopy adherence, timing delay continues and a large backlog in the invitation of the target population remains. Thus, it is critical to implement strategies to minimize the long-term effects.

Short-term impact of the COVID-19 pandemic on a population-based screening program for colorectal cancer in Catalonia (Spain) (preprint)

Background By mid-March 2020, colorectal cancer (CRC) screening program in Catalonia was suspended at all levels. Our goal was to assess the short-term impact of the COVID-19 pandemic at a FIT-based CRC screening hub in the metropolitan area of Barcelona.Methods Short-term impact was measured in individuals invited between 1 January and 12 March 2020: screening participation, colonoscopy adherence, interval from positive test result to colonoscopy and psychological distress.Results Lockdown with the first wave of COVID-19 caused 111,000 individuals to defer their screening invitations. Participation among invitees between January - March 2020 was 39.3% (95% CI: 38.9–39.7), a decrease of 5% in comparison with the 41.4% (95% CI: 41.2–41.6) participation in 2019. Adherence to colonoscopy decreased from 89.3% (95% CI: 88.4–90.2) in 2019 to 81.4% (95% CI: 78.9–83.7) in the first quarter of 2020. The mean time to colonoscopy after resumption was 128.7 days (CI 95%: 125.3–132.2). Irrespective of test results, factors associated with higher levels of distress were a greater perceived risk of CRC and greater impairment of emotional wellbeing due to COVID-19.Conclusions The short-term impact of COVID-19 on CRC screening seems to have been modest, with a slight decrease in participation, a moderate decrease in colonoscopy adherence, and lengthened waiting times. However, a marked impact on future CRC incidence and deaths could be expected. Thus, it is critical to revert participation and colonoscopy adherence rates to that previously achieved while reducing the 5-month delay in screening invitations.