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Introduction: Croatian National Cancer Registry of Croatian Institute for Public Health reported that in year 2020 lung cancer was the second most common cancer site diagnosed in men with 16% and the third most common in women with 10% incidence among all cancer sites. Unfortunatelly lung cancer has the highest mortality in both men and women. Haematological malignancies had 7% share in all malignancies in both male and female cances cases. In 2020 190 newly diagnosed cases of lymphatic leukemia in men and 128 cases in women were reporeted, meaning 1.5 and 1.2% of all malignancies, respectively. Chronic lymphatic leukemia (CLL) is an advanced age disease and incidence increases with age. Impaired immunity, T and B cell dysfunction in CLL, chromosomal aberations, long-term immunosuppressive therapy and genetic factors can all cause secondary malignancies. Co- occurence of solid tumors and CLL is very rare. Although patiens with CLL have an increased risk of developing second primary malignancies including lung carcinoma, the data about their clinical outcomes are lacking. Parekh et al. retrospectively analyzed patients with simultaneous CLL and lung carcinoma over a 20-year period, and they found that ~2% of patients with CLL actually developed lung carcinoma. The authors claimed that up to 38% of patients will also develop a third neoplasm more likely of the skin (melanoma and basal cell carcinoma), larynx (laryngeal carcinoma) or colon. Currently there are no specific guidelines for concurrent CLL and non-small cell lung carcinoma (NSCLC) treatment. Usually, when the tumors are diagnosed simultaneously, treatment is based to target the most aggressive malignancy, as the clinical outcomes depend on the response of the tumor with the poorest prognosis. For this reason, a multidisciplinary approach is mandatory. Case report: A patient with history of coronary heart disease, myocardial infarction and paroxysmal atrial fibrillation was diagnosed in 2019 (at the age of 71) with B chronic lymphocytic leukemia with bulky tumor (inguinal lymph nodes 8x5 cm), stage B according to Binet, intermediate risk. He was treated with 6 cycles of chemoimmunotherapy (rituximab/cyclofosfamid/fludarabine). In 10/2019 remission was confirmed, but MSCT described tumor in the posterior segment of upper right lung lobe measuring 20x17 mm and bilateral metastases up to 11 mm. Bronchoscopy and biopsy were performed, and EGFR neg, ALK neg, ROS 1 neg, PD-L1>50% adenocarcinoma was confirmed. He was referred to Clinical Hospital Center Osijek where monotherapy with pembrolizumab in a standard dose of 200 mg intravenously was started in 01/2020. Partial remission was confirmed in October 2020. Immunotherapy was discontinued due to development of pneumonitis, dysphagia and severe weight loss (20kg), but without radiologically confirmed disease progression. At that time he was referred to our hospital for further treatment. Gastroscopy has shown erosive gastritis with active duodenal ulcus, Forrest III. Supportive therapy and proton pump inhibitor were introduced. After complete regression of pneumonitis, improvement of general condition and resolution of dysphagia, no signs of lung cancer progression were found and pembrolizumab was reintroduced in 12/2021. Hypothyroidism was diagnosed in 01/2021 and levothyroxine replacement ther apy was started. In 03/2021 he underwent surgical removal of basal cell carcinoma of skin on the right temporal region with lobe reconstruction. From 02/2021, when pembrolizumab was reintroduced, regression in tumor size was continously confirmed with complete recovery of general condition. He was hospitalized for COVID 19 infection in 09/2021, and due to complications pembrolizumab was discontinued till 11/2021. Lung cancer immunotherapy proceeded till 11/2022, when Multidisciplinary team decided to finish pembrolizumab because of CLL relapse. CLL was in remission till August 2022 when due to B symptoms, lymphcytosis, anemia and generalized lymphadenopathy, hematological workup including biopsy of cervical lymph node was performed and CLL/SLL relapse was confirmed. Initially chlorambucil was introduced, but disease was refractory. Based on cytogenetic test results (IGHV unmutated, negative TP53) and due to cardiovascular comorbidity (contraindication for BTK inhibitors) venetoclax and rituximab were started in 01/2023. After just 1 cycle of treatment normal blood count as well as regression of B symptoms and peripheral lymphadenopathy occured, indicating the probability of complete disease remission. In our patient with metastatic lung adenocarcinoma excellent disease control is achieved during 41 month of treatment in first line setting. Furthermore, relapsed/refractory CLL/SLL is currently in confirmed remission. Conclusion(s): Successful treatment of patients with multiple primary malignancies is based on multidisciplinarity, early recognition and management of side effects, treatment of comorbidities with the aim of prolonging life, controlling symptoms of disease and preserving quality of life.
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Introduction: Pediatric brain tumors are the most common tumor in children after hematological malignancies. There is very few data about the epidemiology of pediatric brain tumors in India. Methods - This was a prospective and retrospective study in pediatric patients who had undergone surgery in our institute (JIPMER,Pondicherry). 80 cases were recruited and followed up for minimum follow up period of 1 year. The demographic profile was analysed and IHC markers were done for embroyonal tumors and glioma. Result(s): Pediatric brain tumors was equally distributed among male and females. (1:1) .Mean age of presentation was 10 years . 27.5 % of our cases were embryonal tumors,low grade glioma (16.25 % ) ,high grade glioma ( 12.5 % ) ,ependymoma and craniopharyngioma comprised 15 % of our cases each. Medulloblastoma comprised 23.75 % of cases Out of which 31.5 % had craniospinal metastasis at time of diagnosis. The most common location of SHH pathway medulloblastoma was cerebellar hemisphere and non WNT/non SHH was fourth ventricle. 45.45 % of patients with high grade glioma had recurrence .50 % of ependymoma cases were infratentorial. we had 2 cases of ganglioglioma ,one in the midbrain and other in temporal lobe .Gross total resection was achieved in 30 % ,Subtotal resection in 46.25 % and partial resection in 20 % of our cases. Outcome of patients at the end of 1 year for low and high grade glioma, ependymoma and craniopharyngioma were similar to western literature. Two patients acquired COVID 19 and died while undergoing treatment. Molecular markers like INI1, LIN28 A was highly sensitive and specific for diagnosing atypical teratoid rhabdoid tumor (ATRT) and embryonal tumor with multilayered rosettes (ETMR )respectively. Conclusion(s): Our study emphasizes the need of standardized and systemic cancer registries in India. (Figure Presented).
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Background: As the February 2022 Surveillance, Epidemiology, and End Results (SEER) Call for Data deadlines approached, the New York State Cancer Registry had received reports for approximately 10% fewer consolidated incident cases for 2020 than expected. We used claims data to examine changes in the volume of cancer claim records during the COVID-19 pandemic and possible contributors to the deficit in cancer reports. Methods: The New York State (NYS) Statewide Planning and Research Cooperative System (SPARCS) requires reporting of all patient encounters from licensed ambulatory surgery, emergency department, and hospital inpatient and outpatient providers. Each record includes patient demographics and up to 17 diagnosis codes from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). For this project, we extracted 6,725,416 SPARCS records with any malignant neoplasm code for 2018 through June 2021 for NYS residents. Using SAS 9.4, we focused on comparing the cancer-related records for 2020 to the records from 2019. Results: Overall, there were 5% more cancer-related records in 2019 than in 2018 (2,009,600 vs 1,914,364), but 8.2% fewer records in 2020 (1,844,054 total) than in 2019. Looking by month and year, the number of claims in the first 2 months of 2020 exceeded the numbers from 2019 by 5%. However, a decrease in the number of claims started in March 2020, with the biggest drop in April 2020, where there was a deficit of 38.8% for cancer-related encounter reports relative to the same month the previous year. Although the numbers rose after April, the number of claims for the last half of 2020 was still 4% lower than the same time frame in 2019. There were substantial decreases in the number of records in 2020 for all encounter types and across levels of each covariate examined, including age, sex, race/ethnicity, and facility region of NYS. In analyses of all reporting facilities, facilities in New York City had a more pronounced and more prolonged drop in reporting in 2020 than facilities in the rest of the state. Conclusion: Although SPARCS data do not provide definitive evidence of decreases in incident cancer diagnoses, these data suggest that there were fewer cancers diagnosed among NYS residents in 2020. Additional analyses are needed to assess the impacts of COVID-19-related delays in cancer diagnosis and treatment on stage at diagnosis and outcomes.
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COVID-19 , Neoplasms , Humans , COVID-19/epidemiology , Neoplasms/epidemiology , New York/epidemiology , New York City , Pandemics , Registries , Case Reports as TopicABSTRACT
ObjectivesãTo show the impact of COVID-19 on cancer treatment in Tochigi prefecture.MethodsãThe number of cancer cases registered in Tochigi prefecture before (2019) and after (2020) COVID-19 was compared using cancer registry data from 18 member hospitals of the Tochigi Prefecture Cancer Care Collaboration Council. Data were compared by sex, age, patient's address at the time of diagnosis, month of diagnosis, cancer site, cancer stage, and treatment. Data on screenings for stomach, colorectum, lung, female breast, cervix, and prostate cancers were investigated in detail.ResultsãThe total number of registered cancer cases was 19,748 in 2019 and 18,912 in 2020 (a decrease of 836 cases [-4.2%]). Among the total cases, there were 11,223 and 10,511 males in 2019 and 2020, respectively (a decrease of 712 cases [-6.3%]) and 8,525 and 8,401 females in 2019 and 2020, respectively (a decrease of 124 cases [-1.5%]). The decrease was greater among males than among females. There was no decrease in the number of registered patients aged <40 years between 2019 and 2020. Based on the patients' address at the time of diagnosis, there was no decrease in the number of cases from outside of the Tochigi prefecture. Regarding the month of diagnosis, there was a notable decrease in the number of registered patients in May and August of 2020. Among the decrease of 836 cases detected by screening, 689(82.4%) were cases of stomach, lung, colorectum, female breast, cervix, and prostate cancer. The number of registered cases of malignant lymphoma, leukemia, and cancer of the oral cavity and pharynx, pancreas, bone and soft tissue, corpus uteri, and bladder did not decrease between 2019 and 2020. In terms of stage of cancer, the number of registered cases of carcinoma in situ, localized cancer, and regional lymph node metastases was lower in 2020 than in 2019, but there was no decrease in the number of registered cases of distant metastases or regional extension.ãConclusion The number of cancer cases registered in 2020 was lower than in 2019, and the degree of change varied by age, hospital, site, whether the case was detected by screening, and stage of cancer. In particular, a marked decrease was observed in the number of cases detected by screening. Furthermore, the decrease in the number of cancer cases registered in May and August of 2020 were believed to be due to the peak in the spread of COVID-19 and the associated declaration of a state of emergency.
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The significant deficit in cancer diagnoses in 2020 due to COVID-19 pandemic disruptions in health care, can pose challenges in the estimation and interpretation of long-term cancer trends. Using SEER (2000-2020) data, we demonstrate that inclusion of the 2020 incidence rates in joinpoint models to estimate trends can result in a poorer fit to the data, less accurate, or less precise trend estimates, providing challenges in the interpretation of the estimates as a cancer control measure. To measure the decline in 2020 relative to 2019 cancer incidence rates, we use the percent change of rates in 2020 compared to 2019. Overall, SEER cancer incidence rates dropped approximately 10% in 2020, but for thyroid cancer the drop was as big as 18%, after adjusting for reporting delay. The 2020 SEER incidence data is available in all SEER released products, except for joinpoint estimates of trends and lifetime risk of developing cancer.
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Objectives : To describe impact of COVID-19 on lung cancer incidence, stage at diagnosis, treatment utilisation and timeliness of care in Victoria, Australia. Design : Retrospective study using population wide Victorian Cancer Registry data and clinical data from the Victorian Lung Cancer Registry, comparing data pre-COVID (2019 and Q1 of 2020) with the COVID era (April 2020-31/12/2020). Setting and participants : Population wide data on lung cancer diagnoses diagnosed in 2019 and 2020 in Victoria, and 4485 cases with additional clinical data. Result(s): Compared In the COVID-era, 177 fewer males (-12%) and 4 fewer females (-0.3%) were diagnosed with lung cancer. Stage at diagnoses for NSCLC was higher on average in Q2 2020 and was similar to the pre-COVID distribution in Q2 and Q4. No changes were detected in the stage distribution for SCLC. The proportion of patients whose time from referral to diagnosis was >=28 d decreased with increasing volume of referrals but was higher in the COVID era (74.6%) compared with the pre-COVID era (67.5%), not caused by a decrease in volume. The proportion of patients receiving any anti-cancer treatment reduced slightly from 84% in the pre-COVID era to 81% in the COVID era ( p = 0.022). Time from diagnosis to treatment (>=14 d;37.3% of patients on average) was not associated with volume of new diagnoses, nor did change in the COVID-era ( p = 0.13). The proportion of NSCLC patients who received guideline concordance treatment did not differ between pre-COVID (83.1%) and the COVID era (81.7%;p = 0.31).
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Objective. To evaluate the impact of the COVID-19 pandemic on the course of cancers and to estimate the achievement of the main indicators of a cancer service in case of the Nizhny Novgorod Region. Subjects and methods. In the Nizhny Novgorod Region, data on the detection and registration of COVID-19 in patients with malignant neoplasms (MNs) were analyzed on the basis of data of the information and analytical system (IAS) <<Cancer Registry 6S>>. Results. As of December 31, 2020, there were a total of 99.477 cancer patients, including 1.470 confirmed COVID-19 cases, accounting for 1.5% of all the registered patients with MNs. Among the cancer patients with COVID-19, the females were 1.6 times more likely to be ill than the males. Analyzing the age structure of cancer patients with COVID-19 revealed that the older ablebodied persons (61.6%) were more likely to get sick than younger ones (38.0%). Cancer concurrent with COVID-19 led to a severe course of COVID-19 in 15.9% of cases and resulted in death of cancer patients in 17.8% of cases. The older able-bodied patients were more likely to die, which accounted for 89.3% of the total number of died cancer patients with COVID-19. In the structure of the causes of death of cancer patients with COVID-19, the latter comes first (51.3%), MNs ranked next (33.0%), circulatory system diseases occupied the third place (13.0%), and other causes ranked fourth (2.7%). According to the 2020 results, the Nizhny Novgorod Region during the COVID-19 pandemic displayed a 0.4% increase in the mortality rate from neoplasms, including that from malignant ones, a 5.0% decrease in the proportion of MNs detected at Stages 1-2, a 22.0% reduction in active detection rates, and a 21.0% rise in neglect rates. Conclusion. Thus, the COVID-19 pandemic negatively affects the course of cancers, by aggravating the condition of cancer patients, which results in a fatal outcome in 17.8% of cases.Copyright © 2022, Media Sphera Publishing Group. All rights reserved.
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Introduction. The SARS-CoV-2 infection rate and the COVID-19 death rate were relatively high in the Netherlands during the first wave of the COVID-19 pandemic (2.7 and 7.2 times higher than in Norway, respectively). Moreover, social measures differed between the two countries. This study aimed to compare the effect of the pandemic on breast cancer incidence and stage between the Netherlands and Norway. Methods. Women diagnosed with DCIS or invasive breast cancer between January 2017 and December 2021 were selected from the Netherlands Cancer Registry and from the Cancer Registry of Norway. The COVID-19 period was divided in three approximately equal periods: March-September 2020 (first wave), October 2020-April 2021 (second wave), May-December 2021 (post-second wave). Breast cancer incidence during the COVID-19 periods was compared with averaged data of the corresponding reference period: March-September 2017, 2018, 2019 (first wave-ref), October-April 2017, 2018, 2019 (second wave-ref), May-December 2017, 2018, 2019 (post-second wave-ref). Incidences were compared by age group, clinical tumor stage, and method of detection. Results. The number of breast cancer diagnosis and the breast cancer incidence are shown in Table 1. Compared to the reference period, breast cancer incidence was lower during the first wave in the Netherlands and Norway (IRR: 0.72;95%CI: 0.70-0.75;IRR: 0.83, 95%CI 0.78-0.88, respectively), and was higher post-second wave in Norway (IRR: 1.10, 95%CI: 1.04-1.16) (Table 1). During the first wave, breast cancer incidence was lower in all age groups in the Netherlands (age < 50 IRR: 0.85, 95%CI: 0.79-0.91;50-69 IRR: 0.64, 95%CIL 0.61-0.67;70-74 IRR: 0.61, 95%CI: 0.56-0.67;>74 IRR: 0.86, 95%CI: 0.80-0.93, respectively). During the first wave, incidence was lower in women aged 50- 69 in Norway (i.e., women eligible for screening;IRR: 0.68, 95%CI: 0.62-0.74). Post-second wave incidence was higher in women aged 50-69 and >74 in Norway (IRR: 1.09, 95%CI: 1.01-1.17;IRR: 1.13, 95%CI: 1.00-1.28, respectively). In the first wave the incidence of DCIS, stage I tumors, and screen-detected tumors was lower in the Netherlands (IRR: 0.55, 95%CI: 0.50-0.61;IRR: 0.62, 95%CI: 0.59-0.65, IRR: 0.36, 95%CI: 0.33-0.38, respectively) as well as Norway (IRR: 0.66, 95%CI: 0.54-0.79;IRR: 0.73, 95%CI: 0.66-0.81, IRR: 0.46;95%CI: 0.40-0.52, respectively). Conclusion. The current study showed that the incidence of early-stage tumors mainly decreased. Moreover, during the first wave of the pandemic breast cancer incidence decreased in all age groups in the Netherlands but only in women aged 50-69 in Norway. The relatively high infection and death rate in the Netherlands might have increased the fear of patients to visit the general practitioner (GP) and/or to overburden the healthcare system at the start-up of the pandemic. In addition, it might have reduced the capacity at the GP. As a result, appointments with the GP might have been postponed, resulting in a decrease in the number of breast cancer diagnoses in all age groups. A catch-up in breast cancer diagnoses was seen post-second wave in Norway, but not in the Netherlands. Incidence rates should therefore be monitored in the coming period. (Table Presented).
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Background. Prostate cancer incidence rates continue to increase every year, therefore, the study of the quality indicators for cancer care, especially during a pandemic, is of great importance. Aim. To analyze prostate cancer incidence rates and quality indicators of cancer care in the Siberian Federal District. Materials and methods. For the calculation of cancer incidence rates, population-bases cancer registry data were used. Quality indicators were calculated according to the methodological recommendations of P.A. Hertzen Moscow Oncology Research Institute - branch of the National Medical Research Radiological Center. Results. The implementation of restrictive measures and the suspension of cancer screening programs in 2020 negatively affected the cancer care. The prostate cancer incidence rate decreased from 52.8 per 100 000 population in 2019 to 43.1 per 100 000 population in 2020, especially in the territories of the Republic of Tyva and the Omsk Region. Morphological verification in 2020 decreased compared to 2019 (97.0 % versus 97.8 %), with the exception of the Krasnoyarsk Territory and the Republic of Altai. Early prostate cancer detection increased from 62.9 to 64.0 %, and cancer detection at late stages decreased from 36.3 to 35.0 %. One-year mortality in the region decreased from 8.0 % (2019) to 7,3 % (2020), however, it increased significantly in the Republic of Tyva (from 3.2 to 40.0 %) and the Altai Republic (from 3.7 to 10.7 %). The number of patients who have been followed-up for 5 years or more increased from 40.7 to 42.3 %, except for Republic of Altai (from 32.8 to 25.0 %). Conclusion. Delay in the diagnosis of prostate cancer is associated with advanced stage, poor survival and high cost treatment.Copyright © 2022 Authors. All rights reserved.
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Objective: The COVID-19 pandemic has had an impact on health care. In the Netherlands, hospital capacity for non-covid care was limited and population screening temporarily halted. The aim of this study was to investigate the impact of the pandemic on the diagnostic pathway of breast cancer. Method(s): In this study, 48,425 breast cancer patients with a primary breast tumour were selected from the Netherlands Cancer Registry and the Dutch Hospital Data. Patients diagnosed in period January 2020 to July 2021 were divided into six periods, based on the number of hospitalizations due to the COVID-19 pandemic and compared to the same periods in 2017-2019. A t-test was performed to compare the number of diagnosed patients per period. Patient characteristics were compared using chi-squared test. The impact on the procedures performed was analysed using logistic regression. The median time between diagnosis and therapy and the median time between first diagnostic procedure and therapy was analysed using Cox Proportional Hazards Regression. All results were corrected for age, stage and region. Result(s): During the first peak of the pandemic in 2020, significantly fewer patients (-48,2%) have been diagnosed with breast cancer. This decrease is mainly seen in lower stage tumours. Mammography and echography were performed significantly less per patient during the first recovery in 2020 (OR=0.83 and OR=0.85 respectively) compared to 2017-2019. PET-CT was performed significantly more often during the first peak and first recovery in 2020 (OR=1.94 and OR=1.39 respectively). The median time between diagnosis and start of therapy significantly decreased in 2020, during the first peak by 3 days (HR=1.26), during first recovery and second peak by 1 day (HR=1.04 and HR=1.16 respectively). The median time between first diagnostic procedure and start of therapy significantly decreased in 2020, during the first peak by 4 days (HR=1.25), during the first recovery by 1 day (HR=1.04) and during the second peak by 2 days (HR=1.13). Conclusion(s): The decreased number of diagnosis was related to the temporary halt of the screening. Diagnostics for early stage tumours was limited and for PET-CT was performed more often reflecting the change in proportion of higher stage. A reduced time of the diagnostic pathway is the result of less hospitalized patients with cancer and the effort on keeping the oncology care in place. (Table Presented).
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The aim of this study was to investigate how breast cancer follow-up in the Netherlands changed during the COVID-19 pandemic, compared to 2018-2019, and to what extent follow-up during the pandemic corresponded to the patient risk of recurrence. During the early phase of the pandemic the Dutch Society for Surgical Oncology (NVCO) issued a report with recommendations on how follow-up could be postponed, as a guidance for the pandemic, based on a low, intermediate or high risk of recurrence. In this study we investigated to what extent this advice was followed. A dataset of 33160 women diagnosed with primary invasive breast cancer between January of 2017 and July of 2021 was selected from the Netherlands Cancer Registry (NCR) and Dutch Hospital Data (DHD). The pandemic, 2020 and weeks 1-32 of 2021, was divided into six periods (A to F), based on the number of hospitalized COVID patients in the Netherlands. The five-year risk of locoregional recurrence (LRR) was determined for each patient with the INFLUENCE nomogram. The LRR risk was compared to the risk groups from the NVCO report with a Kruskal-Wallis test. The percentage of patients who received a mammogram during period A to F was compared to the same periods of 2018-2019 with a chisquared test. Correlation between the LRR risk, and if patients had a mammogram, was investigated with logistic regression. This analysis was repeated separately for the risk groups. Correlation between the LRR risk, and time intervals between surgery and the first and second mammogram was analyzed using cox proportional hazard models, this was also repeated for the risk groups. There was a significant difference in LRR risk between the NVCO risk groups. In the low-risk group (n=7673), 86 patients (1.1%) had a risk >5%. In the intermediate risk group (n=19197), 18364 patients (95.7%) had a risk of < 5%, and 65 patients (0.34%) had a risk of >10%. In the high-risk group (n=2674), 2365 patients (88.4%) had a risk < 10%. The percentage of patients who received a mammogram was significantly lower in periods B to F of the pandemic. Logistic regression showed a negative correlation between the risk of LRR and if patients had a mammogram in 2020 (OR 0.93) and 2021 (OR 0.93). There was also a negative correlation between the risk groups and mammography in 2020 (OR 0.92 for intermediate and 0.80 for high), and for the risk groups and mammography in 2021 (OR 0.98 for intermediate and 0.95 for high). There was no significant impact of LRR risk, or risk group, on time intervals between mammograms. During the pandemic, patients with a higher LRR risk, or a higher risk according to NVCO advice, had lower odds of having a mammogram. If the advice would have been followed, in 0.5% of the patients scheduled for follow-up, the recommendation was to postpone in contrast to a high estimation of the individual risk. For 62.7%, a follow-up was recommended, despite a low estimated individuals risk. Because the number of high-risk patients is relatively low, individual risk prediction could be supportive, in case of future restrictions. This way the high-risk patients can be identified and prioritized for follow-up, and can also be encouraged to come to the hospital.
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Background: A survivorship care plan (SCP) is a detailed cancer care summary and future care plan that is generally given to a patient upon completion of adjuvant treatment for a cancer diagnosis. The initial goals of SCPs were to educate patients and other health care professionals about the treatments received, make them aware about potential long-term effects of therapy, and emphasize recommendations for future cancer screening and care (1). Due to numerous barriers-scheduling, staffing, and lack of awareness-SCPs are not delivered to all eligible patients. To address this unmet need our multidisciplinary breast clinic (MDBC) established an Advanced Practice Professional (APP) Survivorship Clinic. With the acute impact of the COVID-19 pandemic, survivorship referrals decreased. We, therefore, developed and implemented system solutions to address SCP access. Method(s): System solutions include partnering with the Cancer Registry to provide the list of patients potentially in need of survivorship visits, partnering with pharmacy to confirm patient eligibility, creating specifically designated telemedicine survivorship visits in our electronic scheduling system, prospectively scheduling persons identified, engagement of APPs across the MDBC, and establishing a single coordinating point. Numbers of SCPs delivered are tracked monthly and patient satisfaction is assessed through data collected Press Ganey surveys. Result(s): This presentation will share our process interventions and outcomes as they mature. Our early data demonstrate the efficacy of the workflow and appear promising. Conclusion(s): We anticipate that system-based solutions will provide more patients with SCPs and demonstrate patient satisfaction. Blaes AH, Adamson PC, Foxhall L, Bhatia S. Survivorship Care Plans and the Commission on Cancer Standards: The Increasing Need for Better Strategies to Improve the Outcome for Survivors of Cancer.
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PURPOSE: The aim of our study was to explore the impact of the COVID-19 pandemic on reported cancer cases in Bavaria, Germany, by comparing pre-pandemic (March 2019 to February 2020) and pandemic period (March 2020 to February 2021). METHODS: Data on incident cases were retrieved from the Bavarian Cancer Registry (until 22nd April 2022). We included patients with malignant and in situ neoplasms reported by pathology departments with consistent reporting. We calculated the number of incident cases during the COVID-19 pandemic and the pre-pandemic period with 95% confidence intervals (CI) with Bonferroni correction (α = 0.0018) based on a Poisson approach. We stratified for malignancy (malignant, in situ), tumor site, and month of year. RESULTS: Data was available for 30 out of 58 pathology departments (51.7%) from Bavaria. Incident malignant neoplasms dropped from 42,857 cases in the pre-pandemic period to 39,980 cases in the pandemic period (- 6.7%; 95% CI - 8.7%, - 4.7%). Reductions were higher for colon, rectum, skin/melanoma as well as liver (> 10.0% reduction) and less for breast cancer (4.9% reduction). No case reductions were observed for pancreas, esophagus, ovary, and cervix. Percent changes were largest for April 2020 (- 20.9%; 95% CI - 24.7%, - 16.8%) and January 2021 (- 25.2%; 95% CI - 28.8%, - 21.5%) compared to the previous year. Declines tended to be larger for in situ compared to malignant neoplasms. CONCLUSION: Detection and diagnosis of cancer were substantially reduced during the COVID-19 pandemic. Potential effects, e.g. a stage shift of tumors or an increase of cancer mortality, need to be monitored.
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Aim. The study is aimed at investigating the incidence of lung cancer (LC) at the population level with the analysis of key analytical indicators in the context of coronavirus. Materials and methods. We have used data from the IARC, statistical reference books of P.A. Herzen Moscow Research Oncological Institute, data from N.N. Petrov NMRC of Oncol¬ogy, and the database of the Population Cancer Registry of St. Petersburg (DB PCR St. Petersburg) for the current study. Results. The study has established a steady decline in the incidence of LC among the male population in the worldwide, in Russia and in St. Petersburg. Among the female population, a significant increase in the incidence has been revealed. On the basis of the database PCR St. Petersburg, the patterns of age-sex indicators of the incidence of LC have been analyzed. It has been established that the largest number of cases is registered in the age group of patients over 70 years old, here the largest losses due to coronavirus have also been identified. An increase in the proportion of early stages of the disease has been noted. The accounting reliability index decreased from 2000 to 2019, with the exception of 2017. Comparison of yearly lethality in the DB PCR St. Petersburg showed a signifi¬cant difference in the data. The detailed localization structure of LC has been studied, where it has been found out that the first place is occupied by cancer of the upper lobe, bronchi or lung, although over 19 years of observation, a decrease in the proportion of this localization in the total volume of C34 has been noted. The proportion of patients with LC without histological verification has decreased. The influence of the smoking factor on the increased risk of LC has been studied.
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In Kenya, cancer is the third leading cause of death. The African Inland Church Kijabe Hospital (AICKH) is a level 4 missionary hospital. The hospital serves the Kenyan population in many areas, including cancer care, and some of these services were affected during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to leverage a recently established hospital-based cancer registry of patients treated at AICKH between 2014 and 2020 to describe the cancer cases and patient referral patterns seen at AICKH during the COVID-19 pandemic in 2020. A cross-sectional retrospective survey was conducted through medical records abstraction in the surgery, breast clinic, palliative care and pathology departments. A total of 3279 cases were included in the study, with females accounting for 58.1% of the cases. The top-three cancers overall were breast (23.0%), oesophagus (20.5%) and prostate (8.6%). There was a minimal increase in the number of cancer cases in 2020 (1.7%) compared with 2019, with an increase of 19.3% in 2019 compared with 2018. In conclusion, AICKH is one of the few hospitals in Kenya where a large number of cancer patients seek healthcare, and referral of cancer cases changed in 2020, which may be due to the COVID-19 pandemic. Future efforts can leverage this registry to determine the impacts of cancer diagnosis and treatment on survival outcomes.
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INTRODUCTION: This study assesses the risk of infection and clinical outcomes in a large consecutive population of cancer and non-cancer patients tested for SARS-CoV-2 status. METHODS: Study patients underwent SARS-CoV-2 molecular-testing between 22 February 2020 and 31 July 2020, and were found infected (CoV2+ve) or uninfected. History of malignancy was obtained from regional population-based cancer registries. Cancer-patients were distinguished by time between cancer diagnosis and SARS-CoV-2 testing (<12/⩾12 months). Comorbidities, hospitalization, and death at 15 September 2020 were retrieved from regional population-based databases. The impact of cancer history on SARS-CoV-2 infection and clinical outcomes was calculated by fitting a multivariable logistic regression model, adjusting for sex, age, and comorbidities. RESULTS: Among 552,362 individuals tested for SARS-CoV-2, 55,206 (10.0%) were cancer-patients and 22,564 (4.1%) tested CoV2+ve. Irrespective of time since cancer diagnosis, SARS-CoV-2 infection was significantly lower among cancer patients (1,787; 3.2%) than non-cancer individuals (20,777; 4.2% - Odds Ratio (OR)=0.60; 0.57-0.63). CoV2+ve cancer-patients were older than non-cancer individuals (median age: 77 versus 57 years; p<0.0001), were more frequently men and with comorbidities. Hospitalizations (39.9% versus 22.5%; OR=1.61; 1.44-1.80) and deaths (24.3% versus 9.7%; OR=1.51; 1.32-1.72) were more frequent in cancer-patients. CoV2+ve cancer-patients were at higher risk of death (lung OR=2.90; 1.58-5.24, blood OR=2.73; 1.88-3.93, breast OR=1.77; 1.32-2.35). CONCLUSIONS: The risks of hospitalization and death are significantly higher in CoV2+ve individuals with past or present cancer (particularly malignancies of the lung, hematologic or breast) than in those with no history of cancer.
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Introduction: Patients (pts) with metastatic cancers undergoing treatment are considered a high risk group for infection and potentially inferior outcome during the SarsCov2 pandemic. Currently no data have been published on the test rate, infection rate, efects on treatment and potential outcome. Here we present data from four prospective cohort studies (cancer registries) addressing these questions. Method(s): MYRIAM (multiple myeloma (MM), NCT03308474), OPAL (advanced breast cancer (ABC), NCT03417115), CARAT (advanced or metastatic renal cell carcinoma (mRCC), NCT03374267) and SAPHIR (gastric/oesophageal cancer (ESCC, GAC or GEJAC), NCT04290806) are prospective, observational, open, multicentre, interdisciplinary and intersectional clinical registries that collect data on all (sequential) treatments, patient and tumour characteristics, clinical and patient-reported outcomes in about 200 hospitals and ofce-based practices in Germany. Pts are recruited at start of treatment. In April 2nd 2020 data collection was updated regarding testing for SarsCov2, test results, efects on cancer treatment and outcome for all patients newly recruited, under observation or deceased afer March 1st 2020. Interim results as by June 17th have been summarised here and will be updated regarding further details with a data cut on August 31st 2020. Result(s): Until data cut for this snapshot analysis the question regarding testing had been answered for a total of 239 pts in the four projects (94 ABC, 72 MM, 46 RCC, 27 GAC/ESCC/GEJAC). Of these a total of 56 pts (23%) had been tested for a SarsCov2 infection and 5 patients (2% and 9% of those tested) had been tested positive. Further results on the test rate, severity of symptoms at diagnosis, course of disease and consequences on the cancer treatment will be analysed and presented with an updated data cut when about 500 pts are expected to have been documented. Conclusion(s): First data on SarsCov2 testing in patients with advanced cancers in Germany reveals that this high risk group had access to testing and that positive cases were identifed in routine care. While these first interim data have to be interpreted with caution, they proof that quick implementation of relevant new variables into existing cohort studies is feasibly and important to address urgent questions regarding the care of cancer patients.
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Background: During the Covid-19 (Cov19) pandemic hospitals were assigned to four levels according their resources to manage the increased demand of intensive care treatments. This study aims to contribute towards quantifying the impact of the Cov19 pandemic on cancer care of patients with cervical cancer in Germany by investigating the diagnoses and treatments in Hessian hospitals of different Cov19 levels. Method(s): Data of patients with cervical cancer (C53) diagnosed from 2016 to 2020, were extracted from the database of the Hessian cancer registry. With regard to a continuously stable registration activity eleven hospitals were included in the analysis. Seven hospitals met the criteria for Cov19 level 1 (highest requirements) and four hospitals for level 2. Result(s): In 2020, 31% fewer patients with cervical cancer were diagnosed in eleven Hessian hospitals compared to previous years (n=124 vs. n=179). Primary tumor resections were reduced by 24%, whereas no difference could be detected in their relative amount or timespan from diagnosis. The patient cohort was younger with a median age of 46 vs. 50 years and with early stage I-II in 70% vs. 62%. The reduction in treatment was mostly seen in the Cov19 level 1 hospitals, while level 2 hospitals could increase the amount of diagnosed (14%) and treated (27%) patients. Discussion(s): Despite a reduction of diagnoses and treatments, primary surgery was not delayed. The patient characteristics imply that predominantly elder women with advanced stages omitted hospital treatment. The increased burden of care of Cov19 patients for the level 1 hospitals clearly had an impact on the care of cancer patients, which could be partially absorbed by level 2 hospitals. Conclusion(s): Reorganisation of hospitals according to Cov19 levels was an important tool to enable treatment of Cov19 patients while maintaining cancer care by shifting treatment to other hospitals. However, there is an impact on missed diagnoses and treatments of patients, that will result in a higher morbidity and mortality.
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Background: The effects of the COVID-19 pandemic on incidence, stage distribution, primary therapy, and delay in therapy were analyzed for breast cancer, prostate cancer, colorectal cancer, bronchial cancer, lymphoma and leukemia. Method(s): The years 2020 versus 2019 were compared with focus on the months of the first wave of pandemics from February to May 2020 analyzing data from the clinical cancer registry Regensburg. Result(s): The total numbers of annual new cases were lower in all entities in 2020 vs. 2019. The percentage decrease ranged between -1.9% for breast cancer and -15.3% for colorectal cancer, with highly significant difference for colorectal cancer (p<0.001). The comparison of the monthly reported number of cases showed a decrease in all analyzed cancer entities, in March to May 2020 compared to 2019 with statistical significance. There was no significantly increased rate of patients with advanced stages III/IV, larger tumors T3/T4, positive node status or distant metastases in nearly all entities neither in the annual nor the monthly comparison. Colorectal cancer was an exception, with significantly increased rates in March and April 2020. Apart from bronchial cancer, rates of primary therapy in stages I-III in 2020 were mostly slight, but not significantly lower than in 2019. Significantly lower treatment rates were found for prostate cancer in March 2020 and for colorectal cancer in November 2020. The mean interval between diagnosis and start of therapy was the same or slightly longer in 2020, but not significant, except for lung cancer, leukemia and lymphoma. Discussion(s): A potential lack in transmitted medical informations, a delay of documentation and consequently restricted real-time analysis must be considered when using data from clinical cancer registries. Conclusion(s): A decreased incidence especially during the first wave could be shown. A shift of stage distribution and treatment delay was not observed. Follow-up analyses and observation of the subsequent pandemic waves are necessary to confirm the current results.
ABSTRACT
Coronaviruses (lat. Coronaviridae) is a family of RNA-containing viruses, including 43 species as of May 2020 (it is constantly being updated), of which 7 coronaviruses affect humans (the first of them HCoV-229E is an alphacoronavirus, first identified in 1965). Transmission mechanisms: airborne, airborne-dust, fecal-oral, contact. In December 2019, an outbreak of pneumonia began in China caused by the seventh newly discovered SARS-CoV-2 virus, betacoronavirus. Coronaviruses suppress the immune system, the body ceases to recognize the infection and fight it. Very quickly, the coronavirus pandemic swept across all continents. New strains of this virus are being registered in various countries, the third, fourth, fifth and even sixth waves of its prevalence are noted. At the first stage of the pandemic, panic was certainly observed, outpatient clinics and even specialized hospitals were closed. All were aimed at fighting the new virus, The purpose of our study is to determine the impact of the newly emerged virus on the organizational problems of the oncological service in connection with the generalization of statistical data on morbidity and mortality from malignant neoplasms for the first year of the pandemic in Russia, the Northwestern Federal District of the Russian Federation and St. Petersburg. Materials and methods. The research material was the official data of the state reporting of the activities of the oncological service (f. No 7), the data of the State Statistics Committee on the deceased, the database of the cancer registry of St. Petersburg and the Northwestern Federal District of the Russian Federation. Results. The study made it possible to determine the impact of the spread of the SARS-CoV-2 coronavirus in Russia on the activities of the oncological service, primarily on the possibility of screening programs and early diagnosis programs for cancer. The tasks set to determine the maximum damage from the coronavirus to patients with cancer have been completed by us. It was found that in Russia as a whole, the under-registration of patients with cancer amounted to about 100,000 people, the quality of primary registration of patients decreased by 13%. The structure of cancer incidence in men and women has not changed much, but it turned out to be at lower absolute values. The maximum damage in the accounting of primary patients with cancer was inflicted on elderly and senile citizens, especially in localities with a low mortality rate. The incidence (detectability) of cancer decreased by almost a quarter in Moscow (this is 12,000 patients), in St. Petersburg - 3.5 thousand, in the Northwestern Federal District of the Russian Federation by 8.4 thousand. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.