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Quantifying the impact of the COVID-19 pandemic on gastrointestinal cancer care delivery.
Perkons, Nicholas R; Kim, Casey; Boedec, Chris; Keele, Luke J; Schneider, Charles; Teitelbaum, Ursina R; Ben-Josef, Edgar; Gabriel, Peter E; Plastaras, John P; Shulman, Lawrence N; Wojcieszynski, Andrzej P.
  • Perkons NR; Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Kim C; Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Boedec C; Data Analytics Center, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Keele LJ; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Schneider C; Department of Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Teitelbaum UR; Department of Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Ben-Josef E; Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Gabriel PE; Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Plastaras JP; Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Shulman LN; Department of Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • Wojcieszynski AP; Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Cancer Rep (Hoboken) ; : e1427, 2021 Jun 17.
Article in English | MEDLINE | ID: covidwho-1274682
ABSTRACT
BACKGROUND AND

AIM:

This study quantifies how changes in healthcare utilization and delivery during the first months of the COVID-19 pandemic have altered the presentation, treatment, and management of patients with gastrointestinal (GI) malignancies within an academic health system. METHODS AND

RESULTS:

Patients diagnosed with a GI malignancy (ICD10 C15-C26) who received medical care within the health system during the observation period (first 44 weeks of 2019 and 2020) were identified for a retrospective cohort study. Deidentified patient encounter parameters were collected for this observation period and separated into pre-pandemic (weeks 1-10) and early pandemic (weeks 11-20) study periods. Difference-in-difference analyses adjusted for week-specific and year-specific effects quantified the impact of the COVID-19 pandemic on care delivery between pre-pandemic and early pandemic study periods in 2020. Across all GI malignancies, the COVID-19 pandemic has been associated with a significant decline in the number of patients with new patient visits (NPVs) (p = 1.2 × 10-4 ), Radiology encounters (p = 1.9 × 10-7 ), Surgery encounters (p = 1.6 × 10-3 ), Radiation Oncology encounters (p = 4.1 × 10-3 ), and infusion visits (6.1 × 10-5 ). Subgroup analyses revealed cancer-specific variations in changes to delivery. Patients with colorectal cancer (CRC) had the most significant decrease in NPVs (p = 7.1 × 10-5 ), which was significantly associated with a concomitant decrease in colonoscopies performed during the early pandemic period (r2  = 0.722, p = 2.1 × 10-10 ).

CONCLUSIONS:

The COVID-19 pandemic has been associated with significant disruptions to care delivery. While these effects were appreciated broadly across GI malignancies, CRC, diagnosed and managed by periodic screening, has been affected most acutely.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Observational study / Risk factors Language: English Journal: Cancer Rep (Hoboken) Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Observational study / Risk factors Language: English Journal: Cancer Rep (Hoboken) Clinical aspect: Etiology Year: 2021
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