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Gastrointestinal Cancer Stage at Diagnosis Before and During the COVID-19 Pandemic in Japan.
Kuzuu, Kento; Misawa, Noboru; Ashikari, Keiichi; Kessoku, Takaomi; Kato, Shingo; Hosono, Kunihiro; Yoneda, Masato; Nonaka, Takashi; Matsushima, Shozo; Komatsu, Tatsuji; Nakajima, Atsushi; Higurashi, Takuma.
  • Kuzuu K; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
  • Misawa N; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
  • Ashikari K; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
  • Kessoku T; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
  • Kato S; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
  • Hosono K; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
  • Yoneda M; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
  • Nonaka T; National Hospital Organization Yokohama Medical Center, Totuka-ku, Yokohama, Japan.
  • Matsushima S; National Hospital Organization Yokohama Medical Center, Totuka-ku, Yokohama, Japan.
  • Komatsu T; National Hospital Organization Yokohama Medical Center, Totuka-ku, Yokohama, Japan.
  • Nakajima A; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
  • Higurashi T; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
JAMA Netw Open ; 4(9): e2126334, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1427027
ABSTRACT
Importance The COVID-19 pandemic has delayed medical consultations, possibly leading to the diagnosis of gastrointestinal cancer at advanced stages.

Objective:

To evaluate stage at diagnosis among patients with gastrointestinal cancer in Japan before and during the COVID-19 pandemic. Design, Setting, and

Participants:

This retrospective cohort study included patients in a hospital-based cancer registry who were diagnosed with gastrointestinal cancer (ie, esophageal, gastric, colorectal, pancreatic, liver, and biliary tract cancers) between January 2016 and December 2020 at 2 tertiary Japanese hospitals. Exposures The pre-COVID-19 period was defined as January 2017 to February 2020, and the COVID-19 period was defined as March 2020 to December 2020. Main Outcome and

Measure:

Monthly numbers of patients with newly diagnosed cancer were aggregated, classified by stage, and compared.

Results:

The study evaluated 5167 patients, including 4218 patients (2825 [67.0%] men; mean [SD] age, 71.3 [10.9] years) in the pre-COVID-19 period and 949 patients (607 [64.0%] men; mean [SD] age, 71.8 [10.7] years) in the COVID-19 period. Comparing the pre-COVID-19 period with the COVID-19 period, significant decreases were observed in the mean (SD) number of patients with newly diagnosed gastric cancer (30.63 [6.62] patients/month vs 22.40 [5.85] patients/month; -26.87% change; P < .001) and colorectal cancer (41.61 [6.81] patients/month vs 36.00 [6.72] patients/month; -13.47% change; P = .03). Significant decreases were also observed in the mean (SD) number of cases of stage I gastric cancer (21.55 [5.66] cases/month vs 13.90 [5.99] cases/month; -35.51% change; P < .001), stage 0 colorectal cancer (10.58 [3.36] cases/month vs 7.10 [4.10] cases/month; -32.89% change; P = .008), and stage I colorectal cancer (10.16 [3.14] cases/month vs 6.70 [2.91] cases/month; -34.04% change; P = .003). No significant increases were observed for esophageal, gastric, pancreatic, liver, or biliary tract cancers. A significant decrease was observed in the mean (SD) number of cases per month of stage II colorectal cancer (7.42 [3.06] cases/month vs 4.80 [1.75] cases/month; -35.32% change; P = .01); a significant increase was observed for the mean (SD) number of cases per month of stage III colorectal cancer (7.18 [2.85] cases/month vs 12.10 [2.42] cases/month; 68.42% change; P < .001). Conclusions and Relevance In this cohort study of patients in a hospital-based cancer registry form Japan, significantly fewer patients were diagnosed with stage I gastric and colorectal cancers during the COVID-19 pandemic. Thus, the number of screening-detected cancers might have decreased, and colorectal cancer may have been diagnosed at more advanced stages.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pancreatic Neoplasms / Biliary Tract Neoplasms / Early Detection of Cancer / Pandemics / Gastrointestinal Neoplasms / COVID-19 / Liver Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study / Screening study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article Affiliation country: Jamanetworkopen.2021.26334

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pancreatic Neoplasms / Biliary Tract Neoplasms / Early Detection of Cancer / Pandemics / Gastrointestinal Neoplasms / COVID-19 / Liver Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study / Screening study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article Affiliation country: Jamanetworkopen.2021.26334