Sars-Cov- 2 Pandemic Impact in Rectal Cancer Patients in the South of Portugal (Algarve)

ABSTRACT

Aim: Since the early phases of the COVID-19 pandemic, health systems tried to adapt to ensure the continuity of care of oncological patients. This study aimed to describe the impact of SARS-CoV- 2 on rectal cancer screening and staging. Method(s) A two-year (March 2019 to March 2021) retrospective study concerning rectal cancer patients from a referral center was conducted. Patients clinical data from pre-COVID (March 2019 -February 2020) and COVID time (March 2020 -March 2021) was compared. Descriptive and inferential analysis was performed (Chi-Square test). Result(s) One hundred and sixty-five patients were discussed at the multidisciplinary meetings during the 2-year study period (mean age 69 years [+/- 11.1];M 64%;F36%). Upon comparative analysis both pre-COVID and COVID patients were found to have similar demographic characteristics, however during the pandemic a higher proportion of patients presented with low rectal cancers (36% vs. 42%;P = 0.1). Moreover, during the COVID period, fewer patients (minus 26%;npre-covid= 95 vs. ncovid = 70) were referred to the hospital, and a larger number of patients presented in Stage IV of the disease (17,9% (n = 17) in pre COVID period vs. 28,6% (n = 20) in COVID period (P = 0.07)). Lastly, the authors run a comparative sub-analysis between the above results and data from the 3 years prior to the pandemic (2017-2019) and still came across with lesser rectal cancer referrals during the pandemic year. Conclusion(s) Our data clearly shows that, during the COVID period, fewer patients received in-hospital care and a higher number were referred in Stage IV. This represents a red flag for the community and should alert the government to implement public health policies to reestablish colorectal cancer standard of care.