Disruption of National Cancer Database Data Models in the First Year of the COVID-19 Pandemic

JAMA Surgery, Journal Year: 2023, Volume and Issue: 158(6), P. 643 - 643

Published: April 12, 2023

Each year, the National Cancer Database (NCDB) collects and analyzes data used in reports to support research, quality measures, Commission on program accreditation. Because models generate these have been historically stable, year-to-year variances attributed changes within cancer rather than modeling. submissions 2020 were anticipated be significantly different from prior years because of COVID-19 pandemic. This study involved a validation analysis observed expected NCDB comparison with 2019 2018.The captured total 1 223 221 overall cases 2020, decrease 14.4% (Δ = -206 099) compared 2019. The early months pandemic (March-May 2020) coincided nadir April that did not recover prepandemic levels through remainder 2020. In pandemic, proportion early-stage disease decreased sharply overall, while late-stage increased. However, differences stage distribution varied by primary site. Statistically significant proportions race ethnicity, sex, insurance type, geographic location, education, income identified, but consistent patterns evident.Historically stable for administrative, improvement purposes disrupted during first year users will need carefully interpret disease- program-specific findings come account aberrations when running include

Language: Английский

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Impact of the COVID-19 pandemic on cancer diagnoses, stage and survival in Alberta

Canadian Medical Association Journal, Journal Year: 2023, Volume and Issue: 195(23), P. E804 - E812

Published: June 11, 2023

The COVID-19 pandemic is suspected to have affected cancer care and outcomes among patients in Canada. In this study, we evaluated the impact of state emergency period during (Mar. 17 June 15, 2020) on diagnoses, stage at diagnosis 1-year survival Alberta.We included new diagnoses 10 most prevalent types from Jan. 1, 2018, Dec. 31, 2020. We followed up 2021. used interrupted time series analysis examine first COVID-19-related Alberta number diagnoses. multivariable Cox regression compare who received a 2020 after with those 2018 2019. also performed stage-specific analyses.We observed significant reductions breast (incidence rate ratio [IRR] 0.67, 95% confidence interval [CI] 0.59-0.76), prostate (IRR 0.64, CI 0.56-0.73) colorectal 0.56- 0.74) melanoma 0.57, 0.47-0.69) compared before it. These decreases largely occurred early-stage rather than late-stage Patients cancer, non-Hodgkin lymphoma uterine had lower diagnosed 2018; no other sites survival.The results our analyses suggest that health disruptions considerably outcomes. Given largest was cancers organized screening programs, additional system capacity may be needed mitigate future impact.

Language: Английский

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Effects of the COVID‐19 pandemic on gastroenterological surgeries in 2020: A study using the National Clinical Database of Japan

Annals of Gastroenterological Surgery, Journal Year: 2022, Volume and Issue: 7(3), P. 407 - 418

Published: Nov. 18, 2022

Abstract Aim This study aimed to investigate the effect of coronavirus disease pandemic on number surgeries for gastroenterological cancer cases in Japan. Methods The data recorded National Clinical Database Japan between 2018 and 2020 were utilized this study. Five specific primary cancers surgery acute diffuse peritonitis considered endpoints. We divided period into prepandemic postpandemic (after April 2020) periods examined relation clinical factors. Results Overall, 228 860 analyzed. Among five surgeries, distal gastrectomies gastric decreased most (to 81.0% monthly period), followed by that low anterior resections rectal (91.4%). In contrast, pancreaticoduodenectomies pancreatic increased 7.1%, while remained stable. trend was observed nationwide. also noted a marked reduction gastrectomy 72.5%), resection (84.0%), esophagectomy (88.8%) procedures T1 tumors. noncurative rate mortalities despite proportion T4 tumors older patients. Conclusion A with early T factors may reflect prioritization screenings. Although quality maintained terms reduced morbidities, long‐term effects should be monitored.

Language: Английский

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The impact of lag time to cancer diagnosis and treatment on clinical outcomes prior to the COVID-19 pandemic: A scoping review of systematic reviews and meta-analyses

eLife, Journal Year: 2023, Volume and Issue: 12

Published: Jan. 31, 2023

Background: The COVID-19 pandemic has disrupted cancer care, raising concerns regarding the impact of wait time, or ‘lag time’, on clinical outcomes. We aimed to contextualize pandemic-related lag times by mapping pre-pandemic evidence from systematic reviews and/or meta-analyses association between time diagnosis and treatment with mortality- morbidity-related Methods: systematically searched MEDLINE, EMBASE, Web Science, Cochrane Library Systematic Reviews for published prior (1 January 2010–31 December 2019). extracted data methodological characteristics, interval start endpoints, qualitative findings reviews, pooled risk estimates (i.e., overall survival) morbidity- local regional control) related outcomes meta-analyses. categorized according milestones across care continuum summarized site interval. Results: identified 9032 records through database searches, which 29 were eligible. classified 33 unique types intervals 10 sites, breast, colorectal, head neck, ovarian cancers investigated most. Two investigating reported different survival among paediatric patients Ewing’s sarcomas central nervous system tumours. Comparable mortality found surgery adjuvant chemotherapy cancers. Risk pathologic complete response indicated an optimal window 7–8 weeks neoadjuvant completion rectal In comparing methods same times, outcomes, we critical variations in research design. Conclusions: Our review highlighted measured associations cancer-related need a standardized approach areas such as definitions accounting waiting-time paradox. Prioritization is integral revised guidelines under contingency assessing pandemic’s long-term effect cancer. Funding: present work was supported Canadian Institutes Health Research (CIHR-COVID-19 Rapid Funding opportunity, VR5-172666 grant Eduardo L. Franco). Parker Tope, Eliya Farah, Rami Ali each received MSc. stipend Gerald Bronfman Department Oncology, McGill University.

Language: Английский

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Cancer Screening Disparities Before and After the COVID-19 Pandemic

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(11), P. e2343796 - e2343796

Published: Nov. 20, 2023

Breast, cervical, and colorectal cancer-screening disparities existed prior to the COVID-19 pandemic, it is unclear whether those have changed since pandemic.

Language: Английский

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Preventive care recommendations to promote health equity

Canadian Medical Association Journal, Journal Year: 2023, Volume and Issue: 195(37), P. E1250 - E1273

Published: Sept. 24, 2023

Background:

Avoidable disparities in health outcomes persist Canada despite substantial investments a publicly funded care system that includes preventive services. Our objective was to provide recommendations promote equity by prioritizing effective interventions for people experiencing disadvantages.

Methods:

The guideline developed primary provider–patient panel, with input from patient-partner panel diverse lived experiences. After selecting priority topics, we searched systematic reviews and recent randomized controlled trials of screening other relevant studies accuracy management efficacy. We used the Grading Recommendations, Assessment, Development Evaluation (GRADE) approach develop followed Appraisal Guidelines Research (AGREE II) reporting guidance. managed competing interests using Guideline International Network principles. were externally reviewed content experts circulated endorsement national stakeholders.

Recommendations:

15 1 policy recommendation on improving access care. recommend prioritized outreach colorectal cancer starting at age 45 years cardiovascular disease risk assessment, help address inequities health. Specific should be rolled out ways include human papillomavirus (HPV) self-testing, HIV self-testing interferon-γ release assays tuberculosis infection. Screening depression, substance use, intimate partner violence poverty connect specific disadvantages proven interventions. automatic connection

Interpretation:

Proven can if are prioritized. Clinicians, organizations governments take evidence-based actions track progress promoting across Canada.

Language: Английский

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The impact of the early COVID-19 pandemic on healthcare system resource use and costs in two provinces in Canada: An interrupted time series analysis

PLoS ONE, Journal Year: 2023, Volume and Issue: 18(9), P. e0290646 - e0290646

Published: Sept. 8, 2023

Introduction The aim of our study was to assess the initial impact COVID-19 on total publicly-funded direct healthcare costs and health services use in two Canadian provinces, Ontario British Columbia (BC). Methods This retrospective repeated cross-sectional used population-based administrative datasets, linked within each province, from January 1, 2018 December 27, 2020. Interrupted time series analysis estimate changes level trends weekly resource costs, with March 16–22, 2020 as first pandemic week. Also, week 2020, we identified cases their positive SARS-CoV-2 test estimated until death or Results resources largest declines (95% confidence interval) compared previous were physician [Ontario: -43% (-49%,-37%); BC: -24% (-30%,-19%) (both p<0.001)] emergency department visits -41% (-47%,-35%); -29% (-35%,-23%) p<0.001)]. Hospital admissions declined by 27% (-32%,-23%) 21% (-26%,-16%) BC p<0.001). Resource subsequently rose but did not return pre-pandemic levels. Only home care dialysis clinic significantly decrease pre-pandemic. Costs for represented 1.3% 0.7% BC, respectively. Conclusions Reduced utilization overall population outweighed patients Meeting needs all across is essential maintain resilient systems.

Language: Английский

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Noteworthy impacts of COVID-19 pandemic on cancer screening: A systematic review

Fundamental Research, Journal Year: 2024, Volume and Issue: 4(3), P. 484 - 494

Published: Feb. 8, 2024

The sudden onset of the coronavirus disease 2019 (COVID-19) in January 2020 has affected essential global health services. Cancer-screening services that can reduce cancer mortality are strongly affected. However, specific role COVID-19 screening is not fully understood. This study aimed to assess efficiency programs before and during pandemic promote potential cancer-screening strategies for next pandemic. Electronic searches PubMed, Embase, Web Science, manual were performed between 1, March 2023. Cohort studies reported number participants who underwent included. methodological quality included was assessed using Newcastle-Ottawa Scale. Differences rates estimated incidence rate ratio (IRR). Fifty-five cohort this meta-analysis. colorectal invasive methods (Pooled IRR=0.52, 95% CI: 0.42 0.65, p<0.01), cervical IRR=0.56, 0.47 0.67, breast IRR=0.57, 0.49 0.66, p<0.01) prostate IRR=0.71, 0.56 0.90, significantly lower than those lung IRR=0.77, 0.58 1.03, p=0.08) noninvasive IRR=0.74, 0.50 1.09, p=0.13) reduced with no statistical differences. subgroup analyses revealed reduction varied across economies. Our results suggest had a noteworthy impact on colorectal, cervical, breast, screening. Developing innovative technologies important post-COVID-19 era prepare

Language: Английский

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Timeliness and Modality of Treatment for New Cancer Diagnoses During the COVID-19 Pandemic in Canada

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(1), P. e2250394 - e2250394

Published: Jan. 10, 2023

Importance The impact of COVID-19 on the modality and timeliness first-line cancer treatment is unclear yet critical to planning subsequent care. Objective To explore association pandemic with modalities wait times for first treatment. Design, Setting, Participants This retrospective population-based cohort study using administrative data was conducted in Ontario, Canada, among adults newly diagnosed between January 3, 2016, November 7, 2020. were followed up from date diagnosis 1 year, until death, or June 26, 2021, whichever occurred first, ensure a minimum 6-month follow-up time. Exposures Receiving vs prepandemic period, March 15, 2020, when elective hospital procedures halted. Main Outcomes Measures main outcome time-to-event variable describing number days receiving (surgery, chemotherapy, radiation) being censored. For each modality, multivariable competing-risk regression model used assess time period. A secondary continuous defined patients who treated 6 months after as waiting Results Among 313 499 patients, mean (SD) age 66.4 (14.1) years 153 679 (49.0%) male patients. Those during less likely receive surgery (subdistribution hazard ratio [sHR], 0.97; 95% CI, 0.95-0.99) but more chemotherapy (sHR, 1.26; 1.23-1.30) radiotherapy 1.16; 1.13-1.20) first. received within (228 755 [73.0%]), their decreased 35.1 (37.2) 29.5 (33.6) surgery, 43.7 (34.1) 38.4 (30.6) 55.8 (41.8) 49.0 (40.1) radiotherapy. Conclusions Relevance In this study, significantly associated greater use nonsurgical therapy initial Wait shorter period those diagnosis. Future work needs examine how these changes may have affected patient outcomes inform future guideline development.

Language: Английский

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Potential global loss of life expected due to COVID-19 disruptions to organised colorectal cancer screening

EClinicalMedicine, Journal Year: 2023, Volume and Issue: 62, P. 102081 - 102081

Published: July 20, 2023

Screening for colorectal cancer (CRC) decreases burden through removal of precancerous lesions and early detection cancer. The COVID-19 pandemic has disrupted organised CRC screening programs worldwide, with some completely suspending others experiencing significant in participation diagnostic follow-up. This study estimated the global impact disruptions on outcomes, potential effects catch-up screening.Organised were identified 29 countries, data rates COVID-related changes to 2020 extracted where available. Four independent microsimulation models (ASCCA, MISCAN-Colon, OncoSim, Policy1-Bowel) used estimate long-term cases deaths, based 2020. For countries not available, approximated excess mortality rates. Catch-up strategies involving additional 2021 also simulated.In which direct volumes at a country level decreased by an 1.3-40.5% Globally, it is that led deficit 7.4 million fewer faecal screens performed In absence any screening, this would lead 13,000 7,900 deaths globally from 2050; 79% 85% could have been prevented respectively.COVID-19-related will cause but appropriately implemented reduced over 80%. Careful management disruption key improving resilience programs.The authors disclosed receipt following financial support research, authorship, and/or publication article: work was supported Cancer Council New South Wales, Health Canada, Dutch National Institute Public Environment.

Language: Английский

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