Impact of COVID-19 on cancer incidence, presentation, diagnosis, treatment and survival in Northern Ireland

被引:4
作者
Bennett, Damien [1 ,2 ,3 ]
Murray, Inez [2 ]
Mitchell, Helen [1 ]
Gavin, Anna [2 ]
Donnelly, David [1 ]
机构
[1] Ctr Publ Hlth, Northern Ireland Canc Registry, Belfast, North Ireland
[2] Queens Univ Belfast, Ctr Publ Hlth, Belfast, North Ireland
[3] Ctr Publ Hlth, Northern Ireland Canc Registry, Mulhouse Bldg,Grosvenor Rd, Belfast BT12 6DP, North Ireland
关键词
cancer; COVID-19; impact; stage; survival; treatment; POPULATION; ENGLAND; MANAGEMENT; UK;
D O I
10.1002/ijc.34847
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The COVID-19 pandemic had a major impact on cancer patients and services but has been difficult to quantify. We examined how the entire cancer pathway-from incidence, presentation, diagnosis, stage, treatment and survival-was affected in Northern Ireland during April-December 2020 compared to equivalent 2018-2019 periods using retrospective, observational cancer registry data from the Northern Ireland Cancer Registry (NICR). There were 6748 cancer cases in April-December 2020 and an average 7724 patients in April-December 2018-2019. Incident cases decreased by 13% (almost 1000). Significant differences were found across age cohorts and deprivation quintiles, with reductions greatest for younger people (<55 years; 19% decrease) and less deprived (22% decrease). A higher proportion had emergency admission (16%-to-20%) with lower proportions diagnosed pathologically (85%-to-83%). There was a significant stage shift, with lower proportions of early stage (29%-to-25%) and higher late-stage (21%-to-23%). Lower proportions received surgery (41%-to-38%) and radiotherapy (24%-to-22%) with a higher proportion not receiving treatment (29%-to-33%). One-year observed-survival decreased from 73.7% to 69.8% and 1-year net-survival decreased from 76.1% to 72.9%, with differences driven by five tumours; Lung (40.3%-to-35.0%), Head-and-Neck (77.4%-to-68.4%), Oesophageal (53.5%-to-42.3%), Lymphoma (81.1%-to-75.2%) and Uterine cancer (87.4%-to-80.4%). Our study reveals profound adverse impact of COVID-19 on the entire cancer patient pathway, with 13% fewer cases, greater emergency admissions and significant stage-shift from early to more advanced-stage disease. There was major treatment impact with lower rates of surgery and radiotherapy and higher proportions receiving no treatment. There were significant reductions in 1-year survival. Our study will support service recovery and protect cancer services in future pandemics or disruptions.
引用
收藏
页码:1731 / 1744
页数:14
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