Delayed care for patients with newly diagnosed cancer due to COVID-19 and estimated impact on cancer mortality in France

被引：59

作者：

Blay, J. Y. ^{[1
]}

Boucher, S. ^{[2
]}

Le Vu, B. ^{[2
]}

Cropet, C. ^{[1
]}

Chabaud, S. ^{[1
]}

Perol, D. ^{[1
]}

Barranger, E. ^{[3
]}

Campone, M. ^{[4
,5
]}

Conroy, T. ^{[6
]}

Coutant, C. ^{[7
]}

De Crevoisier, R. ^{[8
]}

Debreuve-Theresette, A. ^{[9
]}

Delord, J. P. ^{[9
]}

Fumoleau, P. ^{[10
]}

Gentil, J. ^{[7
]}

Gomez, F. ^{[1
]}

Guerin, O. ^{[4
,5
]}

Jaffre, A. ^{[11
]}

Lartigau, E. ^{[12
]}

Lemoine, C. ^{[13
]}

Mahe, M. A. ^{[14
]}

Mahon, F. X. ^{[11
]}

Mathieu-Daude, H. ^{[15
]}

Merrouche, Y. ^{[16
]}

Penault-Llorca, F. ^{[17
]}

Pivot, X. ^{[18
]}

Soria, J. C. ^{[19
]}

Thomas, G. ^{[14
]}

Vera, P. ^{[20
]}

Vermeulin, T. ^{[20
]}

Viens, P. ^{[13
]}

Ychou, M. ^{[15
]}

Beaupere, S. ^{[2
]}

机构：

[1] Ctr Leon Berard, Lyon, France

[2] Unicancer, Paris, France

[3] Ctr Antoine Lacassagne, Nice, France

[4] Inst Cancerol Ouest, Nantes, France

[5] Inst Cancerol Ouest, Angers, France

[6] Inst Cancerol Lorraine, Nancy, France

[7] Ctr George Francoise Leclerc, Dijon, France

[8] Ctr Eugene Marquis, Rennes, France

[9] IUCT Oncopole, Inst Claudius Regaud, Toulouse, France

[10] Inst Curie, Paris, France

[11] Inst Bergonie, Bordeaux, France

[12] Ctr Oscar Lambret, Lille, France

[13] Inst Paoli Calmettes, Marseille, France

[14] Ctr Francois Baclesse, Caen, France

[15] Inst Cancerol Montpellier, Montpellier, France

[16] Inst Jean Godinot, Reims, France

[17] Ctr Jean Perrin, Clermont Ferrand, France

[18] ICANS, Ctr Paul Strauss, Strasbourg, France

[19] Gustaye Roussy, Villejuif, France

[20] Ctr Henri Becquerel, Rouen, France

来源：

ESMO OPEN | 2021年 / 6卷 / 03期

关键词：

COVID-19; cancer; delay; diagnosis; treatment; ADVANCED-STAGE; BREAST-CANCER; NECK-CANCER; SURVIVAL; TIME; SURGERY; OUTCOMES; CHEMOTHERAPY; INITIATION; LYMPHOMA;

D O I：

10.1016/j.esmoop.2021.100134

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: The impact of the first coronavirus disease 2019 (COVID-19) wave on cancer patient management was measured within the nationwide network of the Unicancer comprehensive cancer centers in France. Patients and methods: The number of patients diagnosed and treated within 17 of the 18 Unicancer centers was collected in 2020 and compared with that during the same periods between 2016 and 2019. Unicancer centers treat close to 20% of cancer patients in France yearly. The reduction in the number of patients attending the Unicancer centers was analyzed per regions and cancer types. The impact of delayed care on cancer-related deaths was calculated based on different hypotheses. Results: A 6.8% decrease in patients managed within Unicancer in the first 7 months of 2020 versus 2019 was observed. This reduction reached 21% during April and May, and was not compensated in June and July, nor later until November 2020. This reduction was observed only for newly diagnosed patients, while the clinical activity for previously diagnosed patients increased by 4% similar to previous years. The reduction was more pronounced in women, in breast and prostate cancers, and for patients without metastasis. Using an estimated hazard ratio of 1.06 per month of delay in diagnosis and treatment of new patients, we calculated that the delays observed in the 5-month period from March to July 2020 may result in an excess mortality due to cancer of 1000-6000 patients in coming years. Conclusions: In this study, the delays in cancer patient management were observed only for newly diagnosed patients, more frequently in women, for breast cancer, prostate cancer, and nonmetastatic cancers. These delays may result is an excess risk of cancer-related deaths in the coming years.

引用

页数：11

共 55 条

[11] Impact of time from diagnosis to initiation of curative-intent chemotherapy on clinical outcomes in patients with classical Hodgkin lymphoma [J].