Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese Hospitals
Introduction: The outbreak of coronavirus disease 2019 (COVID-19) had affected clinical practice in several ways, including the restriction of nonessential endoscopic procedures. Therefore, our aim was to evaluate how colorectal cancer (CRC) diagnosis and management was affected during the first yea...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-07-01
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| Series: | GE: Portuguese Journal of Gastroenterology |
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| Online Access: | https://beta.karger.com/Article/FullText/531234 |
| _version_ | 1797742012131180544 |
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| author | Maria Ana Rafael Cristiana Sequeira Sónia Isabel da Silva Barros Bárbara Silva Abreu Cristina Teixeira Pierre Lahmek Marine Besnard Bruno Lesgourgues |
| author_facet | Maria Ana Rafael Cristiana Sequeira Sónia Isabel da Silva Barros Bárbara Silva Abreu Cristina Teixeira Pierre Lahmek Marine Besnard Bruno Lesgourgues |
| author_sort | Maria Ana Rafael |
| collection | DOAJ |
| description | Introduction: The outbreak of coronavirus disease 2019 (COVID-19) had affected clinical practice in several ways, including the restriction of nonessential endoscopic procedures. Therefore, our aim was to evaluate how colorectal cancer (CRC) diagnosis and management was affected during the first year of pandemics in Portugal. Methods: This is a Portuguese substudy of the French retrospective multicentric study ETICC (Etude de l’Impact de la pandémie COVID-19 sur le diagnostic et la prise en charge du Cancer Colorectal). We compared patients’ characteristics, clinical manifestations, CRC staging at diagnosis, delay to first medical appointment, histological diagnosis, surgical and medical treatments between the year previous to the pandemics (control) and the first year of pandemics. Results: We included 766 patients: 496 in the control group and 270 in the COVID group. There was no significant difference in CRC staging at diagnosis between both groups, with 21% being diagnosed as metastatic in the control group and 22% in the first year of pandemics (p = 0.770). Contrary to what happened in France, there was a significant decrease in CRC diagnosis in asymptomatic patients (25–8.4%; p < 0.001) and after a positive fecal immunochemical test (20.8–11.3%; p = 0.002) during the pandemics. Although the increase in the overall complication rate at diagnosis was nonsignificant, in Portugal, there was a significant increase in diagnosis of abdominal occlusion (12.1–18.1%; p = 0.033). In Portugal, time between the beginning of symptoms and the first medical appointment significantly increased from a median of 50 days to 64 days during COVID (p < 0.001). On the contrary, time between histological diagnosis and tumor resection had significantly decreased from a median of 65 to 39 days (p < 0.001). Time between histological diagnosis and neoadjuvant treatment was not statistically different (median of 64–67 days; p = 0.590), as was time between histological diagnosis and palliative chemotherapy (median of 50–51 days; p = 1.000). Time from CRC resection and adjuvant treatment has significantly decreased from a median of 54 to 43 days (p = 0.001). Discussion: We found a significant impact in CRC diagnosis in the first year of pandemics, more pronounced than what was found in France. These are likely related not only with the closing of endoscopy units but also with the difficulties patients had in finding an appointment with their general practitioners. On the other hand, both in France and Portugal, the first year of pandemics did not worsen CRC staging at diagnosis and did not significantly affect medical and surgical treatments once the diagnosis was made. |
| first_indexed | 2024-03-12T14:34:54Z |
| format | Article |
| id | doaj.art-0aaf0cd323ab4b0eb2968252fbb02673 |
| institution | Directory Open Access Journal |
| issn | 2387-1954 |
| language | English |
| last_indexed | 2024-03-12T14:34:54Z |
| publishDate | 2023-07-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | GE: Portuguese Journal of Gastroenterology |
| spelling | doaj.art-0aaf0cd323ab4b0eb2968252fbb026732023-08-17T09:00:00ZengKarger PublishersGE: Portuguese Journal of Gastroenterology2387-19542023-07-011610.1159/000531234531234Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese HospitalsMaria Ana Rafael0Cristiana Sequeira1https://orcid.org/0000-0001-5568-3732Sónia Isabel da Silva Barros2Bárbara Silva Abreu3Cristina Teixeira4https://orcid.org/0000-0003-4024-6526Pierre Lahmek5Marine Besnard6Bruno Lesgourgues7Gastroenterology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, PortugalNúcleo de Gastrenterologia dos Hospitais Distritais, Lisboa, PortugalNúcleo de Gastrenterologia dos Hospitais Distritais, Lisboa, PortugalNúcleo de Gastrenterologia dos Hospitais Distritais, Lisboa, PortugalNúcleo de Gastrenterologia dos Hospitais Distritais, Lisboa, PortugalAssociation Nationale des Gastroentérologues des Hôpitaux Généraux, Montfermeil, FranceAssociation Nationale des Gastroentérologues des Hôpitaux Généraux, Montfermeil, FranceAssociation Nationale des Gastroentérologues des Hôpitaux Généraux, Montfermeil, FranceIntroduction: The outbreak of coronavirus disease 2019 (COVID-19) had affected clinical practice in several ways, including the restriction of nonessential endoscopic procedures. Therefore, our aim was to evaluate how colorectal cancer (CRC) diagnosis and management was affected during the first year of pandemics in Portugal. Methods: This is a Portuguese substudy of the French retrospective multicentric study ETICC (Etude de l’Impact de la pandémie COVID-19 sur le diagnostic et la prise en charge du Cancer Colorectal). We compared patients’ characteristics, clinical manifestations, CRC staging at diagnosis, delay to first medical appointment, histological diagnosis, surgical and medical treatments between the year previous to the pandemics (control) and the first year of pandemics. Results: We included 766 patients: 496 in the control group and 270 in the COVID group. There was no significant difference in CRC staging at diagnosis between both groups, with 21% being diagnosed as metastatic in the control group and 22% in the first year of pandemics (p = 0.770). Contrary to what happened in France, there was a significant decrease in CRC diagnosis in asymptomatic patients (25–8.4%; p < 0.001) and after a positive fecal immunochemical test (20.8–11.3%; p = 0.002) during the pandemics. Although the increase in the overall complication rate at diagnosis was nonsignificant, in Portugal, there was a significant increase in diagnosis of abdominal occlusion (12.1–18.1%; p = 0.033). In Portugal, time between the beginning of symptoms and the first medical appointment significantly increased from a median of 50 days to 64 days during COVID (p < 0.001). On the contrary, time between histological diagnosis and tumor resection had significantly decreased from a median of 65 to 39 days (p < 0.001). Time between histological diagnosis and neoadjuvant treatment was not statistically different (median of 64–67 days; p = 0.590), as was time between histological diagnosis and palliative chemotherapy (median of 50–51 days; p = 1.000). Time from CRC resection and adjuvant treatment has significantly decreased from a median of 54 to 43 days (p = 0.001). Discussion: We found a significant impact in CRC diagnosis in the first year of pandemics, more pronounced than what was found in France. These are likely related not only with the closing of endoscopy units but also with the difficulties patients had in finding an appointment with their general practitioners. On the other hand, both in France and Portugal, the first year of pandemics did not worsen CRC staging at diagnosis and did not significantly affect medical and surgical treatments once the diagnosis was made.https://beta.karger.com/Article/FullText/531234covid-19colorectal cancerpandemic |
| spellingShingle | Maria Ana Rafael Cristiana Sequeira Sónia Isabel da Silva Barros Bárbara Silva Abreu Cristina Teixeira Pierre Lahmek Marine Besnard Bruno Lesgourgues Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese Hospitals GE: Portuguese Journal of Gastroenterology covid-19 colorectal cancer pandemic |
| title | Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese Hospitals |
| title_full | Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese Hospitals |
| title_fullStr | Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese Hospitals |
| title_full_unstemmed | Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese Hospitals |
| title_short | Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese Hospitals |
| title_sort | portuguese results of the eticc study impact of the pandemic covid 19 in the diagnosis and management of colorectal cancer in 2020 in portuguese hospitals |
| topic | covid-19 colorectal cancer pandemic |
| url | https://beta.karger.com/Article/FullText/531234 |
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