Early survival for patients newly diagnosed with cancer during COVID-19 in Ontario, Canada: A population-based cohort study.
COVID-19
cancer
cancer detection
cancer survivorship
oncology
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
15
02
2023
received:
17
01
2023
accepted:
16
03
2023
medline:
7
6
2023
pubmed:
1
4
2023
entrez:
31
3
2023
Statut:
ppublish
Résumé
Little is known about the association between the COVID-19 pandemic and early survival among newly diagnosed cancer patients. This retrospective population-based cohort study used linked administrative datasets from Ontario, Canada. Adults (≥18 years) who received a cancer diagnosis between March 15 and December 31, 2020, were included in a pandemic cohort, while those diagnosed during the same dates in 2018/2019 were included in a pre-pandemic cohort. All patients were followed for one full year after the date of diagnosis. Cox proportional hazards regression models were used to assess survival in relation to the pandemic, patient characteristics at diagnosis, and the modality of first cancer treatment as a time-varying covariate. Interaction terms were explored to measure the pandemic association with survival for each cancer type. Among 179,746 patients, 53,387 (29.7%) were in the pandemic cohort and 37,741 (21.0%) died over the first post-diagnosis year. No association between the pandemic and survival was found when adjusting for patient characteristics at diagnosis (HR 0.99 [95% CI 0.96-1.01]), while marginally better survival was found for the pandemic cohort when the modality of treatment was additionally considered (HR 0.97 [95% CI 0.95-0.99]). When examining each cancer type, only a new melanoma diagnosis was associated with a worse survival in the pandemic cohort (HR 1.25 [95% CI 1.05-1.49]). Among patients able to receive a cancer diagnosis during the pandemic, one-year overall survival was not different than those diagnosed in the previous 2 years. This study highlights the complex nature of the COVID-19 pandemic impact on cancer care.
Sections du résumé
BACKGROUND
Little is known about the association between the COVID-19 pandemic and early survival among newly diagnosed cancer patients.
METHODS
This retrospective population-based cohort study used linked administrative datasets from Ontario, Canada. Adults (≥18 years) who received a cancer diagnosis between March 15 and December 31, 2020, were included in a pandemic cohort, while those diagnosed during the same dates in 2018/2019 were included in a pre-pandemic cohort. All patients were followed for one full year after the date of diagnosis. Cox proportional hazards regression models were used to assess survival in relation to the pandemic, patient characteristics at diagnosis, and the modality of first cancer treatment as a time-varying covariate. Interaction terms were explored to measure the pandemic association with survival for each cancer type.
RESULTS
Among 179,746 patients, 53,387 (29.7%) were in the pandemic cohort and 37,741 (21.0%) died over the first post-diagnosis year. No association between the pandemic and survival was found when adjusting for patient characteristics at diagnosis (HR 0.99 [95% CI 0.96-1.01]), while marginally better survival was found for the pandemic cohort when the modality of treatment was additionally considered (HR 0.97 [95% CI 0.95-0.99]). When examining each cancer type, only a new melanoma diagnosis was associated with a worse survival in the pandemic cohort (HR 1.25 [95% CI 1.05-1.49]).
CONCLUSIONS
Among patients able to receive a cancer diagnosis during the pandemic, one-year overall survival was not different than those diagnosed in the previous 2 years. This study highlights the complex nature of the COVID-19 pandemic impact on cancer care.
Identifiants
pubmed: 36999960
doi: 10.1002/cam4.5861
pmc: PMC10242323
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
11849-11859Informations de copyright
© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
J Am Acad Dermatol. 2022 Nov;87(5):1217-1219
pubmed: 35738513
Lancet Public Health. 2022 Jun;7(6):e537-e548
pubmed: 35660215
PLoS One. 2021 Mar 31;16(3):e0248492
pubmed: 33788858
ESMO Open. 2021 Jun;6(3):100134
pubmed: 33984676
JAMA Oncol. 2022 Sep 1;8(9):1287-1293
pubmed: 35797056
J Surg Res. 2023 May;285:100-106
pubmed: 36652768
BMJ Support Palliat Care. 2021 Oct 28;:
pubmed: 34711656
Int J Cancer. 2022 Apr 15;150(8):1244-1254
pubmed: 34843106
BJS Open. 2022 Jan 6;6(1):
pubmed: 35143629
Eur J Cancer. 2020 Dec;141:92-104
pubmed: 33130550
Can J Surg. 2022 Aug 4;65(4):E496-E503
pubmed: 35926883
Curr Oncol. 2022 Oct 14;29(10):7732-7744
pubmed: 36290888
BMJ Open Gastroenterol. 2022 Apr;9(1):
pubmed: 35450934
Dig Liver Dis. 2022 Jan;54(1):10-18
pubmed: 34654679
BJS Open. 2021 Nov 9;5(6):
pubmed: 34755189
J Geriatr Oncol. 2023 Mar;14(2):101443
pubmed: 36709553
Cancer Med. 2023 Mar;12(5):6056-6067
pubmed: 36176264
JAMA Netw Open. 2023 Jan 3;6(1):e2250394
pubmed: 36626169
Lancet Oncol. 2020 Aug;21(8):1023-1034
pubmed: 32702310
Rev Esp Enferm Dig. 2022 Aug;114(8):509-510
pubmed: 35297265
CMAJ. 2022 Mar 21;194(11):E408-E414
pubmed: 35314440
J Natl Compr Canc Netw. 2022 Feb 1;20(3):276-284
pubmed: 35104788
Int J Cancer. 2022 May 15;150(10):1609-1618
pubmed: 35001364
Colorectal Dis. 2022 Aug;24(8):925-932
pubmed: 35362199
Oncologist. 2022 Jun 8;27(6):e518-e523
pubmed: 35285490
J Natl Compr Canc Netw. 2022 Nov;20(11):1190-1192
pubmed: 36351330
ANZ J Surg. 2022 May;92(5):1110-1116
pubmed: 35393720
JAMA Netw Open. 2021 Mar 1;4(3):e211104
pubmed: 33704472
BMJ. 2020 Nov 4;371:m4087
pubmed: 33148535
Front Med (Lausanne). 2022 Sep 26;9:954878
pubmed: 36226153
JAMA Netw Open. 2022 Aug 1;5(8):e2225118
pubmed: 35917122
Int J Cancer. 2021 Jul 15;149(2):287-296
pubmed: 33634852
JNCI Cancer Spectr. 2022 Sep 1;6(5):
pubmed: 35980176
Ecancermedicalscience. 2021 Mar 11;15:1202
pubmed: 33889211
JAMA Netw Open. 2022 Apr 1;5(4):e228855
pubmed: 35467731
Cancer Med. 2023 May;12(10):11849-11859
pubmed: 36999960
Med Care. 1998 Jan;36(1):8-27
pubmed: 9431328