The impact of the California state lockdown during the COVID-19 pandemic on management of patients with pancreatic ductal adenocarcinoma.
COVID‐19
healthcare access
lockdown
pancreatic cancer
pandemic
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
18 Jun 2024
18 Jun 2024
Historique:
received:
06
05
2024
accepted:
12
05
2024
medline:
19
6
2024
pubmed:
19
6
2024
entrez:
19
6
2024
Statut:
aheadofprint
Résumé
The SARS-COVID-19 pandemic significantly limited healthcare access. We sought to evaluate whether California's lockdown in March 2020 affected staging and time to treatment of pancreatic ductal adenocarcinoma (PDAC). We hypothesized that patients diagnosed after the lockdown would have longer time to treatment and higher stage at presentation. We retrospectively identified and categorized 1294 patients presenting to five University of California healthcare systems with a new diagnosis of PDAC into "pre-lockdown" and "post-lockdown" groups based on timing of pathologic diagnosis. In the 12 months pre-lockdown, 835 patients were diagnosed with PDAC, and 459 patients in the 6 months post-lockdown. Demographics, staging, and treatment type were similar between eras. There was a decreased male:female ratio post- versus pre-lockdown (0.97 vs. 1.25; p = 0.03). Time from symptom onset to first treatment was significantly increased among females post-lockdown (p = 0.001). However, overall time from diagnosis to first treatment was shorter in the post-lockdown era (median 23 vs. 26 days, p < 0.001). The COVID-19 lockdown did not significantly delay initial presentation, diagnosis, or treatment of newly diagnosed PDAC patients. Time from diagnosis to first treatment was shorter post-lockdown. Reduced healthcare utilization for minor complaints and increased telehealth utilization may have contributed.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
The SARS-COVID-19 pandemic significantly limited healthcare access. We sought to evaluate whether California's lockdown in March 2020 affected staging and time to treatment of pancreatic ductal adenocarcinoma (PDAC). We hypothesized that patients diagnosed after the lockdown would have longer time to treatment and higher stage at presentation.
METHODS
METHODS
We retrospectively identified and categorized 1294 patients presenting to five University of California healthcare systems with a new diagnosis of PDAC into "pre-lockdown" and "post-lockdown" groups based on timing of pathologic diagnosis.
RESULTS
RESULTS
In the 12 months pre-lockdown, 835 patients were diagnosed with PDAC, and 459 patients in the 6 months post-lockdown. Demographics, staging, and treatment type were similar between eras. There was a decreased male:female ratio post- versus pre-lockdown (0.97 vs. 1.25; p = 0.03). Time from symptom onset to first treatment was significantly increased among females post-lockdown (p = 0.001). However, overall time from diagnosis to first treatment was shorter in the post-lockdown era (median 23 vs. 26 days, p < 0.001).
CONCLUSIONS
CONCLUSIONS
The COVID-19 lockdown did not significantly delay initial presentation, diagnosis, or treatment of newly diagnosed PDAC patients. Time from diagnosis to first treatment was shorter post-lockdown. Reduced healthcare utilization for minor complaints and increased telehealth utilization may have contributed.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIH HHS
Pays : United States
Informations de copyright
© 2024 The Author(s). Journal of Surgical Oncology published by Wiley Periodicals LLC.
Références
Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12‐49.
Walter FM, Mills K, Mendonça SC, et al. Symptoms and patient factors associated with diagnostic intervals for pancreatic cancer (SYMPTOM pancreatic study): a prospective cohort study. Lancet Gastroenterol Hepatol. 2016;1(4):298‐306.
Park W, Chawla A, O'Reilly EM. Pancreatic cancer: a review. JAMA. 2021;326(9):851‐862.
Pujolar G, Oliver‐Anglès A, Vargas I, Vázquez ML. Changes in access to health services during the COVID‐19 pandemic: a scoping review. Int J Environ Res Public Health. 2022;19(3):1749.
London JW, Fazio‐Eynullayeva E, Palchuk MB, Sankey P, McNair C. Effects of the COVID‐19 pandemic on cancer‐related patient encounters. JCO Clin Cancer Inform. 2020;4:657‐665.
Kaufman HW, Chen Z, Niles J, Fesko Y. Changes in the number of US patients with newly identified cancer before and during the coronavirus disease 2019 (COVID‐19) pandemic. JAMA Netwk Open. 2020;3(8):e2017267.
Paluri R, Laursen A, Gaeta J, Wang S, Surinach A, Cockrum P. Impact of the COVID‐19 pandemic on management of patients with metastatic pancreatic ductal adenocarcinoma in the United States. Oncologist. 2022;27(6):e518‐e523.
Liu C, Zhao Y, Okwan‐Duodu D, Basho R, Cui X. COVID‐19 in cancer patients: risk, clinical features, and management. Cancer Biol Med. 2020;17(3):519‐527.
Giannakoulis VG, Papoutsi E, Siempos II. Effect of cancer on clinical outcomes of patients with COVID‐19: a meta‐analysis of patient data. JCO Global Oncol. 2020;6:799‐808.
Vanni G, Materazzo M, Pellicciaro M, et al. Breast cancer and COVID‐19: the effect of fear on patients' decision‐making process. In Vivo. 2020;34(3 suppl):1651‐1659.
Glasbey J, Ademuyiwa A, Adisa A, et al. Collaborative C Effect of COVID‐19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study. Lancet Oncol. 2021;22(11):1507‐1517.
Marron JM, Joffe S, Jagsi R, Spence RA, Hlubocky FJ. Ethics and resource scarcity: ASCO recommendations for the oncology community during the COVID‐19 pandemic. J Clin Oncol. 2020;38(19):2201‐2205.
Jones CM, Radhakrishna G, Aitken K, et al. Considerations for the treatment of pancreatic cancer during the COVID‐19 pandemic: the UK consensus position. Br J Cancer. 2020;123(5):709‐713.
Galdas PM, Cheater F, Marshall P. Men and health help‐seeking behaviour: literature review. J Adv Nurs. 2005;49(6):616‐623.
Janczewski LM, Browner AE, Cotler JH, et al. Survival among patients with high‐risk gastrointestinal cancers during the COVID‐19 pandemic. JAMA Netwk Open. 2024;7(3):e240160.
Li D, Jia AY, Zorzi J, et al. Impact of the COVID‐19 pandemic on liver cancer staging at a multidisciplinary liver cancer clinic. Ann Surg Open. 2022;3(4):e207.
Burns S, Vella M, Paciorek A, et al. Characteristics and growth rate of lung metastases in patients with primary gastrointestinal malignancies and lung‐dominant metastatic disease: a retrospective cohort analysis. Am J Clin Oncol. 2022;45(1):22‐27.
Patt D, Gordan L, Diaz M, et al. Impact of COVID‐19 on cancer care: how the pandemic is delaying cancer diagnosis and treatment for American seniors. JCO Clin Cancer Inform. 2020;4:1059‐1071.
Yao P, Cooley V, Kuhel W, et al. Times to diagnosis, staging, and treatment of head and neck cancer before and during COVID‐19. OTO Open. 2021;5(4):2473974X211059429.
Kuzuu K, Misawa N, Ashikari K, et al. Gastrointestinal cancer stage at diagnosis before and during the COVID‐19 pandemic in Japan. JAMA Netwk Open. 2021;4(9):e2126334.
Gheorghe A, Maringe C, Spice J, et al. Economic impact of avoidable cancer deaths caused by diagnostic delay during the COVID‐19 pandemic: a national population‐based modelling study in England, UK. Eur J Cancer. 2021;152:233‐242.
Maringe C, Spicer J, Morris M, et al. The impact of the COVID‐19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population‐based, modelling study. Lancet Oncol. 2020;21(8):1023‐1034.
Kaufman HW, Chen Z, Niles JK, Fesko YA. New cancer diagnoses still lagging in the United States in second full year of COVID‐19 pandemic. JCO Clin Cancer Inform. 2022;6:e2200102.
London JW, Fazio‐Eynullayeva E, Palchuk MB, McNair C. Evolving effect of the COVID‐19 pandemic on cancer‐related encounters. JCO Clin Cancer Inform. 2022;6:e2100200.
Cinar P, Bold R, Bosslet BA, et al. Planning for post‐pandemic cancer care delivery: recovery or opportunity for redesign? CA Cancer J Clin. 2021;71(1):34‐46.