Evaluating the burden of the COVID‑19 pandemic on patients with colorectal cancer

Abstract

After the emergence of the coronavirus disease 2019 (COVID-19) pandemic, individuals needing medical help preferred to not go to the hospital to avoid the risk of severe acute respiratory syndrome coronavirus 2 infection. The present study investigated the influence of the COVID-19 pandemic on patients with colorectal cancer. Patients with colorectal cancer treated between January and December 2019 were classified as the pre-pandemic group (pre-group) and those treated between April 2020 and March 2021 as the post-pandemic group (pandemic group). The clinicopathologic features of patients who underwent surgery for colorectal cancer in the two groups were retrospectively compared. A total of 161 patients were enrolled: 79 In the pre-group and 82 in the pandemic group. Although no significant differences were observed in tumor location and surgical procedure between the two groups, circumferential lesions (P<0.001), colorectal stenting (P=0.016) and Stage IV classification (P=0.019) had a higher frequency in the pandemic group compared with the pre-group; additionally, surgical curability was significantly lower (P=0.036) in the pandemic group. The spread of COVID-19 has increased the incidence of patients with advanced colorectal cancer. To reduce this incidence, healthcare professionals should inform the general public not only about the risk of COVID-19, but also about the increased incidence of advanced colorectal cancer after the pandemic.

Changes in colorectal cancer treatment during the COVID-19 pandemic in Japan: Interrupted time-series analysis using the National Database of Japan

“…A registry-based study in the Netherlands reported that the number of patients with colon cancer presenting with the ileus increased during the pandemic [41] . Similarly, single-institution studies in Japan reported an increase in the number of obstructive colorectal cancers and colorectal stent placements [33] , [34] . Mizuno et al suggested that delays in the detection and surgery of colorectal cancer during the pandemic may have promoted progression and resulted in an increase in the number of obstructive colorectal cancers [33] .…”

“…In a systematic review and meta-analysis, minimally invasive approaches were more commonly used in the pre-pandemic group than in the pandemic group, although the difference was not statistically significant [14] . A registry-based study in England [5] and single-institution studies in Japan [34] and China [16] reported a higher proportion of open surgeries during the pandemic than in the pre-pandemic period. Unlike ACPGBI, the Japan Surgery Society stated that there is no evidence to support open surgery over minimally invasive surgery in their guidelines [9] .…”

“…However, changes in the numbers according to the type of surgery, including endoscopic, laparoscopic, or open surgery, have not been reported. Additionally, several studies have suggested the progression of colorectal cancer stages during the pandemic by comparing the stages at diagnosis, number of emergency admissions, number of obstructive colorectal cancers, and number of colorectal stent placements before and during the COVID-19 pandemic [32] , [33] , [34] . However, these were all single-institution studies.…”

Influence of the COVID-19 Pandemic on Patients with Rectal Cancer

“…In summary, studies that did not differentiate between the rectum and colon showed more advanced postoperative tumor stages during the COVID-19 pandemic [ 47 , 48 , 49 ]. The lack of differentiation between colon and rectal cancer makes comparability difficult due to the different treatment regimen, particularly with regard to the often-missing information on neoadjuvant therapy and initial tumor staging (cTNM).…”

Effect of the COVID-19 pandemic on allogeneic stem cell transplantation in Japan

“…Japan more successfully controlled the COVID-19 pandemic than Western countries; the number of infected people and deaths in 2020 were 187 per 100,000 and 3492, respectively [ 2 ]. Even still, the COVID-19 pandemic affected healthcare quality and access in fields such as cancer and emergency medicine throughout Japan [ 10 – 13 ].…”