Gastrointestinal Cancer Stage at Diagnosis Before and During the COVID-19 Pandemic in Japan

Kuzuu, Kento; Misawa, Noboru; Ashikari, Keiichi; Kessoku, Takaomi; Kato, Shingo; Hosono, Kunihiro; Yoneda, Masato; Nonaka, Takashi; Matsushima, Shoji; Komatsu, Tatsuji; Nakajima, Atsushi; Higurashi, Takuma

doi:10.1001/jamanetworkopen.2021.26334

Cited by 104 publications

(103 citation statements)

References 35 publications

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“…In the past months, a substantial body of literature has investigated the effects of the COVID-19 crisis on cancer diagnosis (Andrew et al 2021 ; De Luca et al 2021 ; Erdmann et al 2021 ; Gurney et al 2021 ; Jacob et al 2021 ; Kuzuu et al 2021 ; Patt et al 2020 ; Peacock et al 2021 ; Piontek et al 2021 ; Reichardt et al 2021 ; Ruiz-Medina et al 2021 ; Stang et al 2020 ; Tsibulak et al 2020 ; Vardhanabhuti and Ng 2021 ; Voigtländer et al 2021 ). For example, a study, using national data from New Zealand, showed that cancer registrations (new diagnoses of primary malignant cancers) declined by 40% in this country in March–April 2020 compared with 2018–2019, and that registrations increased in the subsequent months to reach pre-lockdown levels (Gurney et al 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…The deleterious effects of the COVID-19 pandemic on the care of acute and chronic disorders may be explained, at least partially, by overwhelmed healthcare systems (Tangcharoensathien et al 2021 ) and the fear of patients to consult primary care practices and emergency departments due to the potential risk of being infected by the SARS-CoV-2 (Czeisler et al 2020 ; Lazzerini et al 2020 ). Some literature also suggests that COVID-19 has been associated with a substantial decrease in cancer diagnosis (Andrew et al 2021 ; De Luca et al 2021 ; Erdmann et al 2021 ; Gurney et al 2021 ; Jacob et al 2021 ; Kuzuu et al 2021 ; Patt et al 2020 ; Peacock et al 2021 ; Piontek et al 2021 ; Reichardt et al 2021 ; Ruiz-Medina et al 2021 ; Stang et al 2020 ; Tsibulak et al 2020 ; Vardhanabhuti and Ng 2021 ; Voigtländer et al 2021 ). Interestingly, a study conducted in Germany found that cancer diagnoses decreased in March–May 2020 compared with March–May 2019, and this decrease was particularly strong for cancers of the skin and the respiratory and intrathoracic organs (Jacob et al 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Decrease in the number of patients diagnosed with cancer during the COVID-19 pandemic in Germany

Jacob

Kalder

Kostev³

2022

J Cancer Res Clin Oncol

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Purpose Little is known on how coronavirus disease 2019 (COVID-19) has impacted cancer diagnosis in Germany since the first lockdown in March 2020. Therefore, this retrospective study aimed to compare the number of patients newly diagnosed with cancer in general and specialized practices in Germany between April 2020–March 2021 and April 2019–March 2020. Methods Patients aged ≥ 18 years with at least 1 visit to 1 of 1403 general and specialized practices in Germany in April 2020–March 2021 ( n = 3,804,596) and April 2019–March 2020 ( n = 3,913,386) were included in this retrospective study. Specialized practices were composed of gynecology, dermatology and urology practices. Cancer diagnoses included all types of cancer documented using the International Classification of Diseases, 10th revision (ICD-10 codes: C00-C97). The number of patients newly diagnosed with cancer per practice was compared between April 2020–March 2021 and April 2019–March 2020 using Wilcoxon tests. Results There were 126,379 and 138,996 patients diagnosed with cancer in April 2020–March 2021 and April 2019–March 2020, respectively. The number of patients diagnosed with cancer decreased in all types of practice, and this decrease was significant in general practices (− 7.1%, p value = 0.038). In terms of cancer type, this decrease was particularly pronounced for skin cancers (− 12.8%, p value = 0.025). Conclusion The COVID-19 pandemic has been associated with a decrease in the number of patients newly diagnosed with cancer in general and specialized practices in Germany. Public health interventions are urgently warranted to mitigate the deleterious effects of this health crisis on cancer diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Decrease in the number of patients diagnosed with cancer during the COVID-19 pandemic in Germany

Jacob

Kalder

Kostev³

2022

J Cancer Res Clin Oncol

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“…Although there was no indication of widespread serious medical disruption in Japan by April 2021, patients might have refrained from visiting hospitals to receive medical checkups, including gastric cancer screening, because of the COVID-19 pandemic. In Japan, a significant decrease in the mean number of stage I gastric cancer cases and an increase in the number of symptomatic gastric cancer patients were observed during the COVID-19 pandemic from March to December 2020 [ 6 ]. In another Japanese study, the number of gastrectomies was < 80%, and there was a 50% decrease from May to August 2020 in Tokyo when compared to the previous year as determined using questionnaires [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of the first era of the coronavirus disease 2019 pandemic on gastric cancer patients: a single-institutional analysis in Japan

et al. 2022

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Background Little is known about the disadvantages of the coronavirus disease 2019 (COVID-19) pandemic in patients with gastric cancer. This study aimed to examine the negative impact of the COVID-19 pandemic on patients with gastric cancer in the first era in Japan. Methods This retrospective study included 725 patients diagnosed with gastric cancer who visited our hospital between April 2019 and March 2021. The number of patients and their characteristics before and during the COVID-19 pandemic were compared. Results The number of patients diagnosed with gastric cancer during the COVID-19 pandemic decreased by 26.2% (from 417 to 308; p = 0.013) compared to that before the COVID-19 pandemic. There was a significant decrease in cStage I cancer and an increase in cStage III cancer ( p = 0.004). Patients were often symptomatic ( p = 0.029), especially those with stenosis-related symptoms ( p < 0.001) and longer symptom duration ( p < 0.001). The number of endoscopic resections was decreased by 34.8% ( p = 0.005). The number of total gastrectomy was higher than that of partial gastrectomy ( p = 0.021). The median time to treatment was significantly shorter ( p < 0.001). Conclusions In Japan, delays diagnosing patients with gastric cancer, probably due to refraining from consultation, may have resulted in an increase in the diagnosis of advanced-stage cancer. Moreover, an increasing proportion of patients required more invasive gastrectomy. Therefore, it may be necessary to educate patients not to refrain from consultation, even during the COVID-19 pandemic, as it can have a negative impact on treatment, policy decision, and prognosis of gastric cancer.

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“…A single-centre study in the UK reported a reduction in the number of patients referred for oesophageal cancer during the pandemic compared with the same period in 2019 ( 4 ). In Japan, a recent study on the status of oesophageal cancer consultations revealed no significant differences; however, the number of patients with stage 0 to II disease decreased, whereas that of patients with stage III or IV disease increased ( 5 ).…”

Section: Introductionmentioning

confidence: 93%

Impact of the coronavirus disease 2019 pandemic on first-visit patients with oesophageal cancer in the first infection wave in Saitama prefecture near Tokyo: a single-centre retrospective study

Miyawaki

Satô

Lee

et al. 2022

Japanese Journal of Clinical Oncology

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Background Although the novel coronavirus disease 2019 did not lead to a serious medical collapse in Japan, its impact on treatment of oesophageal cancer has rarely been investigated. This study aimed to investigate the influence of the pandemic on consultation status and initial treatment in patients with primary oesophageal cancer. Methods A retrospective study was conducted among 546 patients with oesophageal cancer who visited our hospital from April 2018 to March 2021. Pre-pandemic and pandemic data were compared with the clinical features, oncological factors and initial treatment as outcome measures. Results Diagnoses of oesophageal cancer decreased during the early phase of the pandemic from April to June (P = 0.048); however, there was no significant difference between the pre-pandemic and pandemic periods throughout the year. The proportion of patients diagnosed with distant metastases significantly increased during the pandemic (P = 0.026), while the proportion of those who underwent initial radical treatment decreased (P = 0.044). The rate of definitive chemoradiotherapy decreased by 58.6% relative to pre-pandemic levels (P = 0.001). Conclusions Patients may have refrained from consultation during the early phase of the coronavirus disease 2019 pandemic. The resultant delay in diagnosis may have led to an increase in the number of patients who were not indicated for radical treatment, as well as a decrease in the number of those who underwent definitive chemoradiotherapy. Our findings highlight the need to maintain the health care system and raise awareness on the importance of consultation.

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Gastrointestinal Cancer Stage at Diagnosis Before and During the COVID-19 Pandemic in Japan

Cited by 104 publications

References 35 publications

Decrease in the number of patients diagnosed with cancer during the COVID-19 pandemic in Germany

Decrease in the number of patients diagnosed with cancer during the COVID-19 pandemic in Germany

Impact of the first era of the coronavirus disease 2019 pandemic on gastric cancer patients: a single-institutional analysis in Japan

Impact of the coronavirus disease 2019 pandemic on first-visit patients with oesophageal cancer in the first infection wave in Saitama prefecture near Tokyo: a single-centre retrospective study

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