Newly diagnosed cancer and the COVID-19 pandemic: tumour stage migration and higher early mortality
Deniz Can Güven, Taha Koray Şahin, Hasan Çagri Yildirim, Engin Çeşmeci, Fatima Gul Gulbahce Incesu, Yağmur Tahıllıoğlu, Enes Üçgül, Melek Seren Aksun, Suleyman Cagin Gurbuz, Oktay Halit Aktepe, Zafer Arık, Ömer Dızdar, Şuayib Yalçın, Sercan Aksoy, Saadettin Kılıçkap, Neyran Kertmen
Abstract
BACKGROUND: We compared the new outpatient clinic referrals during the first 10 months of the COVID-19 pandemic with the year before. METHODS: and Mann-Whitney U tests and calculated ORs with binary logistic regression. To evaluate the expected changes in the cancer survival secondary to stage migration, we used the 5-year survival data of Survival, Epidemiology and End Results (SEER) Program 2010-2016. RESULTS: The percentage of patients with inoperable or metastatic disease was significantly increased during the pandemic (49.8% vs 39%, OR: 1.553, 95% CI: 1.309 to 1.843, p<0.001). We observed a significant decrease in the percentage of patients diagnosed via the screening methods (18.8% vs 28.7%, OR: 1.698, 95% CI: 1.240 to 2.325, p=0.001). The 90-day mortality after the cancer diagnosis was significantly higher during the pandemic (10.5% vs 6.6%, OR: 1.661, 95% CI: 1.225 to 2.252, p=0.001). Due to the increased advanced-stage disease rate at first referral, significant decreases in 5-year survival rates were expected for breast cancer (-8.9%), colorectal cancer (-11.1%), cervix cancer (-10.3%) and melanoma (-7%). CONCLUSION: We think that collaborative efforts are paramount to prevent the pandemic of late cancer diagnoses and ensure patient safety during the pandemic.