Effect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021.

IF 2.7 3区 医学 Q3 ONCOLOGY
Flurina Suter, Miriam Wanner, Andreas Wicki, Dimitri Korol, Sabine Rohrmann
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Abstract

Purpose: Swiss healthcare institutions conducted only urgent procedures during the COVID-19 lockdown, potentially leading to a lack of care for other severe diseases, such as cancer. We examined the effects of the pandemic on cancer stage distribution and time between cancer diagnosis and treatment initiation using population-based cancer registry data.

Methods: The study was based on data of the cancer registry of the cantons of Zurich and Zug from 2018 to 2021. Cancer stage distribution was analysed descriptively and with a Pearson's Chi-squared test. Time between cancer diagnosis and treatment initiation was determined in days and analysed descriptively and by fitting Quasipoisson regression models.

Results: For all-cancer and colorectal, lung, and prostate cancer statistically significant evidence for a difference in cancer stages distribution among the incidence years was observed. Based on the all-cancer regression models, longer time to treatment initiation (TTI) was observed for patients diagnosed in 2021 and receiving surgery (Rate Ratio = 1.08 [95% confidence interval 1.03, 1.14]) or hormone therapy (1.20 [1.03, 1.40]) compared to those diagnosed in 2018/19 receiving those therapies. We observed no difference in TTI between cancer patients diagnosed in 2020 compared to 2018/19 for any of the therapies investigated, except for chemotherapy with shorter TTI (0.92 [0.86, 0.98]).

Conclusion: The observed effects on cancer outcomes in 2020 and 2021 compared to 2018/19 coincided with the beginning of the COVID-19 pandemic in Switzerland in 2020 onwards. Short- and long-term effects of the pandemic on cancer outcomes and the public healthcare system were observed. However, we cannot exclude that the implementation of the new Swiss law on cancer registration in 2020 explains part of our observations.

利用2018年至2021年瑞士苏黎世州和楚格州的癌症登记数据,研究COVID-19大流行和封锁对癌症分期分布和开始治疗时间的影响。
目的:瑞士医疗机构在COVID-19封锁期间只进行了紧急程序,可能导致对癌症等其他严重疾病缺乏护理。我们使用基于人群的癌症登记数据检查了大流行对癌症分期分布和癌症诊断和开始治疗之间时间的影响。方法:研究基于2018年至2021年苏黎世和楚格州癌症登记处的数据。对癌症分期分布进行描述性分析,并采用皮尔逊卡方检验。以天为单位确定癌症诊断和治疗开始之间的时间,并通过拟合准泊松回归模型进行描述性分析。结果:对于所有癌症以及结直肠癌、肺癌和前列腺癌,在不同的发病年份中观察到有统计学意义的癌症分期分布差异的证据。基于全癌回归模型,与2018/19年确诊并接受手术治疗的患者相比,2021年确诊并接受手术治疗的患者(比率比= 1.08[95%可信区间1.03,1.14])或激素治疗的患者(比率比= 1.20[1.03,1.40])的开始治疗时间(TTI)更长。我们观察到,除了TTI较短的化疗(0.92[0.86,0.98])外,2020年诊断的癌症患者的TTI与2018/19年相比没有任何差异。结论:与2018/19年相比,观察到的2020年和2021年对癌症结局的影响与2020年以后瑞士COVID-19大流行的开始相吻合。观察了大流行对癌症结局和公共卫生系统的短期和长期影响。然而,我们不能排除2020年瑞士新癌症登记法的实施解释了我们观察到的部分原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.00
自引率
2.80%
发文量
577
审稿时长
2 months
期刊介绍: The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.
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