The Impact of the COVID-19 Pandemic on Bladder Cancer Care in the Netherlands.

IF 1 4区医学 Q4 ONCOLOGY

Bladder Cancer Pub Date : 2022-06-03 eCollection Date: 2022-01-01 DOI:10.3233/BLC-211608

Lisa M C van Hoogstraten, Lambertus A Kiemeney, Richard P Meijer, Geert J L H van Leenders, Ben G L Vanneste, Luca Incrocci, Tineke J Smilde, Sabine Siesling, J Alfred Witjes, Katja K H Aben

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引用次数: 0

Abstract

Background: The COVID-19 pandemic has disrupted regular health care with potential consequences for non-COVID diseases like cancer. To ensure continuity of oncological care, guidelines were temporarily adapted.

Objective: To evaluate the impact of the COVID-19 outbreak on bladder cancer care in the Netherlands.

Methods: The number of bladder cancer (BC) diagnoses per month during 2020-2021 was compared to 2018-2019 based on preliminary data from the Netherlands Cancer Registry (NCR). Additionally, detailed data were retrieved from the NCR for the cohort diagnosed between March 1^st-May 31^st 2020 (first COVID wave) and 2018-2019 (reference cohort). BC diagnoses, changes in age and stage at diagnosis, and time to first-line treatment were compared between both periods. Changes in treatment were evaluated using logistic regression.

Results: During the first COVID wave (week 9-22), the number of BC diagnoses decreased by 14%, corresponding with approximately 300 diagnoses, but increased again in the second half of 2020. The decline was most pronounced from week 13 onwards in patients≥70 years and patients with non-muscle invasive BC. Patients with muscle-invasive disease were less likely to undergo a radical cystectomy (RC) in week 17-22 (OR = 0.62, 95% CI = 0.40-0.97). Shortly after the start of the outbreak, use of neoadjuvant chemotherapy decreased from 34% to 25% but this (non-significant) effect disappeared at the end of April. During the first wave, 5% more RCs were performed compared to previous years. Time from diagnosis to RC became 6 days shorter. Overall, a 7% reduction in RCs was observed in 2020.

Conclusions: The number of BC diagnoses decreased steeply by 14% during the first COVID wave but increased again to pre-COVID levels by the end of 2020 (i.e. 600 diagnoses/month). Treatment-related changes remained limited and followed the adapted guidelines. Surgical volume was not compromised during the first wave. Altogether, the impact of the first COVID-19 outbreak on bladder cancer care in the Netherlands appears to be less pronounced than was reported for other solid tumors, both in the Netherlands and abroad. However, its impact on bladder cancer stage shift and long-term outcomes, as well as later pandemic waves remain so far unexamined.

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新冠肺炎大流行对荷兰癌症膀胱治疗的影响

背景：新冠肺炎大流行扰乱了常规医疗保健，对癌症等非COVID疾病有潜在影响。为了确保肿瘤学护理的连续性，暂时调整了指导方针。目的：评估新冠肺炎疫情对荷兰癌症膀胱治疗的影响。方法：根据荷兰癌症登记处（NCR）的初步数据，将2020-2021年期间每月癌症（BC）诊断数与2018-2019年进行比较。此外，从NCR中检索了2020年3月1日至5月31日（第一波新冠肺炎）至2018-2019年（参考队列）期间诊断的队列的详细数据。比较两个时期的BC诊断、诊断时年龄和分期的变化以及一线治疗的时间。采用逻辑回归法评估治疗的变化。结果：在第一波新冠肺炎疫情期间（第9-22周），BC诊断数量减少了14%，约有300例，但在2020年下半年再次增加。从第13周开始，≥70岁的患者和非肌肉侵袭性BC患者的下降最为明显。肌肉侵袭性疾病患者在第17-22周接受根治性膀胱切除术（RC）的可能性较小（OR = 0.62，95%CI = 0.40–0.97）。疫情爆发后不久，新辅助化疗的使用率从34%下降到25%，但这种（不显著）影响在4月底消失。在第一波期间，与前几年相比，进行的随机对照试验增加了5%。从诊断到RC的时间缩短了6天。总体而言，2020年观察到RC减少了7%。结论：在第一波新冠肺炎疫情期间，BC诊断数量急剧下降了14%，但到2020年底再次增加到新冠肺炎前的水平（即每月600例诊断）。与治疗相关的变化仍然有限，并遵循了调整后的指南。在第一波手术中，手术量没有受到影响。总之，第一次新冠肺炎疫情对荷兰癌症膀胱治疗的影响似乎不如荷兰和国外其他实体瘤的报道那么明显。然而，到目前为止，它对癌症阶段转变和长期结果的影响，以及后来的大流行浪潮，仍然没有得到研究。

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

Bladder Cancer Medicine-Urology

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.