在德国癌症中心（CC）， COVID-19大流行期间结直肠癌护理的显著改变与高质量标准的遵守——来自AIO CancerCOVID联盟（AIO- ymo /KRK 520/ass）的数据。

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2025-01-21 DOI:10.1016/j.clcc.2025.01.001

Céline Lugnier , Sarah Förster , Sabine Sommerlatte , Olaf Schoffer , Jens Christmann , Anna-Lena Kraeft , Tobias Terzer , Eleni Kourti , Oliver Overheu , Elena Schlageter , Ira Ekmekciu , Waldemar Uhl , Christoph Biermann , Lothar Müller , Marianne Sinn , Stefan Kasper-Virchow , Dominik Modest , Volker Heinemann , Jochen Schmitt , Jan Schildmann , Anke Reinacher-Schick

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引用次数: 0

摘要

背景：尽管基于指南的治疗取得了显著进展，但结直肠癌（CRC）仍然是导致死亡的主要原因。我们提供了德国COVID-19大流行期间CRC护理变化的数据。方法：来自22个AIO cc和病理学学术研究所的回顾性数据，将第一波（fw, 03-05.2020）和第二波（sw, 11-12.2020）与2019年相应时期进行比较。参数包括：确诊病例数、年龄、性别、肿瘤分期、手术方式、结直肠癌护理质量标准（在多学科肿瘤委员会（MTB）中的表现、心理或社会咨询）、癌前病变和恶性结直肠癌病变数量（CRL）。根据Clopper和Pearson（1934）估计的置信区间，将数据点作为平均值进行比较。使用泊松回归模型进行假设检验，其中包括相互作用项（年龄*性别或年龄* 70岁以上）。P < 0.05认为有统计学意义。结果：共有4316例诊断为AIO CC的患者显示出显著的降低(fw -20.58%；sw -23.48%)。假设检验表明，由于流感大流行的严重性，发病率显著下降。除试验参与外，癌症治疗的质量标准保持稳定。对60,695例CRL的分析发现癌前病变（fw: - 16% /sw: - 4%）和恶性病变（fw: - 18%）减少，而恶性CRL在sw中增加（+ 8%）。假设检验显示，只有在2020年之前，年龄才会显著下降，并发现年龄在70岁以下是两波的独立危险因素。结论：我们检测到大流行期间癌症护理的实质性变化，包括检测到的癌前CRL。CCs在CRC护理的质量标准中显示出高弹性。

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Significant Alterations of Colorectal Cancer Care in the COVID-19 Pandemic With High Adherence to Quality Criteria in German Cancer Centers (CC) ‒ Data From the AIO CancerCOVID Consortium (AIO-YMO/KRK 520/ass)

Background

Colorectal cancer (CRC) remains a leading cause of death despite notable advancements through guideline-based management. We present data on changes of CRC care during the COVID-19 pandemic in Germany.

Methods

Retrospective data from 22 AIO CCs and an academic Institute of Pathology compared the first (fw, 03-05.2020) and second wave (sw, 11-12.2020) of the pandemic with corresponding 2019 periods. Parameters were: number of cases diagnosed, age, sex, tumor stage, surgical procedures, quality criteria of CRC care (presentation in multidisciplinary tumor boards (MTB), psychological or social consultation), number of precancerous and malignant colorectal lesions (CRL). Data points were compared as mean values with confidence intervals estimated according to Clopper and Pearson (1934). Hypothesis tests were conducted using Poisson regression models that included interaction terms (year*sex or year*age over70). Statistical significance was considered at P < .05.

Results

A total of 4316 cases diagnosed (AIO CC) revealed a substantial reduction (fw -20.58%; sw -23.48%). Hypothesis test showed a significant decline in incidence due to the fw and sw of the pandemic. Quality criteria of cancer care remained stable except for trial participation. Analysis from 60,695 CRL detected a decrease in precancerous (fw: -16 %/sw: -4 %) and malignant (fw: -18 %) lesions while malignant CRL increased in the sw (+8 %). Hypothesis test revealed a significant decline only for the fw 2020 and detected age > 70 as independent risk factor in both waves.

Conclusion

We detected substantial alterations in cancer care during the pandemic, including detected precancerous CRL. CCs showed high resilience in quality criteria for CRC care.

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来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.