Socioeconomic factors and colorectal cancer incidence, stage and quality of care in Denmark during the COVID-19 pandemic.

Autor: Weinberger Rosen A; Center for Surgical Science, Zealand University Hospital, Denmark., Jensen H; The Danish Clinical Quality Program - National Clinical Registries (RKKP), Denmark. Electronic address: herjen@rm.dk., Olesen TB; The Danish Clinical Quality Program - National Clinical Registries (RKKP), Denmark., Møller H; The Danish Clinical Quality Program - National Clinical Registries (RKKP), Denmark; Danish Center for Clinical Health Services Research, Faculty of Medicine, Aalborg University, Denmark., Jensen JW; The Danish Clinical Quality Program - National Clinical Registries (RKKP), Denmark., Gögenur I; Center for Surgical Science, Zealand University Hospital, Denmark; Institute for Clinical Medicine, Copenhagen University, Denmark.
Jazyk: angličtina
Zdroj: Cancer epidemiology [Cancer Epidemiol] 2023 Oct; Vol. 86, pp. 102447. Date of Electronic Publication: 2023 Aug 24.
DOI: 10.1016/j.canep.2023.102447
Abstrakt: Aim: Efforts to control the COVID-19 pandemic might reduce accessibility for diagnostics and treatment of colorectal cancer. A universal public healthcare system may modify the availability of healthcare services. The aim of this study was to investigate changes in the quality of care for patients with colorectal cancer during the COVID-19 pandemic.
Method: Nationwide data from the Danish Colorectal Cancer database and Statistics Denmark on the number of new diagnoses, disease and health behaviour measures, socioeconomic measures, clinical quality measures and time to adjuvant chemotherapy were retrieved. Measures during the COVID-19 pandemic in 2020 and the different pandemic periods were compared to the pre-pandemic period.
Result: In 2020, 4035 patients were diagnosed with colorectal cancer, compared with 4346 in 2019 and 4496 in 2018. During the pandemic, patients were more likely to have UICC stage I disease (25.0% vs 23.4%; PR=1.07(95% confidence interval: 1.00;1.15)), belonging to the highest income quintile (PR=1.06(0.98;1.14), receive surgery with a curative aim (PR=1.02(1.01;1.03)), and to be operated on by a specialist (PR=1.07(1.06;1.08)), and less likely to be 60-69 years of age (PR=0.93(0.86;1.00)), non-western immigrants (PR=0.93(0.86;1.00)), diagnosed by screening (PR=0.79(0.73;0.86)) and receiving an acute operation (PR=0.77(0.66;0.91)). Furthermore, during the pandemic, 11.4% fewer patients waited 28 days or longer for initiation of adjuvant oncological treatment.
Conclusion: Based on nationwide data, we observed no major adverse effect on disease measures or clinical quality in a tax funded health care system. However, small changes in the socioeconomic composition of the patient population were observed.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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