Gynecologic cancer care in the first year of the COVID-19 pandemic.

Autor: Chapman GC; University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA. Electronic address: graham.chapman@uhhospitals.org., Smrz SA; University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA., Gordon JC; University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA., Lynam SK; University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA., Strohl AE; University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA., Ferguson LA; University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA., Armstrong AJ; University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA., Zanotti KM; University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology. 11000 Euclid Ave, Cleveland, OH 44106, USA.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2023 Nov; Vol. 178, pp. 138-144. Date of Electronic Publication: 2023 Oct 19.
DOI: 10.1016/j.ygyno.2023.09.007
Abstrakt: Objective: To analyze the impact of the early COVID-19 pandemic on the diagnosis and initiation of treatment for patients with gynecologic cancer.
Methods: Patients diagnosed with gynecologic cancer in the National Cancer Database during 2017-2020 were included. For the first aim, incidence rate ratios were calculated to compare gynecologic cancer diagnosis in the first year of the COVID-19 pandemic to the three years prior, and factors associated with a reduction in diagnosis were identified. For the second aim, patients who experienced an 8-week delay in cancer treatment were compared to those who did not. Multivariate logistic regression was used to identify factors associated with treatment delay. Propensity score analysis was utilized to compare the rate of cancer treatment delay in patients who were diagnosed with COVID-19 to those who were not.
Results: The incidence rate ratio of being diagnosed with gynecologic cancer in 2020 versus 2017-2019 was 0.90 (95%CI 0.90-0.91). Factors associated with increased risk of missed or delayed diagnosis in 2020 included cervical cancer, earlier cancer stage, younger age, lower levels of medical comorbidity, and lack of health insurance. In 2020, factors associated with treatment delay included COVID-19 diagnosis (aOR 1.50, 95%CI 1.35-1.67), in addition to race and ethnicity, insurance type, comorbidity, cancer stage, and primary site. The risk of treatment delay remained significantly elevated in patients diagnosed with COVID-19 after propensity-score matching.
Conclusions: Gynecologic cancer diagnosis and timely provision of care were negatively impacted during the first year of the COVID-19 pandemic, with certain subgroups at elevated risk.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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