Causes and impact of delays during the COVID-19 pandemic on head and neck cancer diagnosis.

Autor: Gete M; Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada., Huang SH; Department of Radiation Therapy, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.; Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Ringash J; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Irish J; Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Su J; Department of Biostatistics, Princess Margaret Cancer Centre / University of Toronto, Toronto, Canada., Ballal Y; Department of Radiation Therapy, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.; The Michener Institute / University of Toronto, Toronto, Canada., Waldron JN; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Witterick I; Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada., de Almeida J; Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Hosni A; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Hope AJ; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Monteiro E; Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada., Cho J; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., O'Sullivan B; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Kim J; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Bratman S; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Goldstein DP; Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., McPartlin A; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Tsai J; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Tong L; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada., Xu W; Department of Biostatistics, Princess Margaret Cancer Centre / University of Toronto, Toronto, Canada., Hahn E; Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 Sep; Vol. 46 (9), pp. 2197-2205. Date of Electronic Publication: 2024 Apr 25.
DOI: 10.1002/hed.27784
Abstrakt: Background: The causes for delays during the COVID19 pandemic and their impact on head and neck cancer (HNC) diagnosis and staging are not well described.
Methods: Two cohorts were defined a priori for review and analysis-a Pre-Pandemic cohort (June 1 to December 31, 2019) and a Pandemic cohort (June 1 to December 31, 2020). Delays were categorized as COVID-19 related or not, and as clinician, patient, or policy related.
Results: A total of 638 HNC patients were identified including 327 in the Pre-Pandemic Cohort and 311 in the Pandemic Cohort. Patients in the Pandemic cohort had more N2-N3 category (41% vs. 33%, p = 0.03), T3-T4 category (63% vs. 50%, p = 0.002), and stage III-IV (71% vs. 58%, p < 0.001) disease. Several intervals in the diagnosis to treatment pathway were significantly longer in the pandemic cohort as compared to the Pre-Pandemic cohort. Among the pandemic cohort, 146 (47%) experienced a delay, with 112 related to the COVID-19 pandemic; 80 (71%) were clinician related, 15 (13%) were patient related, and 17 (15%) were policy related.
Conclusions: Patients in the Pandemic cohort had higher stage disease at diagnosis and longer intervals along the diagnostic pathway, with COVID-19 related clinician factors being the most common cause of delay.
(© 2024 The Authors. Head & Neck published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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