Abstract
Background:
The COVID-19 pandemic has affected the entire global healthcare system, including oncological care. This study investigated the effects of the COVID-19 pandemic on the diagnosis, stage, and treatment of esophagogastric cancer in the Netherlands.
Methods:
Patients diagnosed in 2020 were divided into 5 periods, based on the severity of the COVID-19 pandemic in the Netherlands, and compared to patients diagnosed in the same period in the years 2017–2019. Patient characteristics and treatments were evaluated for esophageal cancer (EC) and gastric cancer (GC) separately.
Results:
The number of esophagogastric cancer diagnoses decreased prominently during the first 2 months of the COVID-19 pandemic. During this period, a significantly higher percentage of GC patients was diagnosed with incurable disease (52.5% in 2017–2019 and 67.7% in 2020, p = 0.011). We observed a significant reduction in the percentage of patients with potentially curable EC treated with resection and neoadjuvant chemoradiotherapy (from 35.0% in 2017–2019 to 27.3% in 2020, p < 0.001). Also, patients diagnosed with incurable GC were treated less frequently with a resection (from 4.6% in 2017–2019 to 1.5% in 2020, p = 0.009) in the second half of 2020.
Conclusions:
Compared to previous years, the number of esophagogastric cancer diagnoses decreased in the first 2 months of the COVID-19 pandemic, while an increased percentage of patients was diagnosed with incurable disease. Both in the curative and palliative setting, patients were less likely to be treated with a surgical resection.
Original language | English |
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Pages (from-to) | 965–977 |
Number of pages | 13 |
Journal | Journal of Gastroenterology |
Volume | 58 |
Issue number | 10 |
Early online date | 31 Jul 2023 |
DOIs | |
Publication status | Published - Oct 2023 |
Bibliographical note
Funding Information:This study has been funded by ZonMw (Grant No. 10430022010014). The funding sources had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Funding Information:
We thank the Netherlands Cancer Registry (NCR) for providing the data and their data managers for collecting that data. The authors acknowledge the members of the COVID and Cancer-NL Consortium: Prof. Dr. S. Siesling, Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht and Technical Medical Centre, Department of Health Technology and Services Research, Twente University, Enschede; Dr. J.C. van Hoeve, Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht; prof. dr. M.A.W. Merkx, Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen; Prof. Dr. N.J. de Wit, Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht; Dr. C.W. Helsper, Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht; M.Sc. I. Dingemans, Dutch Federation of Cancer Patient Organisations (NFK), Utrecht; Prof. Dr. I.D. Nagtegaal, Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, on behalf of the Automated Pathology Archive (PALGA); Drs. M. van der Schaaf, Department of Insight and Innovation, Dutch Hospital Data (DHD), Utrecht; Prof. Dr. C.H. van Gils, Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht; prof. dr. H.C.P.M. van Weert, Department of General Practice, Amsterdam Public Health, Amsterdam UMC location AMC, Amsterdam.
Publisher Copyright:
© 2023, The Author(s).