Dataset Information

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic.

ABSTRACT:

Objective

Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients.

Methods

This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak.

Results

Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001).

Conclusion

Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.

SUBMITTER: Bogani G

PROVIDER: S-EPMC8728669 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic.

Bogani Giorgio G Scambia Giovanni G Cimmino Chiara C Fanfani Francesco F Costantini Barbara B Loverro Matteo M Ferrandina Gabriella G Landoni Fabio F Bazzurini Luca L Grassi Tommaso T Vitobello Domenico D Vitobello Domenico D Siesto Gabriele G Perrone Anna Myriam AM Zanagnolo Vanna V De Iaco Pierandrea P Multinu Francesco F Ghezzi Fabio F Casarin Jvan J Berretta Roberto R Capozzi Vito A VA Zupi Errico E Centini Gabriele G Pellegrino Antonio A Corso Silvia S Stevenazzi Guido G Montoli Serena S Boschi Anna Chiara AC Comerci Giuseppe G Greco Pantaleo P Martinello Ruby R Sopracordevole Francesco F Giorda Giorgio G Simoncini Tommaso T Caretto Marta M Sartori Enrico E Ferrari Federico F Cianci Antonio A Sarpietro Giuseppe G Matarazzo Maria Grazia MG Zullo Fulvio F Bifulco Giuseppe G Bifulco Giuseppe G Morelli Michele M Ferrero Annamaria A Biglia Nicoletta N Barra Fabio F Ferrero Simone S Leone Roberti Maggiore Umberto U Cianci Stefano S Chiantera Vito V Ercoli Alfredo A Ercoli Alfredo A Sozzi Giulio G Martoccia Angela A Schettini Sergio S Orlando Teresa T Orlando Teresa T Cannone Francesco G FG Cannone Francesco G FG Ettore Giuseppe G Puppo Andrea A Borghese Martina M Martinelli Canio C Muzii Ludovico L Di Donato Violante V Driul Lorenza L Restaino Stefano S Bergamini Alice A Candotti Giorgio G Bocciolone Luca L Plotti Francesco F Angioli Roberto R Mantovani Giulia G Ceccaroni Marcello M Cassani Chiara C Dominoni Mattia M Giambanco Laura L Amodeo Silvia S Leo Livio L Thomasset Raphael R Raimondo Diego D Seracchioli Renato R Malzoni Mario M Gorlero Franco F Di Luca Martina M Busato Enrico E Kilzie Sami S Dell'Acqua Andrea A Scarfone Giovanna G Vercellini Paolo P Petrillo Marco M Dessole Salvatore S Capobianco Giampiero G Ciavattini Andrea A Delli Carpini Giovanni G Giannella Luca L Mereu Liliana L Tateo Saverio S Sorbi Flavia F Fambrini Massimiliano M Cicogna Stefania S Cicogna Stefania S Romano Federico F Ricci Giuseppe G Trojano Giuseppe G Consonni Roberto R Cantaluppi Simona S Lippolis Antonio A Tinelli Raffaele R D'Ippolito Giovanni G Aguzzoli Lorenzo L Mandato Vincenzo D VD Palomba Stefano S Calandra Davide D Calandra Davide D Rosati Maurizio M Gallo Cinzia C Surico Daniela D Remorgida Valentino V Remorgida Valentino V Ruscitto Francesco F Beretta Paolo P Benedetti Panici Pierluigi P Raspagliesi Francesco F

Journal of gynecologic oncology 20211112 1

<h4>Objective</h4>Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients.<h4>Methods</h4>This is a retrospective study involving 54 centers in I ...[more]

PMID: 34910391

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Project description:ObjectiveThe objective was to compare home care episode, standardised assessment, and service patterns in Ontario's publicly funded home care system during the first wave of the COVID-19 pandemic (i.e., March to September 2020) using the previous year as reference.Study design and settingWe plotted monthly time series data from March 2019 to September 2020 for home care recipients in Ontario, Canada. Home care episodes were linked to interRAI Home Care assessments, interRAI Contact Assessments, and home care services. Health status measures from the patient's most recent interRAI assessment were used to stratify the receipt of personal support, nursing, and occupational or physical therapy services. Significant level and slope changes were detected using Poisson, beta, and linear regression models.ResultsThe March to September 2020 period was associated with significantly fewer home care admissions, discharges, and standardised assessments. Among those assessed with the interRAI Home Care assessment, significantly fewer patients received any personal support services. Among those assessed with either interRAI assessment and identified to have rehabilitation needs, significantly fewer patients received any therapy services. Among patients receiving services, patients received significantly fewer hours of personal support and fewer therapy visits per month. By September 2020, the rate of admissions and services had mostly returned to pre-pandemic levels, but completion of standardised assessments lagged behind.ConclusionThe first wave of the COVID-19 pandemic was associated with substantial changes in Ontario's publicly funded home care system. Although it may have been necessary to prioritise service delivery during a crisis situation, standardised assessments are needed to support individualised patient care and system-level monitoring. Given the potential disruptions to home care services, future studies should examine the impact of the pandemic on the health and well-being of home care recipients and their caregiving networks.

Project description:ImportanceDisruptions to health care during the COVID-19 pandemic may have led to missed cancer diagnoses. It is critical to evaluate the association between the COVID-19 pandemic and cancer incidence to address public and patient anxiety, inform recovery efforts, and identify strategies to reduce the system's vulnerability to future disruptions.ObjectiveTo examine the association between the COVID-19 pandemic and cancer incidence in Manitoba, Canada.Design, setting, and participantsA population-based cross-sectional study design was conducted using data from the Manitoba Cancer Registry and an interrupted time-series analysis. All individuals diagnosed with cancer in Manitoba, Canada, from January 1, 2015, until December 31, 2021, were included. Individuals diagnosed with breast, colon, rectal, or lung cancer were grouped by age as follows: younger than 50 years, 50 to 74 years, and 75 years and older.ExposuresCOVID-19 pandemic.Main outcomes and measuresAge-standardized cancer incidence rates and the estimated cumulative difference between the number of cases in the absence of COVID-19 and observed (fitted) number of cancer cases.ResultsA total of 48 378 individuals were included. The median (IQR) age at diagnosis was 68 (59-77) years and 23 972 participants (49.6%) were female. In April 2020, there was a 23% decrease in overall cancer incidence. Cancer incidence decreased by 46% for breast, 35% for colon, 47% for rectal, 50% for head and neck, 65% for melanoma, and 33% for endocrine cancer diagnoses and increased by 12% for hematological cancer diagnoses and 8% for diagnoses of cancers with an unknown primary site. Lung cancer incidence remained stable until December 2020 when it decreased by 11%. Brain and central nervous system and urinary cancer diagnoses decreased consistently over time from April 2020 to December 2021 by 26% and 12%, respectively. No association was observed with gynecologic (1% increase), other digestive (1% decrease), or pancreatic (7% increase) cancer incidence. As of December 2021, Manitoba had an estimated deficit of 692 (5.3%) cancers. The largest estimated deficits were for breast (273 cases, 14.1% deficit), colon (133 cases, 12.2% deficit), and lung cancers (132 cases, 7.6% deficit).Conclusions and relevanceIn this study, the COVID-19 pandemic was associated with an initial decrease in cancer diagnosis incidence followed by a recovery for most cancer sites. However, the cumulative deficit for some cancers with high fatality needs immediate attention.

Dataset Information

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic.

Objective

Methods

Results

Conclusion

Publications

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic.

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