Dataset Information

Changes in the number of cancer diagnosis practices due to the COVID-19 pandemic: interrupted time-series analysis using the National Database of Japan.

ABSTRACT:

Purpose

This study aimed to reveal the impact of coronavirus disease 2019 on the number of practices commonly used for cancer diagnosis in Japan.

Methods

The sampling dataset of the National Database of Japan from January 2015 to January 2021 was used to generate 25-point time-series data for the number of practices (21 points before and 4 points during the pandemic outbreak). The decreased number was estimated by interrupted time-series analysis using a seasonal autoregressive integrated moving average model. Using the pre-pandemic data, expected counterfactual numbers during the pandemic were predicted, and decreased rate was calculated.

Results

In most practices, the number dramatically decreased in the early stage of the pandemic and recovered rapidly thereafter. As of April 2020, gastric endoscopy decreased at the top of the practices (- 42.1%, with 95% confidence intervals of - 50.5% and - 33.7%), followed by gastric biopsy (- 38.6%, with 95% confidence intervals of - 46.7% and - 30.6%). The period of declined practices for lung cancer was relatively prolonged. The number of sentinel lymph node biopsies for breast cancer and colposcopies and biopsies for cervical cancer did not decrease in April 2020, but significantly decreased later in July 2020, which is assumed to be the time lapse after the primary testing before surgical treatment or intense scrutiny.

Conclusion

In general, the number of practices for cancer diagnosis in Japan showed only a temporary decline, which was concordant with reports from several other countries.

SUBMITTER: Fujita M

PROVIDER: S-EPMC9838522 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Changes in the number of cancer diagnosis practices due to the COVID-19 pandemic: interrupted time-series analysis using the National Database of Japan.

Fujita Misuzu M Nagashima Kengo K Suzuki Kiminori K Kasai Tokuzo T Hashimoto Hideyuki H Yamaguchi Kazuya K Onouchi Yoshihiro Y Sato Daisuke D Fujisawa Takehiko T Hata Akira A

Journal of cancer research and clinical oncology 20230111 9

<h4>Purpose</h4>This study aimed to reveal the impact of coronavirus disease 2019 on the number of practices commonly used for cancer diagnosis in Japan.<h4>Methods</h4>The sampling dataset of the National Database of Japan from January 2015 to January 2021 was used to generate 25-point time-series data for the number of practices (21 points before and 4 points during the pandemic outbreak). The decreased number was estimated by interrupted time-series analysis using a seasonal autoregressive in ...[more]

PMID: 36627499

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Project description:BackgroundThe coronavirus disease 2019 (COVID-19) pandemic forced us to accept changes in our usual diagnostic procedures and treatments for colorectal cancer. This study aimed to determine the impact of the pandemic on colorectal cancer treatment in Japan.MethodsThe number of colorectal surgeries, stoma constructions, stent placements or long tube insertions, and neoadjuvant chemoradiotherapies were determined each month using sampling datasets from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. The observation periods before and during the pandemic were January 2015 to January 2020 and April 2020 to January 2021, respectively. An interrupted time-series analysis was used to estimate the changes in the number of procedures during the pandemic.ResultsThe number of endoscopic surgeries for colon cancer significantly decreased in April and July 2020 and for rectal cancer in April 2020. Additionally, the number of laparoscopic and open surgeries for colon cancer significantly decreased in July 2020 and October 2020, respectively. The number of stoma constructions and stent placements or long tube insertions did not increase during the observation period. Neoadjuvant chemoradiotherapy for rectal cancer significantly increased in April 2020 but levels returned shortly thereafter. These results suggest that the recommendations to overcome the pandemic proposed by expert committees, including the replacement of laparoscopic surgery with open surgery, stoma construction to avoid anastomotic leak, and replacement of surgery on the ileus with stent placement, were not widely implemented in Japan. However, as an exception, neoadjuvant chemoradiotherapy for rectal cancer was performed as an alternative treatment to delay surgery in small quantities.ConclusionA declining number of surgeries raises concerns about cancer stage progression; however, we found no evidence to suggest cancer progression from the trajectory of the number of stoma constructions and stent placements. In Japan, even during the pandemic, conventional treatments were performed.

Project description:ObjectiveTo investigate the possible impact of lockdown policies on the diagnosis and treatment of cancer patients in Henan, China.Design setting and participantsWe collected data from the Henan Cancer Hospital, affiliated with Zhengzhou University. The monthly numbers of inpatient admissions from January 2014 to December 2019 were used to forecast the number of inpatient admissions in 2020, which was then compared to the actual number of patients admitted during the pandemic to evaluate how the actual number diverges from this forecast. We conducted an interrupted time series analysis using the autoregressive integrated moving average (ARIMA) model.Main outcomes and measuresFor specific diagnoses, treatment modalities, and age groups, we compared the changes in monthly admissions after the pandemic with the forecasted changes from the model.ResultsThe observed overall monthly number of inpatient admissions decreased by 20.2% [95% confidence interval (CI), 11.7-27.2%], 78.9% (95% CI, 77.3-80.4%), and 40.9% (95% CI, 35.6-45.5%) in January, February, and March 2020, respectively, as compared with those predicted using the ARIMA model. After the lockdown, visits for all treatment modalities decreased sharply. However, apparent compensation and recovery of the backlog appeared in later surgeries. As a result, the number of patients who underwent surgery in 2020 (30,478) was close to the number forecasted by the ARIMA model (30,185). In the same period, patients who received other treatments or underwent examinations were 106,074 and 36,968, respectively; the respective numbers that were forecasted by ARIMA were 127,775 and 60,025, respectively. These findings depict a decrease of 16.9 and 38.4% in patients who received other treatments or underwent examinations only, respectively. Regarding diagnosis, the reported incidence of various cancers decreased dramatically in February, with varying extent and speed of recovery.Conclusion and relevanceThe COVID-19 pandemic has significantly delayed the diagnosis and treatment of cancer in Henan, China. Long-term research should be conducted to assess the future effects of lockdown policies.

Dataset Information

Changes in the number of cancer diagnosis practices due to the COVID-19 pandemic: interrupted time-series analysis using the National Database of Japan.

Purpose

Methods

Results

Conclusion

Publications

Changes in the number of cancer diagnosis practices due to the COVID-19 pandemic: interrupted time-series analysis using the National Database of Japan.

Similar Datasets

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