期刊
CURRENT ONCOLOGY
卷 29, 期 10, 页码 7732-7744出版社
MDPI
DOI: 10.3390/curroncol29100611
关键词
COVID-19; cancer; chemotherapy; cancer surgery; health inequity
类别
资金
- Canadian Institutes of Health Research Operating Grant [179892]
- Sunnybrook Research Institute
- Sunnybrook Foundation COVID-19 Response Grant
This study aimed to quantify the shift in surgery rate following chemotherapy during the pandemic. A retrospective cohort study in Ontario, Canada found that the proportion of patients receiving surgery 9 months after chemotherapy initiation was higher during the pandemic compared to before, with breast cancer patients experiencing the most significant increase. Further evaluations are needed to understand the long-term consequences of these pandemic-related treatment shifts.
Due to the ramping down of cancer surgery in early pandemic, many newly diagnosed patients received other treatments first. We aimed to quantify the pandemic-related shift in rate of surgery following chemotherapy. This is a retrospective population-based cohort study involving adults diagnosed with cancer between 3 January 2016 and 7 November 2020 in Ontario, Canada who received chemotherapy as first treatment within 6-months of diagnosis. Competing-risks regression models with interaction effects were used to quantify the association between COVID-19 period (receiving a cancer diagnosis before or on/after 15 March 2020) and receipt of surgical reSection 9-months after first chemotherapy. Among 51,653 patients, 8.5% (n = 19,558) of them ultimately underwent surgery 9-months after chemotherapy initiation. Receipt of surgery was higher during the pandemic than before (sHR 1.07, 95% CI 1.02-1.13). Material deprivation was independently associated with lower receipt of surgery (least vs. most deprived quintile: sHR 1.11, 95% CI 1.04-1.17), but did not change with the pandemic. The surgical rate increase was most pronounced for breast cancer (sHR 1.13, 95% CI 1.06-1.20). These pandemic-related shifts in cancer treatment requires further evaluations to understand the long-term consequences. Persistent material deprivation-related inequity in cancer surgical access needs to be addressed.
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