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Rectal cancer presentation during the COVID-19 pandemic: Are decreasing screening rates leading to an increase in acute presentations?

Nearly 23 million adults ages 50–75 are overdue for colorectal cancer (CRC) screening. In March 2020, the Centers for Medicare & Medicaid issued guidance that all non-urgent procedures be delayed due to the COVID-19 pandemic. Screening delays may have effects on the presentation of rectal cancer...

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Autores principales: Sutton, Tia S., Hao, Scarlett, Suzuki, Mizuki, Chua, Aimei, Ciarrocca, Anna Lisa, Honaker, Michael D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501676/
https://www.ncbi.nlm.nih.gov/pubmed/37708208
http://dx.doi.org/10.1371/journal.pone.0291447
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author Sutton, Tia S.
Hao, Scarlett
Suzuki, Mizuki
Chua, Aimei
Ciarrocca, Anna Lisa
Honaker, Michael D.
author_facet Sutton, Tia S.
Hao, Scarlett
Suzuki, Mizuki
Chua, Aimei
Ciarrocca, Anna Lisa
Honaker, Michael D.
author_sort Sutton, Tia S.
collection PubMed
description Nearly 23 million adults ages 50–75 are overdue for colorectal cancer (CRC) screening. In March 2020, the Centers for Medicare & Medicaid issued guidance that all non-urgent procedures be delayed due to the COVID-19 pandemic. Screening delays may have effects on the presentation of rectal cancer and the natural history of the disease. The aim of this study was to determine if procedural suspension due to the COVID-19 pandemic was associated with an increased proportion of acute presentations or more advanced stage at diagnosis for patients with rectal cancer. We conducted a single-center, retrospective review of adult patients with new or recurrent rectal adenocarcinoma from 2016–2021. We compared patients presenting before (pre-COVID) to those diagnosed after (COVID) March 1, 2020. Of 208 patients diagnosed with rectal cancer, 163 were diagnosed pre-COVID and 45 patients in the COVID group. Cohorts did not differ among age, sex, race, insurance status, marital status, rurality, or BMI. There was no difference in stage at presentation with the majority diagnosed with stage III disease (40.0% vs 33.3%, p = 0.26). Similar proportions of patients presented acutely (67.5% vs 64.4%, p = 0.71). Presenting symptoms were also similar between cohorts. On adjusted analysis, male sex, white race, and uninsured status were found to have significant impact acuity of presentation, while diagnosis before or after the onset of the pandemic remained non-significant (OR 1.25, 95% CI0.57–2.72; p = 0.59). While screening rates have decreased during the COVID pandemic, patients with rectal cancer did not appear to have an increased level of acuity or stage at presentation. These findings could result from the indolent nature of the disease and may change as the pandemic progresses.
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spelling pubmed-105016762023-09-15 Rectal cancer presentation during the COVID-19 pandemic: Are decreasing screening rates leading to an increase in acute presentations? Sutton, Tia S. Hao, Scarlett Suzuki, Mizuki Chua, Aimei Ciarrocca, Anna Lisa Honaker, Michael D. PLoS One Research Article Nearly 23 million adults ages 50–75 are overdue for colorectal cancer (CRC) screening. In March 2020, the Centers for Medicare & Medicaid issued guidance that all non-urgent procedures be delayed due to the COVID-19 pandemic. Screening delays may have effects on the presentation of rectal cancer and the natural history of the disease. The aim of this study was to determine if procedural suspension due to the COVID-19 pandemic was associated with an increased proportion of acute presentations or more advanced stage at diagnosis for patients with rectal cancer. We conducted a single-center, retrospective review of adult patients with new or recurrent rectal adenocarcinoma from 2016–2021. We compared patients presenting before (pre-COVID) to those diagnosed after (COVID) March 1, 2020. Of 208 patients diagnosed with rectal cancer, 163 were diagnosed pre-COVID and 45 patients in the COVID group. Cohorts did not differ among age, sex, race, insurance status, marital status, rurality, or BMI. There was no difference in stage at presentation with the majority diagnosed with stage III disease (40.0% vs 33.3%, p = 0.26). Similar proportions of patients presented acutely (67.5% vs 64.4%, p = 0.71). Presenting symptoms were also similar between cohorts. On adjusted analysis, male sex, white race, and uninsured status were found to have significant impact acuity of presentation, while diagnosis before or after the onset of the pandemic remained non-significant (OR 1.25, 95% CI0.57–2.72; p = 0.59). While screening rates have decreased during the COVID pandemic, patients with rectal cancer did not appear to have an increased level of acuity or stage at presentation. These findings could result from the indolent nature of the disease and may change as the pandemic progresses. Public Library of Science 2023-09-14 /pmc/articles/PMC10501676/ /pubmed/37708208 http://dx.doi.org/10.1371/journal.pone.0291447 Text en © 2023 Sutton et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sutton, Tia S.
Hao, Scarlett
Suzuki, Mizuki
Chua, Aimei
Ciarrocca, Anna Lisa
Honaker, Michael D.
Rectal cancer presentation during the COVID-19 pandemic: Are decreasing screening rates leading to an increase in acute presentations?
title Rectal cancer presentation during the COVID-19 pandemic: Are decreasing screening rates leading to an increase in acute presentations?
title_full Rectal cancer presentation during the COVID-19 pandemic: Are decreasing screening rates leading to an increase in acute presentations?
title_fullStr Rectal cancer presentation during the COVID-19 pandemic: Are decreasing screening rates leading to an increase in acute presentations?
title_full_unstemmed Rectal cancer presentation during the COVID-19 pandemic: Are decreasing screening rates leading to an increase in acute presentations?
title_short Rectal cancer presentation during the COVID-19 pandemic: Are decreasing screening rates leading to an increase in acute presentations?
title_sort rectal cancer presentation during the covid-19 pandemic: are decreasing screening rates leading to an increase in acute presentations?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501676/
https://www.ncbi.nlm.nih.gov/pubmed/37708208
http://dx.doi.org/10.1371/journal.pone.0291447
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