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Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study

BACKGROUND: An absence of screening recommendations and the rapid progression of testicular germ cell tumours (TGCTs) offer a perspective on the potential impact of the COVID-19 pandemic on cancer presentations. We evaluated the presenting cancer stages of TGCTs in a real-world population before and...

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Autores principales: Lee-Ying, Richard, O’Sullivan, Dylan E., Gagnon, Richard, Bosma, Nicholas, Stewart, Rebecca N., Railton, Cindy, Tilley, Derek, Alimohamed, Nimira, Basappa, Naveen, Cheng, Tina, Kolinsky, Michael, Karim, Safiya, Ruether, Dean, North, Scott, Yip, Steven, Danielson, Brita, Heng, Daniel, Brenner, Darren
Formato: Online Artículo Texto
Lenguaje:English
Publicado: CMA Impact Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262347/
https://www.ncbi.nlm.nih.gov/pubmed/35790231
http://dx.doi.org/10.9778/cmajo.20210285
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author Lee-Ying, Richard
O’Sullivan, Dylan E.
Gagnon, Richard
Bosma, Nicholas
Stewart, Rebecca N.
Railton, Cindy
Tilley, Derek
Alimohamed, Nimira
Basappa, Naveen
Cheng, Tina
Kolinsky, Michael
Karim, Safiya
Ruether, Dean
North, Scott
Yip, Steven
Danielson, Brita
Heng, Daniel
Brenner, Darren
author_facet Lee-Ying, Richard
O’Sullivan, Dylan E.
Gagnon, Richard
Bosma, Nicholas
Stewart, Rebecca N.
Railton, Cindy
Tilley, Derek
Alimohamed, Nimira
Basappa, Naveen
Cheng, Tina
Kolinsky, Michael
Karim, Safiya
Ruether, Dean
North, Scott
Yip, Steven
Danielson, Brita
Heng, Daniel
Brenner, Darren
author_sort Lee-Ying, Richard
collection PubMed
description BACKGROUND: An absence of screening recommendations and the rapid progression of testicular germ cell tumours (TGCTs) offer a perspective on the potential impact of the COVID-19 pandemic on cancer presentations. We evaluated the presenting cancer stages of TGCTs in a real-world population before and during the pandemic to assess stage migration. METHODS: We performed a retrospective review of all new patients with TGCT diagnoses in Alberta, Canada, from Dec. 31, 2018, to Apr. 30, 2021, using the Alberta Cancer Registry. Because potential changes in staging should not occur instantaneously, we used a 6-month lag time from Apr. 1, 2020, for seminomas, and a 3-month lag time for nonseminomas, to compare initial cancer stages at presentation before and during the pandemic. We evaluated monthly rates of presentation by stage and histology. Exploratory outcomes included the largest tumour dimension, tumour markers and, for advanced disease, risk category and treatment setting. RESULTS: Of 335 patients with TGCTs, 231 were diagnosed before the pandemic and 104 during the pandemic (using a lag time). In total, 18 (7.8%) patients diagnosed before the pandemic presented with stage III disease, compared to 16 (15.4%) diagnosed during the pandemic (relative risk 1.97, 95% confidence interval [CI] 1.05–3.72). We observed no significant differences for secondary outcomes. Without a lag time, the rate ratio for a stage II presentation decreased significantly during the pandemic (0.40, 95% CI 0.21–0.72). INTERPRETATION: We observed signs of TGCT stage migration during the COVID-19 pandemic, driven by a decline in stage II disease and a potential rise in stage III disease. Management of TGCTs should remain a priority, even during a global pandemic.
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spelling pubmed-92623472022-07-10 Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study Lee-Ying, Richard O’Sullivan, Dylan E. Gagnon, Richard Bosma, Nicholas Stewart, Rebecca N. Railton, Cindy Tilley, Derek Alimohamed, Nimira Basappa, Naveen Cheng, Tina Kolinsky, Michael Karim, Safiya Ruether, Dean North, Scott Yip, Steven Danielson, Brita Heng, Daniel Brenner, Darren CMAJ Open Research BACKGROUND: An absence of screening recommendations and the rapid progression of testicular germ cell tumours (TGCTs) offer a perspective on the potential impact of the COVID-19 pandemic on cancer presentations. We evaluated the presenting cancer stages of TGCTs in a real-world population before and during the pandemic to assess stage migration. METHODS: We performed a retrospective review of all new patients with TGCT diagnoses in Alberta, Canada, from Dec. 31, 2018, to Apr. 30, 2021, using the Alberta Cancer Registry. Because potential changes in staging should not occur instantaneously, we used a 6-month lag time from Apr. 1, 2020, for seminomas, and a 3-month lag time for nonseminomas, to compare initial cancer stages at presentation before and during the pandemic. We evaluated monthly rates of presentation by stage and histology. Exploratory outcomes included the largest tumour dimension, tumour markers and, for advanced disease, risk category and treatment setting. RESULTS: Of 335 patients with TGCTs, 231 were diagnosed before the pandemic and 104 during the pandemic (using a lag time). In total, 18 (7.8%) patients diagnosed before the pandemic presented with stage III disease, compared to 16 (15.4%) diagnosed during the pandemic (relative risk 1.97, 95% confidence interval [CI] 1.05–3.72). We observed no significant differences for secondary outcomes. Without a lag time, the rate ratio for a stage II presentation decreased significantly during the pandemic (0.40, 95% CI 0.21–0.72). INTERPRETATION: We observed signs of TGCT stage migration during the COVID-19 pandemic, driven by a decline in stage II disease and a potential rise in stage III disease. Management of TGCTs should remain a priority, even during a global pandemic. CMA Impact Inc. 2022-07-05 /pmc/articles/PMC9262347/ /pubmed/35790231 http://dx.doi.org/10.9778/cmajo.20210285 Text en © 2022 CMA Impact Inc. or its licensors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Research
Lee-Ying, Richard
O’Sullivan, Dylan E.
Gagnon, Richard
Bosma, Nicholas
Stewart, Rebecca N.
Railton, Cindy
Tilley, Derek
Alimohamed, Nimira
Basappa, Naveen
Cheng, Tina
Kolinsky, Michael
Karim, Safiya
Ruether, Dean
North, Scott
Yip, Steven
Danielson, Brita
Heng, Daniel
Brenner, Darren
Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study
title Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study
title_full Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study
title_fullStr Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study
title_full_unstemmed Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study
title_short Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study
title_sort stage migration of testicular germ cell tumours in alberta, canada, during the covid-19 pandemic: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262347/
https://www.ncbi.nlm.nih.gov/pubmed/35790231
http://dx.doi.org/10.9778/cmajo.20210285
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