The impact of the COVID-19 pandemic on the diagnosis, stage, and treatment of esophagogastric cancer

• Published in: Journal of gastroenterology Vol. 58; no. 10; pp. 965 - 977
• Main Authors: Doeve, Benthe H., Bakx, Jeanne A. C., Siersema, Peter D., Rosman, Camiel, van Grieken, Nicole C. T., van Berge Henegouwen, Mark I., van Sandick, Johanna W., Verheij, Marcel, Bijlsma, Maarten F., Verhoeven, Rob H. A., van Laarhoven, Hanneke W. M.
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.10.2023; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Adenocarcinoma - diagnosis; Cancer; Care and treatment; Chemoradiotherapy; Colorectal Surgery; COVID-19; COVID-19 - epidemiology; COVID-19 Testing; Diagnosis; Drug therapy; Epidemics; Esophageal cancer; Esophageal Neoplasms - diagnosis; Esophageal Neoplasms - epidemiology; Esophageal Neoplasms - therapy; Gastric cancer; Gastroenterology; Hepatology; Humans; Medical diagnosis; Medicine; Medicine & Public Health; Original Article—Alimentary Tract; Original —Alimentary Tract; Pandemics; Patients; Stomach cancer; Stomach Neoplasms - diagnosis; Stomach Neoplasms - epidemiology; Stomach Neoplasms - therapy; Surgical Oncology; Netherlands; COVID-19; Treatment; Gastric cancer; Esophageal cancer; Incidence
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-023-02009-3

Background The COVID-19 pandemic has affected the entire global healthcare system, including oncological care. This study investigated the effects of the COVID-19 pandemic on the diagnosis, stage, and treatment of esophagogastric cancer in the Netherlands. Methods Patients diagnosed in 2020 were divided into 5 periods, based on the severity of the COVID-19 pandemic in the Netherlands, and compared to patients diagnosed in the same period in the years 2017–2019. Patient characteristics and treatments were evaluated for esophageal cancer (EC) and gastric cancer (GC) separately. Results The number of esophagogastric cancer diagnoses decreased prominently during the first 2 months of the COVID-19 pandemic. During this period, a significantly higher percentage of GC patients was diagnosed with incurable disease (52.5% in 2017–2019 and 67.7% in 2020, p = 0.011). We observed a significant reduction in the percentage of patients with potentially curable EC treated with resection and neoadjuvant chemoradiotherapy (from 35.0% in 2017–2019 to 27.3% in 2020, p < 0.001). Also, patients diagnosed with incurable GC were treated less frequently with a resection (from 4.6% in 2017–2019 to 1.5% in 2020, p = 0.009) in the second half of 2020. Conclusions Compared to previous years, the number of esophagogastric cancer diagnoses decreased in the first 2 months of the COVID-19 pandemic, while an increased percentage of patients was diagnosed with incurable disease. Both in the curative and palliative setting, patients were less likely to be treated with a surgical resection.