Stage shift and relative survival for head and neck cancer during the 2020 COVID-19 pandemic: a population-based study of temporal trends

Frontiers in Oncology

Oncology

Geert Silversmit¹  Liesbet Van Eycken¹  Francesco Giusti¹  Cindy De Gendt¹  Bart van Gool¹  Hanna M. Peacock¹  Jean-Pascal Machiels²  Jan Casselman³  Sandra Nuyts⁴  Vincent Vander Poorten⁵ 

[1] Belgian Cancer Registry, Brussels, Belgium;Department of Medical Oncology, Institut Roi Albert II, Cliniques universitaires Saint-Luc, Brussels, Belgium;Institut de Recherche Clinique et Expérimentale, UCLouvain, Brussels, Belgium;Department of Radiology, AZ St-Jan Brugge-Oostende, Bruges, Belgium;Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium;Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium;Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium;Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium;

关键词: COVID-19;    head and neck neoplasm;    incidence;    mortality;    routinely collected health data;    delayed diagnosis;   

DOI  :  10.3389/fonc.2023.1253968

 received in 2023-07-06, accepted in 2023-08-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveDuring the first wave of the COVID-19 pandemic in 2020, non-essential health services were suspended in Belgium, and the public was ordered to socially isolate. Underdiagnosis of cancer during this period was reported worldwide. Certain risk factors for head and neck cancer (HNC) overlap with those for COVID-19 incidence and mortality, making underdiagnosis and subsequent stage shift of this potentially rapidly progressing cancer a major concern. We aimed to analyze incidence, clinical stage at presentation, and survival of patients diagnosed with HNC in 2020 in Belgium, considering recent temporal trends.MethodsUsing population-based data from the Belgian Cancer Registry (BCR), we extrapolated 2017-2019 trends in incidence, clinical stage, and 1-year relative survival (1yRS) of HNC to create an expected value for 2020 and compared this to the observed value.ResultsThere were 9.5% fewer HNCs diagnosed in 2020, compared to the predicted incidence. Underdiagnosis was larger for males (-11.8%), patients aged 50-64 (-11.2%) and 65-79 (-11.1%), and for oral cavity cancer (-17.6%). Shifts to more advanced stages were observed in larynx and oropharynx tumors and for (male) patients aged 80+. A 2.4 percentage point decline in 1yRS was observed, relative to the increasing trends in 1yRS (2017-2019).ConclusionThe COVID-19 pandemic led to underdiagnosis of HNC, resulting in shifts to more advanced stage at presentation in certain subgroups. A stage shift can be expected for the 9.5% of tumors not yet diagnosed at the end of 2020. HNC patients diagnosed in 2020 suffered higher than expected mortality.

【 授权许可】

Unknown   
Copyright © 2023 Peacock, De Gendt, Silversmit, Nuyts, Casselman, Machiels, Giusti, van Gool, Vander Poorten and Van Eycken