Mizuno Rei, Ganeko Riki, Takeuchi Go, Mimura Kazuya, Nakahara Hideto, Hashimoto Kyoichi, Hinami Junsuke, Shimomatsuya Takumi, Kubota Yoshihiro
Department of Surgery, Uji-Tokushukai Medical Center, Uji, 611-0042, 145 Makishima-cho Ishibashi, Uji, Kyoto, Japan.
Ann Med Surg (Lond). 2020 Dec;60:675-679. doi: 10.1016/j.amsu.2020.11.087. Epub 2020 Dec 2.
The global pandemic of COVID-19 has changed cancer treatment environments. In Japan, cancer screenings were halted and the numbers of endoscopies and surgeries were restricted in some hospitals based on the state of emergency declared. Herein, we investigated the impact of the COVID-19 pandemic on the characteristics of colorectal cancer (CRC) patients in facilities that are on the frontline of both COVID-19 and cancer treatments.
We retrospectively analyzed the cases of all of the CRC patients (n = 123) who underwent surgery at our regional cancer treatment center and tertiary emergency hospital in Japan during a 120-day period ranging from before to after the state of emergency declaration. CRC patients during the corresponding period in the previous year were also examined.
Although the number of CRC patients did not show a significant change related to the pandemic, the incidence of obstructive CRCs significantly increased after the pandemic's start. The numbers of outpatients and colonoscopies both decreased, which could have resulted in the decrease of CRC patients detected by cancer screening during the pandemic. The numbers of symptomatic CRC patients and emergency admissions both increased significantly during the pandemic.
Our findings indicate the possibility that the discovery of CRCs in patients could be delayed due to the halt in screenings caused by the COVID-19 pandemic, resulting in the increase of obstructive CRCs. These results highlight the importance of cancer screening and suggest that the screening system for cancers should be reorganized before future pandemics.
新型冠状病毒肺炎(COVID-19)的全球大流行改变了癌症治疗环境。在日本,癌症筛查被暂停,一些医院根据宣布的紧急状态限制了内镜检查和手术的数量。在此,我们调查了COVID-19大流行对处于COVID-19和癌症治疗前线的医疗机构中结直肠癌(CRC)患者特征的影响。
我们回顾性分析了在日本宣布紧急状态前后120天内,在我们地区癌症治疗中心和三级急救医院接受手术的所有CRC患者(n = 123)的病例。还检查了上一年同期的CRC患者。
尽管CRC患者的数量与大流行没有显著变化,但大流行开始后梗阻性CRC的发病率显著增加。门诊患者数量和结肠镜检查数量均减少,这可能导致大流行期间通过癌症筛查发现的CRC患者数量减少。大流行期间有症状的CRC患者数量和急诊入院人数均显著增加。
我们的研究结果表明,由于COVID-19大流行导致筛查暂停,患者CRC的发现可能会延迟,从而导致梗阻性CRC增加。这些结果凸显了癌症筛查的重要性,并建议在未来大流行之前重新组织癌症筛查系统。