Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Department of Surgery, Ersta Hospital, Stockholm, Sweden.
Colorectal Dis. 2022 Aug;24(8):925-932. doi: 10.1111/codi.16129. Epub 2022 Apr 19.
The COVID-19 pandemic has reduced the capacity to diagnose and treat cancer worldwide due to the prioritization of COVID-19 treatment. The aim of this study was to investigate treatment and outcomes of colon cancer in Sweden before and during the COVID-19 pandemic.
In an observational study, using the Swedish Colorectal Cancer Registry, we included (i) all Swedish patients diagnosed with colon cancer, and (ii) all patients undergoing surgery for colon cancer, in 2016-2020. Incidence of colon cancer, treatments and outcomes in 2020 were compared with 2019.
The number of colon cancer cases in Sweden in April-May 2020 was 27% lower than the previous year, whereas no difference was observed on an annual level (4,589 vs. 4,763 patients [-4%]). Among patients with colon cancer undergoing surgery in 2020, the proportion of resections was 93 vs. 94% in 2019, with no increase in acute resections. Time from diagnosis to elective surgery decreased (29 days vs. 33 days in 2020 vs. 2019). In 2020, more patients underwent a two-stage procedure with a diverting stoma as first surgery (6.1%) vs. (4.4%) in 2019 (p = 0.0020) and more patients were treated with preoperative chemotherapy (5.1%) vs. (3,5%) 2019 (p = 0.0016). The proportion of patients that underwent laparoscopic surgery increased from 54% to 58% (p = 0.0017) There were no differences in length of stay, surgical complications, reoperation, ICU-stay or 30-day mortality between the years.
Based on nationwide annual data, we did not observe adverse effects of the COVID-19 pandemic on colon cancer treatment and short time outcomes in Sweden.
由于优先考虑 COVID-19 的治疗，全球范围内诊断和治疗癌症的能力因 COVID-19 疫情而降低。本研究旨在调查瑞典在 COVID-19 大流行前后结肠癌的治疗和结果。
在一项观察性研究中，我们使用了瑞典结直肠癌登记处的数据，纳入了 (i) 2016-2020 年间所有被诊断为结肠癌的瑞典患者，以及 (ii) 所有接受结肠癌手术的患者。比较了 2020 年与 2019 年的结肠癌发病率、治疗方法和结果。
2020 年 4 月至 5 月瑞典结肠癌病例数比前一年减少了 27%，但按年度水平观察则无差异（4589 例比 4763 例 [-4%]）。2020 年接受结肠癌手术的患者中，切除率为 93%，与 2019 年的 94%相比没有增加急性切除术。从诊断到择期手术的时间缩短（29 天比 2020 年和 2019 年的 33 天）。2020 年，更多的患者接受了两阶段手术，其中第一次手术为转流性造口术（6.1%），而 2019 年为 4.4%（p=0.0020），更多的患者接受了术前化疗（5.1%），而 2019 年为 3.5%（p=0.0016）。腹腔镜手术的比例从 54%增加到 58%（p=0.0017）。在住院时间、手术并发症、再次手术、入住 ICU 或 30 天死亡率方面，两年间无差异。
根据全国年度数据，我们未观察到 COVID-19 大流行对瑞典结肠癌治疗和短期结果的不良影响。
