Nasir Aejaz, Hough Brooke, Baffa Caterina, Khazanchi Arun, Coppola Domenico
Department of Pathology, Florida Digestive Health Specialists, Florida Research Institute, Bradenton, FL, U.S.A.
Cancer Diagn Progn. 2022 Jul 3;2(4):422-428. doi: 10.21873/cdp.10125. eCollection 2022 Jul-Aug.
BACKGROUND/AIM: The coronavirus disease 2019 (COVID-19) pandemic prompted global recommendations to delay non-urgent endoscopic procedures to limit the spread of SARS-COV-2, but such delays had unprecedented impact on the delivery of healthcare. Being a large specialty GI Pathology service, we sought to analyze the effect of the pandemic on the frequency of GI malignancies in our department.
Based on the electronic search of departmental pathology records, we compared the total numbers of cancer diagnoses (primary and metastatic) from various GI biopsy sites during the 12-month pre- and post-pandemic periods. We summarized patient demographics and analyzed pertinent histopathologic data.
For all GI biopsy sites, the number of intramucosal/invasive malignancies reported during the one-year pre-COVID-19 pandemic (pre-COVID) and post-COVID-19 pandemic national lockdown (post-COVID) observation periods were 146 and 218, respectively. Among these, 32 and 70 malignancies were reported for the first quarter (representing the earliest post-lockdown period), 29 and 53 for the second, 41 and 54 for the third, and 44 and 41 for the fourth quarter. During the first two quarters of the post-COVID observation period, the increase in malignant diagnoses was most profound, showing 119% post-COVID increase compared to the pre-COVID levels. Of the two main primary histologic types of large intestinal carcinomas [adenocarcinoma (ADC) and squamous cell carcinoma (SCC)], the most profound post-COVID increase was noted in SCCs (136% vs. 58% for ADCs).
Compared to the pre-pandemic baseline, the COVID-19 pandemic caused a major increase in biopsy diagnoses of GI cancers in our department. The most plausible explanations for this trend include inevitable lockdowns to minimize the spread of SAR-COV2, which affected GI endoscopy procedure schedules/re-schedules as well as patient response and adaptation to emerging post-COVID GI healthcare patterns. The COVID-19 pandemic's long-term impact on the health of GI cancer patients will need to be determined through systematic analyses by multi-disciplinary teams.
背景/目的：2019年冠状病毒病（COVID-19）大流行促使全球建议推迟非紧急内镜检查程序，以限制严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的传播，但这种延迟对医疗服务的提供产生了前所未有的影响。作为一个大型的胃肠病病理学专科服务机构，我们试图分析大流行对我们科室胃肠道恶性肿瘤发生率的影响。
基于对科室病理记录的电子检索，我们比较了大流行前和后12个月期间来自各种胃肠道活检部位的癌症诊断（原发性和转移性）总数。我们总结了患者的人口统计学资料，并分析了相关的组织病理学数据。
对于所有胃肠道活检部位，在2019年冠状病毒病大流行前（COVID前）和2019年冠状病毒病大流行后全国封锁（COVID后）观察期内报告的黏膜内/浸润性恶性肿瘤数量分别为146例和218例。其中，第一季度（代表封锁后的最早时期）报告了32例和70例恶性肿瘤，第二季度为29例和53例，第三季度为41例和54例，第四季度为44例和41例。在COVID后观察期的前两个季度，恶性诊断的增加最为显著，与COVID前水平相比，COVID后增加了119%。在两种主要的原发性组织学类型的大肠癌[腺癌（ADC）和鳞状细胞癌（SCC）]中，COVID后增加最为显著的是SCC（136%，而ADC为58%）。
与大流行前的基线相比，2019年冠状病毒病大流行导致我们科室胃肠道癌症的活检诊断大幅增加。这种趋势最合理的解释包括为尽量减少SARS-CoV-2传播而不可避免的封锁，这影响了胃肠道内镜检查程序的安排/重新安排，以及患者对新兴的COVID后胃肠道医疗模式的反应和适应。2019年冠状病毒病大流行对胃肠道癌症患者健康的长期影响需要通过多学科团队的系统分析来确定。
