Crossley Jason R, Nelson Lacey L, VanDolah Hunter, Davidson Bruce J, Maxwell Jessica H
Department of Otolaryngology-Head and Neck Surgery MedStar Georgetown University Hospital Washington District of Columbia USA.
Department of Otolaryngology-Head and Neck Surgery Stanford University School of Medicine Stanford California USA.
Laryngoscope Investig Otolaryngol. 2022 Aug 12;7(5):1436-40. doi: 10.1002/lio2.893.
To analyze how the COVID-19 pandemic has influenced trends in head and neck squamous cell carcinoma (HNSCC) presentation and diagnosis-including referral patterns, stage at presentation, and time to diagnosis-over a longitudinal time course.
Multicenter tertiary care academic institution.
A retrospective review of patients with HNSCC presenting between January 1, 2019 and December 31, 2020 was performed. Patients were stratified into pre-COVID and COVID cohorts based upon presentation date either before or after the COVID pandemic was declared a national emergency. Data was collected on demographics, referral site, symptoms, tumor characteristics, and time to diagnosis.
Of 203 patients with HNSCC identified, 77.3% (157/203) were in the pre-COVID cohort and 22.7% (46/203) were in the COVID cohort. Patients in the COVID cohort were more likely to present through inpatient or ER consultation (26% vs. 11%) than outpatient setting. There was a greater than 50% decrease in new tumor board case presentations per month in the COVID cohort (4.8) relative to the pre-COVID (10.9) cohort. Cancer stage at presentation was similar between cohorts. Time from presentation to diagnosis was similar between the cohorts at approximately 30 days.
These results suggest that patients presenting during the COVID pandemic may have unique referral patterns. A significant decrease in tumor board presentations was noted, which may contribute to more delayed presentations that have yet to be observed. Further investigation with a larger sample size is warranted.
The COVID-19 pandemic may have changed where and how patients with head and neck cancer initially seek care. We found that patients with newly diagnosed head and neck cancer more often were initially seen in urgent settings than before the pandemic.
分析2019冠状病毒病（COVID-19）大流行如何在纵向时间过程中影响头颈部鳞状细胞癌（HNSCC）的就诊和诊断趋势，包括转诊模式、就诊时的分期以及诊断时间。
多中心三级医疗学术机构。
对2019年1月1日至2020年12月31日期间就诊的HNSCC患者进行回顾性研究。根据就诊日期在COVID大流行被宣布为国家紧急情况之前或之后，将患者分为COVID前队列和COVID队列。收集患者的人口统计学信息、转诊地点、症状、肿瘤特征和诊断时间等数据。
在确诊的203例HNSCC患者中，77.3%（157/203）在COVID前队列，22.7%（46/203）在COVID队列。与门诊环境相比，COVID队列中的患者通过住院或急诊咨询就诊的可能性更大（26%对11%）。与COVID前队列（10.9）相比，COVID队列中每月新的肿瘤委员会病例报告减少了50%以上（4.8）。两个队列就诊时的癌症分期相似。两个队列从就诊到诊断的时间相似，约为30天。
这些结果表明，在COVID大流行期间就诊的患者可能有独特的转诊模式。注意到肿瘤委员会报告显著减少，这可能导致更多延迟就诊情况，而这些情况尚未被观察到。有必要用更大的样本量进行进一步研究。
COVID-19大流行可能改变了头颈癌患者最初寻求治疗的地点和方式。我们发现，新诊断的头颈癌患者比大流行前更常在紧急情况下首次就诊。
3级
