Department of Medical Oncology Department, Hospital Clínico Universitario, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain.
Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.
Cancer Control. 2022 Jan-Dec;29:10732748221131000. doi: 10.1177/10732748221131000.
The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly regarding early cancer diagnosis, sparking public health concerns that possible delays could increase the proportion of patients diagnosed at advanced stages. In 2009, a cancer fast-track program (CFP) was implemented at the Clinico-Malvarrosa Health Department in Valencia, Spain with the aim of shortening waiting times between suspected cancer symptoms, diagnosis and therapy initiation.
The study aimed to explore the effects of the COVID-19 pandemic on our cancer diagnosis fast-track program.
The program workflow (patients included and time periods) was analysed from the beginning of the state of alarm on March 16th, 2020 until March 15th, 2021. Data was compared with data from the same period of time from the year before (2019).
During the pandemic year, 975 suspected cancer cases were submitted to the CFP. The number of submissions only decreased during times of highest COVID-19 incidence and stricter lockdown, and overall, referrals were slightly higher than in the previous 2 years. Cancer diagnosis was confirmed in 197 (24.1%) cases, among which 33% were urological, 23% breast, 16% gastrointestinal and 9% lung cancer. The median time from referral to specialist appointment was 13 days and diagnosis was reached at a median of 18 days. In confirmed cancer cases, treatment was started at around 30 days from time of diagnosis. In total, 61% of cancer disease was detected at early stage, 20% at locally advanced stage, and 19% at advanced stage, displaying time frames and case proportions similar to pre-pandemic years.
Our program has been able to maintain normal flow and efficacy despite the challenges of the current pandemic, and has proven a reliable tool to help primary care physicians referring suspected cancer patients.
COVID-19 大流行扰乱了肿瘤学临床实践的许多方面，特别是在早期癌症诊断方面，引发了公众健康方面的担忧，即可能的延迟会增加诊断为晚期的患者比例。2009 年，西班牙瓦伦西亚的 Clinico-Malvarrosa 卫生部门实施了癌症快速通道计划（CFP），旨在缩短疑似癌症症状、诊断和治疗开始之间的等待时间。
本研究旨在探讨 COVID-19 大流行对我们癌症诊断快速通道计划的影响。
分析 2020 年 3 月 16 日警报状态开始至 2021 年 3 月 15 日期间的计划工作流程（纳入的患者和时间段）。将数据与前一年同期的数据进行比较（2019 年）。
在大流行期间，有 975 例疑似癌症病例提交给 CFP。提交的数量仅在 COVID-19 发病率最高和封锁最严格的时期减少，总体而言，转诊略高于前两年。在 197 例（24.1%）确诊癌症病例中，其中 33%为泌尿科癌症，23%为乳腺癌，16%为胃肠道癌，9%为肺癌。从转诊到专科医生预约的中位时间为 13 天，诊断中位时间为 18 天。在确诊的癌症病例中，治疗大约在诊断后 30 天开始。总的来说，61%的癌症疾病在早期阶段被发现，20%在局部晚期阶段，19%在晚期阶段，表现出与大流行前年份相似的时间框架和病例比例。
尽管当前大流行带来了挑战，但我们的计划能够保持正常的流程和效果，并且已被证明是帮助初级保健医生转诊疑似癌症患者的可靠工具。
