Maghiar Octavian Adrian, Şandor Mircea, Blaj Mădălina-Andrada, Belean Marius, Ardelean Andrei, Turcuş Violeta, Maghiar Teodor Andrei, Pop-Moldovan Adina, Mathe Endre, Bodog Alin, Neamţu Carmen, Dehelean Cristina-Adriana, Pop Ovidiu Laurean, Totolici Bogdan Dan, Neamţu Andreea-Adriana
Chirurgia (Bucur). 2023 Oct;118(5):487-501. doi: 10.21614/chirurgia.2023.v.118.i.5.p.487.
Colorectal cancer, 3rd in incidence and 2nd in mortality among cancers worldwide, represents the most common malignant tumor of the digestive tract. In Romania, it is the most frequently diagnosed type of cancer (approximately 0.06% of the population/year). During the COVID-19 pandemic the legislation preventing the SARS-CoV-2 viral transmission impairing access to outpatient healthcare services combined with patients fear of SARS-CoV-2 infection had consequences on the diagnosis and treatment of all other pathologies. A 5-year retrospective cohort study was conducted in a tertiary hospital in Arad, Romania, and included 1329 newly diagnosed colorectal cancer patients. For statistical analysis, Fisher's exact test was used for categorical data and the unpaired test with Welch's correction for continuous data. The age on diagnosis decreased during the early COVID-19 pandemic to 68.50 (95% CI [67.90 69.11]) years, with the highest percentage (7.41%) of early onset colorectal cancer patients, a steady post-pandemic increase in the percentage of male (52.71% in 2019 to 62.20% in 2022) and urban (54.18% in 2018 to 70.10% in 2022) patients, admitted to the hospital due to an emergency presentation (peaking at 83.95% in 2020) and requiring a longer hospitalization period (10.03 [95% CI (8.76-11.30)] days in 2020 to 8.37 [95% CI (7.44-9.30)] days in 2022). The most common colo-rectal cancer diagnosis of patients in our reference population was malignant neoplasm of the rectum (ICD-10 code C20.0), while the most common complications were peritumoral adherence-related disorder, occlusion, and perforation, encountered in patients with comorbidities such as arterial hypertension, ischemic cardiomyopathy, diabetes mellitus, obesity, and non-alcoholic steatohepatitis. Regional particularities should be analyzed to better target the population at risk and to better direct the necessary healthcare resources towards the reference population, especially during crisis periods similar to the COVID-19 pandemic.
结直肠癌是全球发病率第三、死亡率第二的癌症，是最常见的消化道恶性肿瘤。在罗马尼亚，它是最常被诊断出的癌症类型（每年约占人口的0.06%）。在新冠疫情期间，防止严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒传播的立法影响了门诊医疗服务的可及性，再加上患者对SARS-CoV-2感染的恐惧，对所有其他疾病的诊断和治疗都产生了影响。在罗马尼亚阿拉德的一家三级医院进行了一项为期5年的回顾性队列研究，纳入了1329例新诊断的结直肠癌患者。在统计分析中，分类数据采用Fisher精确检验，连续数据采用经韦尔奇校正的非配对检验。在新冠疫情早期，确诊时的年龄降至68.50（95%置信区间[67.90, 69.11]）岁，早期发病的结直肠癌患者比例最高（7.41%），疫情后男性患者比例稳步上升（从2019年的52.71%升至2022年的62.20%），城市患者比例也稳步上升（从2018年的54.18%升至2022年的70.10%），因急诊入院的患者比例（2020年达到峰值83.95%）以及住院时间更长（从2020年的10.03[95%置信区间(8.76 - 11.30)]天降至2022年的8.37[95%置信区间(7.44 - 9.30)]天）。我们参考人群中患者最常见的结直肠癌诊断是直肠恶性肿瘤（国际疾病分类第十版代码C20.0），而最常见并发症是肿瘤周围粘连相关疾病、梗阻和穿孔，这些并发症出现在患有动脉高血压、缺血性心肌病、糖尿病、肥胖症和非酒精性脂肪性肝炎等合并症的患者中。应分析地区特殊性，以便更好地针对高危人群，并更好地将必要的医疗资源导向参考人群，尤其是在类似于新冠疫情的危机时期。
