Effect of lockdown on digestive system cancer care amongst older patients during the first wave of COVID-19: The CADIGCOVAGE multicentre cohort study

Dig Liver Dis. 2022 Jan;54(1):10-18. doi: 10.1016/j.dld.2021.09.017. Epub 2021 Oct 4.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on cancer diagnosis and treatment. Most patients newly diagnosed with digestive system cancer are aged 65 and over.

Methods: We performed a retrospective, observational, multicentre cohort study based on prospectively collected electronic health records. All adults aged 65 or over and having been newly treated for a digestive system cancer between January 2018 until August 2020 were enroled.

Results: Data on 7882 patients were analysed. The first COVID-19 lockdown period led to a 42.4% decrease in newly treated digestive system cancers, and the post-lockdown period was associated with a 17% decrease. The decrease in newly treated digestive system cancer did not differ as a function of age, sex, comorbidities, primary tumour site, and disease stage. The proportion of patients admitted to an emergency department increased during the lockdown period. We do not observe a higher 3-month mortality rate in 2020, relative to the corresponding calendar periods in 2018 and 2019.

Conclusion: To avoid a decrease in newly treated cancers during future lockdown periods, access to healthcare will have to be modified. Although 3-month mortality did not increase in any of the patient subgroups, the 2020 cohort must be followed up for long-term mortality.

Keywords: COVID-19; Digestive cancer; Lockdown; Older patients; Public health.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology*
  • Communicable Disease Control
  • Digestive System Neoplasms / epidemiology*
  • Digestive System Neoplasms / therapy*
  • Female
  • Health Services Accessibility*
  • Humans
  • Male
  • Pandemics
  • Paris / epidemiology
  • Retrospective Studies
  • SARS-CoV-2