The impact of the COVID-19 pandemic on colorectal and gastric cancer diagnosis, disease stage and mortality

Naim Abu-Freha; Reut Hizkiya; Muhammad Abu-Abed; Tal Michael; Binil Mathew Jacob; Keren Rouvinov; Doron Schwartz; Avraham Reshef; Uri Netz; Ilia Pinsk; Ohad Etzion

doi:10.3389/fmed.2022.954878

The impact of the COVID-19 pandemic on colorectal and gastric cancer diagnosis, disease stage and mortality

Front Med (Lausanne). 2022 Sep 26:9:954878. doi: 10.3389/fmed.2022.954878. eCollection 2022.

Authors

Naim Abu-Freha^{1

2}, Reut Hizkiya^{2

3}, Muhammad Abu-Abed^{2

3}, Tal Michael⁴, Binil Mathew Jacob⁵, Keren Rouvinov^{2

6}, Doron Schwartz^{1

2}, Avraham Reshef^{2

7}, Uri Netz^{2

7}, Ilia Pinsk^{2

7}, Ohad Etzion^{1

2}

Affiliations

¹ The Institute of Gastroenterology and Liver Diseases, Soroka University Medical Center, Beer Sheva, Israel.
² Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
³ Internal Medicine Division, Soroka University Medical Center, Beer Sheva, Israel.
⁴ Department of Public Health, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
⁵ Medical School for International Health, Ben-Gurion University of the Negev, Beer Sheva, Israel.
⁶ The Legacy Heritage Oncology Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva, Israel.
⁷ Department of Surgery, Soroka University Medical Center, Beer Sheva, Israel.

Abstract

Background: Since the outbreak of COVID-19, a significant decline in endoscopic procedures has been observed.

Aims: We investigated the change of incidence, clinical characteristics, disease stage and mortality of patients with gastric cancer (GC) or colorectal cancer (CRC) diagnosed in 2020 compared to the pre-pandemic year 2019.

Methods: Demographic, clinical and laboratory data on all patients diagnosed with GC or CRC at the Soroka University Medical Center were retrospectively collected and compared. Number of cases, time of diagnosis, clinical presentation, staging at diagnosis and mortality rates were compared.

Results: Two hundred sixteen patients were diagnosed with CRC in 2019, whereas only 162 were diagnosed in 2020 (25% reduction), while 36 GC diagnoses were made in 2019 compared to 24 in 2020 (33% reduction). The age-adjusted incidence was calculated to be 24.28 for CRC and 5.0 for GC in 2020 compared to 29.93 and 5.32 in 2019, respectively. CRC patients had a significantly lower rate of rectal bleeding as their presenting symptom in 2020 compared with 2019, 8.1 vs. 19% (p = 0.003), but higher rate of diarrhea as their presenting symptom, 4.3 vs. 1% (p = 0.044). No significant differences regarding other presenting symptoms, comorbidities, surgery or mortality rates were found between the groups diagnosed in 2019 or 2020.

Conclusion: A decrease in GC and CRC incidence was observed during the year 2020; lower rate of rectal bleeding and higher rate of diarrhea as presenting symptoms were noted in 2020, but no significant difference was found regarding other presenting symptoms, disease stage, surgery or mortality.

Keywords: COVID-19; cancer; colon cancer; disease stage; gastric cancer.