학술논문
Cancer Patients First Treated with Chemotherapy: Are They More Likely to Receive Surgery in the Pandemic?
Document Type
Article
Author
Fu, Rui; Sutradhar, Rinku; Dare, Anna; Li, Qing; Hanna, Timothy P.; Chan, Kelvin K. W.; Irish, Jonathan C.; Coburn, Natalie; Hallet, Julie; Singh, Simron; Parmar, Ambica; Earle, Craig C.; Lapointe-Shaw, Lauren; Krzyzanowska, Monika K.; Finelli, Antonio; Louie, Alexander V.; Witterick, Ian J.; Mahar, Alyson; Urbach, David R.; McIsaac, Daniel I.
Source
Subject
*COVID-19 pandemic
*CANCER treatment
*CANCER chemotherapy
*SURGERY
*HEALTH equity
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Language
ISSN
1198-0052
Abstract
Due to the ramping down of cancer surgery in early pandemic, many newly diagnosed patients received other treatments first. We aimed to quantify the pandemic-related shift in rate of surgery following chemotherapy. This is a retrospective population-based cohort study involving adults diagnosed with cancer between 3 January 2016 and 7 November 2020 in Ontario, Canada who received chemotherapy as first treatment within 6-months of diagnosis. Competing-risks regression models with interaction effects were used to quantify the association between COVID-19 period (receiving a cancer diagnosis before or on/after 15 March 2020) and receipt of surgical reSection 9-months after first chemotherapy. Among 51,653 patients, 8.5% (n = 19,558) of them ultimately underwent surgery 9-months after chemotherapy initiation. Receipt of surgery was higher during the pandemic than before (sHR 1.07, 95% CI 1.02–1.13). Material deprivation was independently associated with lower receipt of surgery (least vs. most deprived quintile: sHR 1.11, 95% CI 1.04–1.17), but did not change with the pandemic. The surgical rate increase was most pronounced for breast cancer (sHR 1.13, 95% CI 1.06–1.20). These pandemic-related shifts in cancer treatment requires further evaluations to understand the long-term consequences. Persistent material deprivation-related inequity in cancer surgical access needs to be addressed. [ABSTRACT FROM AUTHOR]