The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore
<i>Background and Objectives</i>: During the COVID-19 pandemic, many countries implemented lockdowns and social distancing measures, which may delay the early diagnosis of colorectal cancer (CRC). This study aims to review the impact of the pandemic on the diagnosis and treatment outcome...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/61/1/138 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832587978935894016 |
|---|---|
| author | Hui Lionel Raphael Chen Piea Peng Lee Yun Zhao Wei Hao Caleb Ng Jiashen Zhao Yu En Christopher Tan Bo Jie Sean Loh Kah-Hoe Pierce Chow Hiang Khoon Tan Kwong-Wei Emile Tan |
| author_facet | Hui Lionel Raphael Chen Piea Peng Lee Yun Zhao Wei Hao Caleb Ng Jiashen Zhao Yu En Christopher Tan Bo Jie Sean Loh Kah-Hoe Pierce Chow Hiang Khoon Tan Kwong-Wei Emile Tan |
| author_sort | Hui Lionel Raphael Chen |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: During the COVID-19 pandemic, many countries implemented lockdowns and social distancing measures, which may delay the early diagnosis of colorectal cancer (CRC). This study aims to review the impact of the pandemic on the diagnosis and treatment outcomes of CRC. <i>Materials and Methods</i>: Patients who underwent colonoscopy or surgery for CRC were included. The study was divided into the pre-COVID-19 (January 2019–January 2020), early COVID-19 (February–May 2020), recovery (June–December 2020), and heightened alert (January–December 2021) periods. Cox regression was used to model the waiting time to colonoscopy. Multivariable logistic regression identified associations between time periods and incidence of CRC diagnosed. The characteristics and outcomes of the surgical procedures that were performed were compared across the time periods. <i>Results</i>: A total of 18,662 colonoscopies and 1462 surgical procedures were performed in the study period. Compared to the pre-COVID-19 period, there was a longer time to colonoscopy during the recovery (HR: 0.91; 95% CI: 0.87, 0.94) and heightened alert periods (HR: 0.88; 95% CI 0.85, 0.91). The early COVID-19 (OR: 1.36; 95% CI: 1.04, 1.77) and recovery (OR: 1.20; 95% CI: 1.01, 1.43) periods were associated with higher odds of diagnosing CRC. Compared to the pre-COVID-19 period, there was a higher proportion of ASA 4 patients (4.3% vs. 1.3%; <i>p</i> < 0.001) and stage 4 CRC patients (22.2% vs. 16.9%; <i>p</i> = 0.001) that required surgery during the heightened alert period. Similarly, there was a higher proportion of emergency surgeries (22% vs. 13.3%; <i>p</i> = 0.002); diverting stomas (13.5% vs. 10.5%; <i>p</i> = 0.005), and Hartmann’s procedures (4.4% vs. 0.4%; <i>p</i> = 0.001) performed during the heightened alert period. <i>Conclusions</i>: The pandemic was associated with a higher proportion of metastatic CRC patients requiring surgery. Healthcare policies should facilitate early cancer screening, diagnosis, and treatment to reduce cancer-related morbidity for future pandemics. |
| format | Article |
| id | doaj-art-2ac68cac369c472ca41290a95f75b2c9 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-2ac68cac369c472ca41290a95f75b2c92025-01-24T13:40:48ZengMDPI AGMedicina1010-660X1648-91442025-01-0161113810.3390/medicina61010138The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in SingaporeHui Lionel Raphael Chen0Piea Peng Lee1Yun Zhao2Wei Hao Caleb Ng3Jiashen Zhao4Yu En Christopher Tan5Bo Jie Sean Loh6Kah-Hoe Pierce Chow7Hiang Khoon Tan8Kwong-Wei Emile Tan9Department of Colorectal Surgery, Singapore General Hospital, Singapore 169608, SingaporeDivision of Surgery & Surgical Oncology, National Cancer Centre Singapore, Singapore 168583, SingaporeDepartment of Colorectal Surgery, Singapore General Hospital, Singapore 169608, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeDuke-NUS Medical School, Singapore 169857, SingaporeDuke-NUS Medical School, Singapore 169857, SingaporeDepartment of Colorectal Surgery, Singapore General Hospital, Singapore 169608, Singapore<i>Background and Objectives</i>: During the COVID-19 pandemic, many countries implemented lockdowns and social distancing measures, which may delay the early diagnosis of colorectal cancer (CRC). This study aims to review the impact of the pandemic on the diagnosis and treatment outcomes of CRC. <i>Materials and Methods</i>: Patients who underwent colonoscopy or surgery for CRC were included. The study was divided into the pre-COVID-19 (January 2019–January 2020), early COVID-19 (February–May 2020), recovery (June–December 2020), and heightened alert (January–December 2021) periods. Cox regression was used to model the waiting time to colonoscopy. Multivariable logistic regression identified associations between time periods and incidence of CRC diagnosed. The characteristics and outcomes of the surgical procedures that were performed were compared across the time periods. <i>Results</i>: A total of 18,662 colonoscopies and 1462 surgical procedures were performed in the study period. Compared to the pre-COVID-19 period, there was a longer time to colonoscopy during the recovery (HR: 0.91; 95% CI: 0.87, 0.94) and heightened alert periods (HR: 0.88; 95% CI 0.85, 0.91). The early COVID-19 (OR: 1.36; 95% CI: 1.04, 1.77) and recovery (OR: 1.20; 95% CI: 1.01, 1.43) periods were associated with higher odds of diagnosing CRC. Compared to the pre-COVID-19 period, there was a higher proportion of ASA 4 patients (4.3% vs. 1.3%; <i>p</i> < 0.001) and stage 4 CRC patients (22.2% vs. 16.9%; <i>p</i> = 0.001) that required surgery during the heightened alert period. Similarly, there was a higher proportion of emergency surgeries (22% vs. 13.3%; <i>p</i> = 0.002); diverting stomas (13.5% vs. 10.5%; <i>p</i> = 0.005), and Hartmann’s procedures (4.4% vs. 0.4%; <i>p</i> = 0.001) performed during the heightened alert period. <i>Conclusions</i>: The pandemic was associated with a higher proportion of metastatic CRC patients requiring surgery. Healthcare policies should facilitate early cancer screening, diagnosis, and treatment to reduce cancer-related morbidity for future pandemics.https://www.mdpi.com/1648-9144/61/1/138COVID-19 pandemiccolorectal cancercolonoscopyoutcomessurgery |
| spellingShingle | Hui Lionel Raphael Chen Piea Peng Lee Yun Zhao Wei Hao Caleb Ng Jiashen Zhao Yu En Christopher Tan Bo Jie Sean Loh Kah-Hoe Pierce Chow Hiang Khoon Tan Kwong-Wei Emile Tan The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore Medicina COVID-19 pandemic colorectal cancer colonoscopy outcomes surgery |
| title | The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore |
| title_full | The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore |
| title_fullStr | The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore |
| title_full_unstemmed | The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore |
| title_short | The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore |
| title_sort | impact of covid 19 pandemic on the diagnosis treatment and outcomes of colorectal cancer in singapore |
| topic | COVID-19 pandemic colorectal cancer colonoscopy outcomes surgery |
| url | https://www.mdpi.com/1648-9144/61/1/138 |
| work_keys_str_mv | AT huilionelraphaelchen theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT pieapenglee theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT yunzhao theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT weihaocalebng theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT jiashenzhao theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT yuenchristophertan theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT bojieseanloh theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT kahhoepiercechow theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT hiangkhoontan theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT kwongweiemiletan theimpactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT huilionelraphaelchen impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT pieapenglee impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT yunzhao impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT weihaocalebng impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT jiashenzhao impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT yuenchristophertan impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT bojieseanloh impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT kahhoepiercechow impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT hiangkhoontan impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore AT kwongweiemiletan impactofcovid19pandemiconthediagnosistreatmentandoutcomesofcolorectalcancerinsingapore |