COVID-19 impact on diagnosis and staging of colorectal cancer: A single tertiary Canadian oncology center experience.
Notice bibliographique
Résumé
33 Background: COVID-19 pandemic urged public health to imposed drastic reduction on endoscopic activities and surgery, leading to delays that still not have been caught up today. The Ministry of Health and Social Services (MSSS) of Quebec conducted a study of the impact of those measures and reported a 66% reduction of colonoscopy and a 30% reduction of colorectal cancer (CRC) surgery activities during the first wave (March to May 2020). Whether those reduction had an impact on diagnosis and staging of CRC remains unknown. Methods: Demographic information of CRC diagnosed at Centre Hospitalier de l’Université de Montréal (CHUM) between January 1 2018 and March 12 2020 (pre-pandemic period), and March 13 2020 and June 30 2021 (pandemic period) were obtained from the SARDO registry and data regarding colonoscopy, surgery and staging at diagnosis (clinical or pathological as appropriate) were collected. Priority of elective colonoscopy was defined using the MSSS grading system ranging from P1 to P5. We compared delays to colonoscopy, delays to surgery and CRC staging of the pandemic period to the pre-pandemic period using one-way ANOVA, t tests and Chi-square tests as appropriate. Only delays in elective surgeries intended as first and curative treatment were analyzed. Results: 280 CRC diagnosis were made at the pre-pandemic period compared to 127 CRC diagnosis during the pandemic period. Mean diagnosis rates of the pandemic period tend to be lower (8.3 vs. 10.5 diagnosis/month, p=0.03) compared to the pre-pandemic period. 37.6% of patient in the pandemic period had a diagnosis of CRC during a hospitalization compared to 25.9% at the pre-pandemic period (p=0.048). 51.7% of elective colonoscopy leading to a diagnostic of CRC during the pandemic period did not meet required delays according to priority compared to 38.3% (p=0.049) during the pre-pandemic period. P3 colonoscopies (mostly indicated for a positive FIT and iron deficiency anemia) were the most affected (58.9 vs. 106.5 days, p˂0.001). P2 colonoscopy (indicated for suspected colorectal cancer) did not experienced an augmentation in delays (20.9 vs. 25.2 days, p=0.39). A mean of 3.5 elective curative surgeries per month were performed during the pandemic period compared to 3.4 at the pre-pandemic period (p=0.96), and mean delays for surgery were not affected (60.4 vs. 57 days, p=0.59). Stages at diagnosis did not differ (p=0.2). Most of the delayed colonoscopies led to a stage 0 or I CRC and did not lead to a higher stage at diagnosis (p=0.2). Conclusions: In our center, the COVID-19 pandemic led to overall less CRC diagnosis and increased diagnostic endoscopic delays without a higher rate of advanced stage disease. Delays for elective surgeries were quite similar once the CRC diagnostic established.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,004 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».