1. Causes and impact of delays during the COVID-19 pandemic on head and neck cancer diagnosis.
- Author
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Gete M, Huang SH, Ringash J, Irish J, Su J, Ballal Y, Waldron JN, Witterick I, de Almeida J, Hosni A, Hope AJ, Monteiro E, Cho J, O'Sullivan B, Kim J, Bratman S, Goldstein DP, McPartlin A, Tsai J, Tong L, Xu W, and Hahn E
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Pandemics, Time-to-Treatment statistics & numerical data, Cohort Studies, Retrospective Studies, SARS-CoV-2, COVID-19 epidemiology, Head and Neck Neoplasms diagnosis, Head and Neck Neoplasms epidemiology, Head and Neck Neoplasms therapy, Delayed Diagnosis statistics & numerical data, Neoplasm Staging
- Abstract
Background: The causes for delays during the COVID19 pandemic and their impact on head and neck cancer (HNC) diagnosis and staging are not well described., Methods: Two cohorts were defined a priori for review and analysis-a Pre-Pandemic cohort (June 1 to December 31, 2019) and a Pandemic cohort (June 1 to December 31, 2020). Delays were categorized as COVID-19 related or not, and as clinician, patient, or policy related., Results: A total of 638 HNC patients were identified including 327 in the Pre-Pandemic Cohort and 311 in the Pandemic Cohort. Patients in the Pandemic cohort had more N2-N3 category (41% vs. 33%, p = 0.03), T3-T4 category (63% vs. 50%, p = 0.002), and stage III-IV (71% vs. 58%, p < 0.001) disease. Several intervals in the diagnosis to treatment pathway were significantly longer in the pandemic cohort as compared to the Pre-Pandemic cohort. Among the pandemic cohort, 146 (47%) experienced a delay, with 112 related to the COVID-19 pandemic; 80 (71%) were clinician related, 15 (13%) were patient related, and 17 (15%) were policy related., Conclusions: Patients in the Pandemic cohort had higher stage disease at diagnosis and longer intervals along the diagnostic pathway, with COVID-19 related clinician factors being the most common cause of delay., (© 2024 The Authors. Head & Neck published by Wiley Periodicals LLC.)
- Published
- 2024
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