Clinical Epidemiology and Ageing

Effect of lockdown on digestive system cancer care amongst older patients during the first wave of COVID-19: The CADIGCOVAGE multicentre cohort study.

Aparicio T, Layese R, Hemery F, Tournigand C, Paillaud E, de Angelis N, Quero L, Ganne N, Prat F, Pachev A, Galula G, Benderra M-A, Canoui-Poitrine F Dig Liver Dis. 2022;54(1):10-18.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on cancer diagnosis and treatment. Most patients newly diagnosed with digestive system cancer are aged 65 and over.

METHODS: We performed a retrospective, observational, multicentre cohort study based on prospectively collected electronic health records. All adults aged 65 or over and having been newly treated for a digestive system cancer between January 2018 until August 2020 were enroled.

RESULTS: Data on 7882 patients were analysed. The first COVID-19 lockdown period led to a 42.4% decrease in newly treated digestive system cancers, and the post-lockdown period was associated with a 17% decrease. The decrease in newly treated digestive system cancer did not differ as a function of age, sex, comorbidities, primary tumour site, and disease stage. The proportion of patients admitted to an emergency department increased during the lockdown period. We do not observe a higher 3-month mortality rate in 2020, relative to the corresponding calendar periods in 2018 and 2019.

CONCLUSION: To avoid a decrease in newly treated cancers during future lockdown periods, access to healthcare will have to be modified. Although 3-month mortality did not increase in any of the patient subgroups, the 2020 cohort must be followed up for long-term mortality.

MeSH terms: Aged; Aged, 80 and over; Communicable Disease Control; COVID-19; Digestive System Neoplasms; Female; Health Services Accessibility; Humans; Male; Pandemics; Paris; Retrospective Studies; SARS-CoV-2
DOI: 10.1016/j.dld.2021.09.017