This retrospective cohort study compared the number of newly diagnosed patients, stage at diagnosis, and detection process of gastrointestinal cancers based on hospital-based cancer registry data at two tertiary Japanese hospitals. The pre-COVID-19 period was from January 2017 to February 2020, with phase 1 (midst of COVID-19 pandemic) from March to December 2020 and phase 2 (the transition period to the “new normal”) from January to December 2021. Each month, the number of patients diagnosed with esophageal, gastric, colorectal, pancreatic, liver, and biliary tract cancers were aggregated, classified by stage and detection process, and compared, including a total of 6453 patients. The number of colorectal Stage 0-II patients decreased significantly in phase 1 and increased in phase 2. The total number of colorectal cancer patients returned to pre-COVID-19 levels (mean monthly patients [SD]: 41.61 [6.81] vs. 36.00 [6.72] vs. 46.00 [11.32]). The number of patients with gastric cancer Stage I significantly decreased in phase 2 following phase 1. The number of gastric cancer patients decreased significantly from pre-COVID-19 levels (30.63 [6.62] vs. 22.40 [5.85] vs. 24.50 [4.15]). During phase 2, the number of patients diagnosed after screening with colorectal cancer increased significantly, whereas that with gastric cancer remained considerably lower. The number of Stage III colorectal and gastric cancer patients increased significantly from the pre-COVID-19 levels. Thus, gastric cancer may not be optimally screened during phases 1 and 2. There was a significant increase in patients with Stage III colorectal and gastric cancers from the pre-COVID-19 period; hence, the stage at diagnosis may have progressed.
本回顾性队列研究基于日本两家三级医院基于医院癌症登记数据，比较了胃肠道癌症新诊断患者数量、诊断分期及检出过程。COVID-19疫情前时期为2017年1月至2020年2月，第一阶段（COVID-19大流行中期）为2020年3月至12月，第二阶段（向“新常态”过渡期）为2021年1月至12月。每月对食管癌、胃癌、结直肠癌、胰腺癌、肝癌及胆道癌的确诊患者数量进行汇总，按分期和检出过程分类后进行比较，共纳入6453例患者。结直肠癌0-II期患者数量在第一阶段显著减少，在第二阶段有所增加。结直肠癌患者总数恢复至疫情前水平（月均患者数[标准差]：41.61[6.81] vs. 36.00[6.72] vs. 46.00[11.32]）。胃癌I期患者数量在第一阶段后的第二阶段显著减少。胃癌患者数量较疫情前水平显著下降（30.63[6.62] vs. 22.40[5.85] vs. 24.50[4.15]）。第二阶段中，经筛查确诊的结直肠癌患者数量显著增加，而胃癌患者数量仍维持在较低水平。结直肠癌和胃癌III期患者数量较疫情前水平显著增加。因此，在第一阶段和第二阶段期间，胃癌筛查可能未达到最优水平。与疫情前相比，结直肠癌和胃癌III期患者显著增加，表明诊断分期可能出现了进展。
肿瘤(癌症)患者之家