Impact Of The COVID-19 Pandemic on Time To Treatment Initiation For Colorectal Cancer In Japan

Abstract

Abstract Purpose This retrospective study aims to evaluate potential differences of diagnosis and treatment of colorectal cancer between the two years before and after the onset of the COVID-19 pandemic. Methods Retrospectively enrolled in this study were consecutive patients with colorectal cancer who underwent surgery at our institution between April 2018 and March 2022 (Trial registration number: UMIN000051148 on May 23, 2023). Clinicodemographic data and short-term postoperative outcomes were collected for statistical analysis. Results This study included 383 patients (203 patients before the pandemic, 180 patients during the pandemic). During the pandemic, the time between initial symptoms and referral was 2 months or less in significantly fewer patients than before the pandemic. Patients who required at least 2 months to initial referral were significantly associated with the COVID-19 pandemic (OR 2.89, 95%CI 1.70–4.93, P˂ 0.001) and absence of fecal occult blood testing (OR 2.44, 95%CI 1.32–4.52, P = 0.005) in multivariate analysis. Conclusions This study demonstrated short-term outcomes of colorectal cancer surgery and risk factors of delay from initial symptoms to referral during the first two years of the COVID-19 pandemic. Specific risk stratification and guidance are recommended in the event of future pandemics to prevent poorer oncological outcomes in patients with colorectal cancer.