The Impact of the Pandemic on the Quality of Colorectal and Anal Cancer Care, and 2-Year Clinical Outcomes

Author:

Powis Melanie12ORCID,Sutradhar Rinku13,Singh Simron145,Alibhai Shabbir156ORCID,Hack Saidah2,Baiad Abed7,Chen Kevin5,Li Huaqi5,Mohmand Zuhal5,Krzyzanowska Monika K.12356ORCID

Affiliation:

1. Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada

2. Cancer Quality Laboratory (CQuaL), Princess Margaret Cancer Centre, Toronto, ON M5G 1X6, Canada

3. Institute for Clinical Evaluative Sciences (ICES), Toronto, ON M4N 3M5, Canada

4. Division of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada

5. Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada

6. Department of Medicine, University Health Network, Toronto, ON M5G 2C4, Canada

7. Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada

Abstract

We undertook a retrospective study to compare the quality of care delivered to a cohort of newly diagnosed adults with colon, rectal or anal cancer during the early phase of COVID-19 (02/20–12/20) relative to the same period in the year prior (the comparator cohort), and examine the impact of the pandemic on 2-year disease progression and all-cause mortality. We observed poorer performance on a number of quality measures, such as approximately three times as many patients in the COVID-19 cohort experienced 30-day post-surgical readmission (10.5% vs. 3.6%; SD:0.27). Despite these differences, we observed no statistically significant adjusted associations between COVID-19 and time to either all-cause mortality (HR: 0.88, 95% CI: 0.61–1.27, p = 0.50) or disease progression (HR: 1.16, 95% CI: 0.82–1.64, p = 0.41). However, there was a substantial reduction in new patient consults during the early phase of COVID-19 (12.2% decrease), which appeared to disproportionally impact patients who traditionally experience sociodemographic disparities in access to care, given that the COVID-19 cohort skewed younger and there were fewer patients from neighborhoods with the highest Housing and Dwelling, ands Age and Labour Force marginalization quintiles. Future work is needed to understand the more downstream effects of COVID-19 related changes on cancer care to inform planning for future disruptions in care.

Funder

Canadian Institute for Health Research

Princess Margaret Cancer Centre Foundation

Publisher

MDPI AG

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