• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Have Stage IV Breast Cancer Diagnoses Increased During the COVID-19 Pandemic?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE: 

  • The COVID-19 pandemic has disrupted cancer screening programs, such as mammograms and colonoscopies, and this may have led to an increase in late-stage cancer diagnoses during the pandemic 
  • Zhou et al. (JAMA Network Open, 2022) compared the incidence of early- and late-stage breast and colorectal cancer diagnoses during vs before the COVID-19 pandemic  

METHODS: 

  • Quality improvement study  
  • Participants 
    • All patients presenting to a cancer center for a new diagnosis of malignant neoplasm or a second opinion  
  • Exposures 
    • Presentation in 2019 
    • Presentation in 2020 
  • Study design 
    • Fisher exact test used to compare the proportions of stage I or stage IV of cancers between 2019 and 2020 
  • Primary outcome 
    • Stage distribution at presentation for  
      • Cancer overall 
      • Colorectal cancer 
      • Breast cancer 

RESULTS: 

  • Men: 55 | Women: 476  
    • Mean age: 58.1 (SD, 13.5) years 
  • The total number of new patient visits for malignant neoplasm was similar in 2019 and 2020 
    • In 2019: 1894 visits 
    • In 2020: 1915 visits 

Overall Cancer  

  • The overall stage distribution for all patients with cancer was similar 
    • Stage I  
      • In 2019: 31.9% of patients 
      • In 2020: 29.0% of patients 
      • OR 1.15 (95% CI, 1.00 to 1.32); P=0.05 
    • Stage IV 
      • In 2019: 26.0% of patients 
      • In 2020: 26.4% of patients 
      • OR 0.98 (95% CI, 0.84 to 1.13); P=0.77 

Colorectal Cancer  

  • After the start of the COVID-19 pandemic, there was no significant decrease in colorectal cancer  
    • Stage I 
      • In 2019: 17.8% 
      • In 2020: 14.6% 
      • OR 1.26 (95% CI, 0.34 to 4.88); P=0.78 
    • Stage IV 
      • In 2019: 6.7% 
      • In 2020: 19.5%  
      • OR 0.3 (95% CI, 0.05 to 1.37); P=0.11 

Breast Cancer  

  • Among patients with breast cancer, a lower percentage of patients presented with stage I disease in 2019 vs 2020 
    • In 2019: 63.9% 
    • In 2020: 51.3% 
    • OR 1.67 (95% CI, 1.13 to 2.47); P=0.008 
  • There was a significantly higher number of patients presenting with stage IV breast cancer in 2020 
    • In 2019: 1.9% 
    • In 2020: 6.2% 
    • OR 0.33 (95% CI, 0.09 to 0.98); P=0.04 
  • Recent data for January through March 2021 demonstrate a continuing trend of a lower percentage of patients with breast cancer presenting with stage I disease and a higher percentage presenting with stage IV disease 
    • Stage I: 41.9% 
    • Stage IV: 8.0% 

CONCLUSION: 

  • The percentage of patients presenting with stage IV breast cancer increased in 2020, compared to before the COVID-19 pandemic 
  • Limitations include a single center study | Study design addresses associations but not causality | Colorectal cancer cases were limited 
  • The authors state 

There is increasing concern regarding the effect of the COVID-19 pandemic on cancer mortality, as the evidence suggests that the number of patients presenting at late, incurable stages is increasing. Patients who have delayed preventative care during the pandemic should be encouraged to resume treatment as soon as possible 

Learn More – Primary Sources: 

Comparison of Early- and Late-Stage Breast and Colorectal Cancer Diagnoses During vs Before the COVID-19 Pandemic 

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Has the Pandemic Impacted Cervical Cancer Diagnoses?
More from the WHI: Are Breast Cancers That Develop Between Mammograms Associated with Worse Survival Outcomes?
RCT Results; Does Clinical Breast Examination Lead to Earlier Breast Cancer Diagnoses in Low- and Middle-Income Countries?
How Effective Is Mammography in Reducing the Number of Advanced Breast Cancer Diagnoses?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site