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Quality Improvement/Clinical Outcomes

E410: Shifts in Patterns of Care of Gastrointestinal Cancer At the Start of the Covid-19 Pandemic

Introduction: The COVID-19 pandemic resulted in unprecedented disruptions in global social, economic, and healthcare systems. An area of particular concern was the effect of potential delays in treatment for patients with non-COVID related illnesses during the early stages of the pandemic. The aim of this study was to understand the impact of the COVID-19 pandemic on the delivery of cancer care for gastrointestinal malignancies in the United States.

Methods: Patients diagnosed with gastric, pancreatic ductal, colon, and rectal adenocarcinoma in 2019 and 2020 were identified in the  National Cancer Database. Univariate and multivariate logistic regression analyses were performed assessing the likelihood of receiving definitive surgery for non-metastatic cancer.

Results:

 



210,615 patients were identified. Of these patients, 140,944 patients had non-metastatic gastric, pancreatic, colon, or rectal cancer at the time of diagnosis. Males represented 53.4% of the cohort. When compared to 2019, the odds of receiving definitive surgery in 2020 for non-metastatic gastric cancer was 0.91 (95% CI: 0.81-1.00), non-metastatic pancreas cancer was 0.93 (95% CI: 0.87-0.99), non-metastatic colon cancer was 0.86 (95% CI: 0.78-0.96), and non-metastatic rectal cancer was 0.81 (95% CI: 0.76-0.86) after adjusting for sex, race, ethnicity, age, socioeconomic status, insurance payor, facility type, facility location and stage of disease.


Conclusions: The Covid-19 pandemic potentially resulted in delays in cancer care the longterm effects of which are yet to be fully appreciated. In this analysis, we demonstrate a small but appreciable shift in the utilization of definitive surgery in the care of patients with non-metastatic gastrointestinal cancers.  Additional future investigations into the latter stages of the pandemic are warranted.

Learning Objectives:

  • describe the optimal therapy for gastrointestinal cancers
  • describe the effect of the covid-19 pandemic on health care delivery
  • discuss the use of non-therapeutic approach to gastrointestinal cancers