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Colorectal

Colorectal Poster Presentations 2

P15: Impact of the COVID-19 pandemic on colorectal cancer stage at presentation

Saturday, March 23, 2024
8:17am – 8:23am ET
Location: C110
Introduction: The primary study objective was to assess the impact of COVID-19 on the stage at presentation for patients with newly diagnosed colorectal cancer treated within a large cancer center network. Additionally, we aimed to evaluate differences in pathologic stage and treatment modality for patients diagnosed with colorectal cancer both immediately before and during the height of the COVID-19 pandemic.


Methods: A retrospective analysis was performed on all subjects newly diagnosed with colorectal cancer between January 2019 and April 2021. Patients had a primary diagnosis of adenocarcinoma of the colon, rectum, or appendix. Patients were categorized into two cohorts based on date of diagnosis, with the pre-COVID-19 group diagnosed between January 2019 and February 2020 and the COVID-19 group diagnosed between March 2020 and April 2021. Chi-squared tests were used to evaluate the association between COVID-19 group and stage at presentation as well as pathologic stage.


Results: A total of 1,190 patients were diagnosed with colorectal cancer within the study timeframe. Of the 613 patients diagnosed pre-COVID-19, 159 (25.9%) had metastatic disease at initial presentation. Comparatively, 577 patients were diagnosed during the COVID-19 study period, with 143 (24.8%) presenting with metastatic disease (p = 0.65). Of the 888 patients who presented with non-metastatic disease, 454 presented pre-COVID-19 and 434 presented during COVID-19.  Surgery was performed on 396 (87.2%) pre-COVID-19 and 374 (86.2%) during COVID-19 (p = 0.65). Likewise, no significant difference was observed for T-classification, N-classification, or overall pathologic stage among patients undergoing surgical resection between the pre-COVID-19 and COVID-19 groups (p = 0.20; Table). Furthermore, amongst patients who presented with non-metastatic disease, chemotherapy was utilized for 200 (44.1%) patients diagnosed pre-COVID-19 and 190 (43.8%) patients diagnosed during COVID-19 (p = 0.93). 


Conclusions: We did not observe a significant difference in the proportion of patients presenting with metastatic colorectal cancer during COVID-19 versus those presenting pre-COVID-19. Furthermore, there was no significant difference observed among non-metastatic patients between the two groups for rates of initial surgical resection, pathologic stage, and treatment with chemotherapy.

Learning Objectives:

  • Upon completion, participants will be able to describe the rates of stage IV colorectal cancer at presentation in pre-COVID-19 and COVID-19 cohorts
  • Upon completion, participants will be able to describe differences in pathologic stage among patients undergoing surgical resection of colorectal cancer between the pre-COVID-19 and COVID-19 groups.
  • Upon completion, participants will be able to describe differences in rates of chemotherapy utilization in patients who presented with non-metastatic disease in pre-COVID-19 and COVID-19 cohorts.