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e23152 Background: The COVID-19 pandemic heavily impacted healthcare services, including cancer diagnostics and surgical management. This study aims to analyze the effects of COVID-19 on mean Time to Treatment Initiation (TTI) for breast, colon, non-small cell lung (NSCLC), and prostate cancers. Methods: Retrospective cohort study analyzing changes in mean TTI for breast, prostate, NSCLC, and colon cancer at an academic medical center from January 2018 to December 2022. “Pre-COVID” was defined as Jan 2018 – Mar 2020; “COVID” as Mar 2020 - Feb 2021; and “Post-COVID” from Mar 2021 - Dec 2022. ANOVA, chi-square, or Fisher’s exact tests were used to test for differences over the periods. Results: The cohort comprised 2014 breast, 501 colon, 1443 NSCLC, and 1355 prostate cancers. The characteristics of the study population are described in Table 1. The “clinical Stage at diagnosis 0 to 3C” was over 98% for breast among all the analyzed periods; for the colon, it decreased from 34% to 14%, while for the lung, it increased from 66% to 73%, and prostate increased from 88% to 97%. TTI was 35, 32, and 37 days (p < 0.01) for breast in the pre-COVID, COVID, and post-COVID periods, respectively. For colon, TTI was 26, 24, and 35 days in the three analyzed periods (p = 0.04), while NSCLC was 42, 46, and 50 days (p < 0.01), and prostate was 67, 57, and 64 days (p = 0.09). Conclusions: TTI was affected by COVID-19, and its effects varied according to the type of cancer. While for breast and prostate, TTI seems to be back to pre-covid period. For colon and NSCLC, the TTI is higher in the post-COVID phase. Further research to quantify the impact of delay is warranted. Table: see text
Markel et al. (Sat,) studied this question.