Measuring the impact of the COVID-19 pandemic on colorectal cancer presentation: a retrospective comparative study.

Abstract

The Coronavirus disease 2019 (COVID-19) pandemic provided challenges to surgical care in Australia. This study aimed to measure the potential impact of COVID-19 on colorectal cancer presentation through surgical volume and cancer staging at a major tertiary referral hospital in the city of Sydney Australia. A retrospective cohort study was performed using routinely collected data from consecutive colorectal cancer patients undergoing surgery during the COVID-19 period (1 March 2020 to 1 October 2021) and compared with the pre-COVID-19 period (1 March 2018 to 1 October 2019). The main outcomes included patient demographics, surgical volume (including overall, elective and emergency) and cancer staging. Differences in outcomes between the two studied periods were compared using Pearson's chi-squared test, Fisher test or t-test. A total of 381 patients composed the COVID-19 group (Mean age = 62.4 years) and 364 patients composed the pre-COVID-19 group (Mean age = 65.6 years; P<0.001). No significant differences were observed for overall, elective or emergency surgical volumes. Patients in the COVID-19 group had a reduction in Stage I and an increase in Stage II and III disease, with Stage IV and recurrent disease being similar with a variation of <1% when compared to the pre-COVID-19 group (P<0.001). Disruptions in patient screening, diagnosis and management from elective surgery restrictions and patient hesitancy may not have resulted in observed changes to surgical volume, however, it may have contributed to an increase in Stages II and III colorectal cancer during COVID-19.