1179 Analysis of the Staging of Colorectal Cancer Before and During the COVID-19 Pandemic in a UK District General Hospital
S Hussain, S Adhya, M Andelic, R Callan, A Shamardal, S Zaidi- Surgery
Abstract
Aim
The COVID-19 pandemic has had significant implications for delays in diagnosis and treatment of colorectal cancer. We set out to investigate the impact of the COVID-19 pandemic on the stage of colorectal cancer in operatively managed patients in our district general hospital in the United Kingdom.
Method
We retrospectively collected data for patients with colorectal cancer who underwent surgery pre-COVID-19 lockdown in the UK (January 1st, 2019 – March 22rd 2020) and compared with those who underwent surgery during the COVID-19 pandemic (March 23rd 2020 to January 2021). Pre-operative and post-operative TNM classification were assessed.
Results
318 patients underwent surgery for colorectal cancer from January 1st, 2019, to 31st January 2021: 136 in 2019, 90 in 2020, and 92 in 2021. There was a rise in proportion of T4 cancers during the COVID-19 pandemic (27%) vs pre-pandemic levels (15.7%). There was an increase in nodal positivity, with 42% of patients presenting with N1/N2 disease during the COVID-19 pandemic, compared to 38.8% in pre-COVID-19. However, we did not see a change in metastatic disease during the Covid-19 pandemic - 91.3% of patients in 2019 had M0 classification, 94% in 2020, and 93.4% in 2021.
Conclusions
There was a large reduction in patients undergoing operative management for colorectal cancer since the start of the pandemic – this may be secondary to late presentations or delays in diagnosis. There is a need for continued research to establish the long-term impacts of the COVID-19 pandemic on the diagnosis and treatment of colorectal cancer.