Impact of the COVID-19 Pandemic on GI Cancer Staging: A Comparative Study of Regional Disparities Between Northern and Southeastern Brazil (2020-2025)
Rafaela Sumienski Girardi, Mariana e Silva, Juliana Vicente BoaventuraPURPOSE
This study analyzes the impact of COVID-19 on cancer staging at diagnosis in gastrointestinal neoplasms, comparing disparities between Brazil’s North and Southeast regions. It aims to investigate changes in early- and late-stage diagnoses and to evaluate the effects of the pandemic on diagnostic access and staging migration toward advanced disease.
METHODS
A descriptive and retrospective epidemiological study was conducted on the staging of gastrointestinal neoplasms at diagnosis in the North and Southeast regions of Brazil between 2020 and 2025. Data were extracted from the Department of Informatics of the Unified Health System, specifically from the “Oncology Panel” database. The analyzed variables included malignant gastrointestinal neoplasms stratified by stage and year of diagnosis.
RESULTS
In the North region, comparison between the pandemic period (2020-2022) and the post-pandemic period (2023-2025) demonstrated a 1.48% reduction in cases diagnosed at stages 0 to III, indicating a decrease in diagnoses with greater curative potential. In the Southeast region, this reduction reached 9.16%, representing a substantial decline in diagnoses at stages associated with better prognosis. Regarding stage IV disease, an increase of 1.77% was observed in the North region, while the Southeast showed a 9.16% increase between the two periods. Furthermore, stage IV cases represented 40.23% of cases with known stage information in the Southeast between 2023 and 2025, compared with 31.07% between 2020 and 2022.
CONCLUSION
The COVID-19 pandemic negatively affected the timely diagnosis of gastrointestinal neoplasms, contributing to staging migration toward advanced disease and increasing the proportion of stage IV diagnoses. These variations were more pronounced in the Southeast region. In contrast, the North region, which already presented elevated rates of late-stage diagnosis before the pandemic, demonstrated smaller variations over time. Additionally, incomplete staging information represents an important limitation for public health management, as it may underestimate the true burden of advanced disease.