International Journal of Environmental Research and Public Health

Editorial

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6 pages, 315 KiB

Open AccessEditorial

COVID-19 Pandemic: Impact on Cancer Patients

by Monika Rucinska and Sergiusz Nawrocki

Int. J. Environ. Res. Public Health 2022, 19(19), 12470; https://doi.org/10.3390/ijerph191912470 - 30 Sep 2022

Cited by 10 | Viewed by 1343

Abstract

In December 2019, there were first reports of an atypical pneumonia detected in Wuhan city, China [...] Full article

(This article belongs to the Special Issue COVID-19 Pandemic: Impact on Cancer Patients)

Research

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14 pages, 2433 KiB

Open AccessArticle

Breast and Colorectal Cancer Screening Utilization after Hurricane María and the COVID-19 Pandemic in Puerto Rico

by Vivian Colón-López, Héctor M. Contreras-Mora, Cynthia M. Pérez, Hérmilis Berríos-Ortiz, Carola T. Sánchez-Díaz, Orville M. Disdier, Nilda Ríos-Morales and Erick L. Suárez-Pérez

Int. J. Environ. Res. Public Health 2023, 20(19), 6870; https://doi.org/10.3390/ijerph20196870 - 1 Oct 2023

Viewed by 2062

Abstract

Puerto Rico (PR) has faced environmental and public health challenges that could have significantly affected cancer screening access. Using administrative claims data from PR’s Medicaid population, this study assessed trends in colorectal and breast cancer screening from 2016 to 2021, the impact of [...] Read more.

Puerto Rico (PR) has faced environmental and public health challenges that could have significantly affected cancer screening access. Using administrative claims data from PR’s Medicaid population, this study assessed trends in colorectal and breast cancer screening from 2016 to 2021, the impact of disasters in screening, and the absolute deficit in screening due to the pandemic. The monthly rates of claims were analyzed using Poisson regression. Significant reductions in breast and colorectal cancer screening utilization were observed. The colorectal cancer screening rate in 2017 was 77% lower a month after Hurricanes Irma and María [RR_adj: 0.23; 95% CI: 0.20, 0.25] compared to the same time period in 2016. Breast cancer screening dropped 50% in November 2017 compared to November 2016 [RR_adj: 0.50; 95% CI: 0.47, 0.54]. Prospectively, a recovery in utilization has been observed only for breast cancer screening. The results revealed that cancer screening utilization substantially declined after environmental disasters and the pandemic. These findings have potentially severe long-term implications for cancer health disparities and mortality in PR. Full article

(This article belongs to the Special Issue COVID-19 Pandemic: Impact on Cancer Patients)

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15 pages, 4080 KiB

Open AccessArticle

Estimating Excess Mortality Due to Prostate, Breast, and Uterus Cancer during the COVID-19 Pandemic in Peru: A Time Series Analysis

by Max Carlos Ramírez-Soto, Mariangel Salazar-Peña and Javier Vargas-Herrera

Int. J. Environ. Res. Public Health 2023, 20(6), 5156; https://doi.org/10.3390/ijerph20065156 - 15 Mar 2023

Cited by 1 | Viewed by 4402

Abstract

During the COVID-19 pandemic, most of the deaths in Peru were related to COVID-19; however, cancer deaths have also been exacerbated in the first months of the pandemic. Despite this, excess mortalities of prostate, breast, and uterus cancer are not available by age [...] Read more.

During the COVID-19 pandemic, most of the deaths in Peru were related to COVID-19; however, cancer deaths have also been exacerbated in the first months of the pandemic. Despite this, excess mortalities of prostate, breast, and uterus cancer are not available by age group and region from January to December 2020. Therefore, we estimated the excess deaths and excess death rates (per 100,000 habitants) due to prostate, breast, and uterus cancer in 25 Peruvian regions. We did a time series analysis. Prostate, breast, and uterus cancer death data for 25 Peruvian regions were retrieved during the COVID-19 pandemic in 2020, as well as data for up to 3 years prior (2017–2019) from the Sistema Informatico Nacional de Defunciones at the Ministry of Health of Peru. Deaths in 2020 were defined as observed deaths. The expected deaths (in 2020) were estimated using the average deaths over 3 preceding years (2017, 2018 and 2019). Excess mortality was calculated as the difference between observed mortality and expected mortality in 2020. We estimated that the number of excess deaths and the excess death rates due to prostate, breast, and uterus cancer were 610 deaths (55%; 12.8 deaths per 100,000 men), 443 deaths (43%; 6 deaths per 100,000 women), and 154 deaths (25%; 2 deaths per 100,000 women), respectively. Excess numbers of deaths and excess death rates due to prostate and breast cancer increased with age. These excess deaths were higher in men aged ≥ 80 years (596 deaths (64%) and 150 deaths per 100,000 men) and women aged 70–79 years (229 deaths (58%) and 15 deaths per 100,000 women), respectively. In summary, during the COVID-19 pandemic, there were excess prostate and breast cancer mortalities in 2020 in Peru, while excess uterus cancer mortalities were low. Age-stratified excess death rates for prostate cancer and breast cancer were higher in men ≥ 80 years and in women ≥ 70 years, respectively. Full article

(This article belongs to the Special Issue COVID-19 Pandemic: Impact on Cancer Patients)

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10 pages, 315 KiB

Open AccessArticle

The Consequences of the COVID-19 Pandemic on Emergency Surgery for Colorectal Cancer

by Catalin Vladut Ionut Feier, Sonia Ratiu, Calin Muntean and Sorin Olariu

Int. J. Environ. Res. Public Health 2023, 20(3), 2093; https://doi.org/10.3390/ijerph20032093 - 23 Jan 2023

Cited by 2 | Viewed by 1263

Abstract

The aim of this study is to analyze the impact of the COVID-19 pandemic on the emergency treatment of patients with colorectal cancer in a university surgery clinic. Data from patients undergoing emergency surgery during the pandemic period (2020–2021) was taken into consideration [...] Read more.

The aim of this study is to analyze the impact of the COVID-19 pandemic on the emergency treatment of patients with colorectal cancer in a university surgery clinic. Data from patients undergoing emergency surgery during the pandemic period (2020–2021) was taken into consideration and the results were analyzed and compared with the periods 2016–2017 and 2018–2019. A significant decrease in the number of patients undergoing emergency surgery was reported (p = 0.028). The proportion of patients who presented more severe symptoms at the hospital was significantly higher (p = 0.007). There was an increase in the average duration of surgical interventions compared to pre-pandemic periods (p = 0.021). An increase in the percentage of stomas performed during the pandemic was reported. The average duration of postoperative hospitalization was shorter during the pandemic. A postoperative mortality of 25.7% was highlighted. Conclusions: The pandemic generated by COVID-19 had significant consequences on the emergency treatment of patients with colon cancer. A smaller number of patients showed up at the hospital, and with more severe symptoms. In order to reduce the risk of infection with SARS-CoV-2 virus, the postoperative hospitalization period was shortened and a higher number of protective stomas were performed. Full article

(This article belongs to the Special Issue COVID-19 Pandemic: Impact on Cancer Patients)

12 pages, 1250 KiB

Open AccessArticle

The Challenges of Colorectal Cancer Surgery during the COVID-19 Pandemic in Romania: A Three-Year Retrospective Study

by Cristi Tarta, Marco Marian, Marco Capitanio, Flaviu Ionut Faur, Ciprian Duta, Razvan Diaconescu, Anca Monica Oprescu-Macovei, Bogdan Totolici and Amadeus Dobrescu

Int. J. Environ. Res. Public Health 2022, 19(21), 14320; https://doi.org/10.3390/ijerph192114320 - 2 Nov 2022

Cited by 2 | Viewed by 1473

Abstract

The predictions on the influence of the SARS-CoV-2 pandemic on access to medical services in Romania predicted a 35% drop in oncological hospitalizations in 2020 compared to the previous decade, raising the hypothesis that patients with colorectal cancer can become indirect victims of [...] Read more.

The predictions on the influence of the SARS-CoV-2 pandemic on access to medical services in Romania predicted a 35% drop in oncological hospitalizations in 2020 compared to the previous decade, raising the hypothesis that patients with colorectal cancer can become indirect victims of the ongoing pandemic. Therefore, the aim of the current research was to observe how the COVID-19 pandemic influenced colorectal cancer surgery in Romania, to determine the level of addressability towards specialized care, to compare the cancer staging between the pandemic and pre-pandemic periods, and to observe the risk factors for disease progression. This retrospective study was spread over three years, respectively, from March 2019 to March 2022, and included a total of 198 patients with a history of colorectal cancer surgery. It was decided to perform a parallel comparison of 2019, 2020, and 2021 to observe any significant changes during the pandemic. Our clinic encountered a significant decrease in all interventions during the pandemic; although the number of CRC surgeries remained constant, the cases were more difficult, with significantly more patients presenting in emergency situations, from 31.3% in 2019 to 50.0% in 2020 and 57.1% in 2021. Thus, the number of elective surgeries decreased significantly. The proportion of TNM (tumor-node-metastasis) staging was, however, statistically significant between the pre-pandemic and pandemic period. In 2019, 13.3% of patients had stage IIa, compared with 28.8% in 2020 and 13.1% in 2021. Similarly, the proportion of very advanced colorectal cancer was higher during the pandemic period of 2020 and 2021 (12.0% in 2019 vs. 12.5% in 2020 and 25.0% in 2021), which was represented by a significantly higher proportion of patients with bowel perforation. Patients with an advanced TNM stage had a 6.28-fold increased risk of disease progression, followed by lymphovascular invasion (HR = 5.19). However, the COVID-19 pandemic, represented by admission years 2020 and 2021, did not pose a significant risk for disease progression and mortality. In-hospital mortality during the pandemic also did not change significantly. After the pandemic restrictions have been lifted, it would be advisable to conduct a widespread colorectal cancer screening campaign in order to identify any instances of the disease that went undetected during the SARS-CoV-2 pandemic. Full article

(This article belongs to the Special Issue COVID-19 Pandemic: Impact on Cancer Patients)

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Other

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10 pages, 1921 KiB

Open AccessOpinion

Nursing Care for Metastatic Bone Cancer: Trends for the Future

by Debra Penrod and Brandon Hirsch

Int. J. Environ. Res. Public Health 2023, 20(15), 6483; https://doi.org/10.3390/ijerph20156483 - 31 Jul 2023

Viewed by 1348

Abstract

To effectively treat patients and minimize viral exposure, oncology nurses and radiology departments during COVID-19 had to re-examine the ability to offer palliative radiation treatments to people with metastatic bone cancer. Decreasing potential exposure to the virus resulted in extra measures to keep [...] Read more.

To effectively treat patients and minimize viral exposure, oncology nurses and radiology departments during COVID-19 had to re-examine the ability to offer palliative radiation treatments to people with metastatic bone cancer. Decreasing potential exposure to the virus resulted in extra measures to keep patients and personnel safe. Limiting radiotherapy treatments, social distancing, and limiting caregivers were a few of the ways that oncology patients were impacted by the pandemic. Hypofractionated radiation therapy (HFRT), or the delivery of fewer higher-dose treatments, was a method of providing care but also limiting exposure to infection for immunocompromised patients as well as healthcare staff. As oncology radiation centers measure the impact of patient care during the pandemic, a trend toward HFRT may occur in treating the painful symptoms of bone cancer. In anticipation that HFRT may be increasingly used in patient treatment plans, oncology nurses should consider patient perspectives and outcomes from the pandemic to further determine how to manage future trends in giving personalized care, and supportive care. Full article

(This article belongs to the Special Issue COVID-19 Pandemic: Impact on Cancer Patients)

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15 pages, 1177 KiB

Open AccessSystematic Review

The Epidemiology of Malignant Melanoma during the First Two Years of the COVID-19 Pandemic: A Systematic Review

by Ana-Olivia Toma, Mihaela Prodan, Akash Reddy Reddyreddy, Edward Seclaman, Zorin Crainiceanu, Vlad Bloanca, Felix Bratosin, Catalin Dumitru, Ciprian Nicolae Pilut, Satish Alambaram, Neeharika Gayatri Vasamsetti, Luminita Decean and Marius Pricop

Int. J. Environ. Res. Public Health 2023, 20(1), 305; https://doi.org/10.3390/ijerph20010305 - 25 Dec 2022

Cited by 16 | Viewed by 2681

Abstract

It is hypothesized that the COVID-19 pandemic had a major impact on the epidemiology of malignant melanoma owing to diminished screening, diagnostic, and treatment capacities, resulting in a more advanced stage at initial presentation. The goal of this study is to undertake a [...] Read more.

It is hypothesized that the COVID-19 pandemic had a major impact on the epidemiology of malignant melanoma owing to diminished screening, diagnostic, and treatment capacities, resulting in a more advanced stage at initial presentation. The goal of this study is to undertake a systematic analysis of all epidemiological and clinical data on the trends and patient outcomes with malignant melanoma during the ongoing pandemic. Records were identified from PubMed, Cochrane, and Web of Science, selecting a total of 39 articles, narrative reviews, and editorial letters, following the PRISMA guidelines. The vast majority of the studies were published in Europe (28/39), and North America (7/39). A total of 99,860 patients were analyzed during 2020 and 2021 of the COVID-19 pandemic, and it was observed that malignant melanoma TNM staging increased significantly compared to the pre-pandemic period. Before the pandemic, 25.88% of patients had TNM stage II or above, compared to 36.25% during 2020–2021. During the COVID-19 pandemic, the malignant melanoma Breslow depth index grew from 1.59 mm before 2020 to 1.86 mm in 2020 and 2021. Patients decreased by 19.58% in 2020 and 2021 compared to pre-pandemic numbers. The patient–loss ratio indicated lower screening activity and patient addressability to dermatology and plastic surgery departments with skin cancer concerns during the COVID-19 pandemic. This systematic study shows that the identification and management of malignant melanoma during the COVID-19 pandemic faced major challenges which should alert medical systems to the high number of patients with advanced disease stages who may need emergency treatment and become incurable. Full article

(This article belongs to the Special Issue COVID-19 Pandemic: Impact on Cancer Patients)

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13 pages, 3089 KiB

Open AccessCase Report

Adapted Physical Activity Protocol for Lower Limb Functional and Strength Recovery in a Young Athlete with Cutaneous Melanoma: Feasibility and Efficacy during COVID-19 Pandemic

by Giuditta Carretti, Daniela Mirandola, Sara Germano, Mirko Manetti and Mirca Marini

Int. J. Environ. Res. Public Health 2022, 19(15), 9590; https://doi.org/10.3390/ijerph19159590 - 4 Aug 2022

Viewed by 2010

Abstract

Adapted physical activity (APA) can improve psychophysical wellbeing and quality of life (QoL) in cancer survivors, a vulnerable population requiring a global management, especially during the recent pandemic. On this basis, we investigated for the first time the impact of a tailored APA [...] Read more.

Adapted physical activity (APA) can improve psychophysical wellbeing and quality of life (QoL) in cancer survivors, a vulnerable population requiring a global management, especially during the recent pandemic. On this basis, we investigated for the first time the impact of a tailored APA intervention on a melanoma-affected 18-year-old female athlete to counteract treatment sequelae and promote lower limb functional and strength recovery. Patient was evaluated at baseline and post-protocol by a test battery focusing on mobility, muscle strength measured by dynamometry, and lower limb girths assessed at specific anatomical points. Moreover, health-related QoL, depression/anxiety, psychological distress and pain intensity were evaluated by Functional Assessment of Cancer Therapy–Melanoma (FACT-M), Hospital Anxiety and Depression Scale (HADS), distress thermometer, and numerical rating scale (NRS) questionnaires, respectively. An almost doubled up increase in lower limb strength, along with hip mobility improvement, and post-surgical edema and pain reduction were observed following the protocol. Concerning the QoL assessment, a moderate post-intervention improvement in physical and emotional wellbeing was detected, while depression state worsened though remaining within the normality range. Our findings show that a specialist-supervised structured APA protocol based on a patient-centered multidisciplinary approach may represent an effective strategy to recover functional and psychophysical efficiency, thus promoting a quick return to daily life activities and offering a concrete chance of resuming competitive sport practice. Full article

(This article belongs to the Special Issue COVID-19 Pandemic: Impact on Cancer Patients)

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