Repository logo
 

Inequalities in the recovery of colorectal cancer services during the COVID-19 pandemic: a national population-based study.

Published version
Peer-reviewed

Repository DOI


Change log

Authors

Kuryba, Angela 
Blake, Helen A 
van der Meulen, Jan 
Fearnhead, Nicola S 

Abstract

AIM: Evidence is lacking on whether there were inequalities in the recovery of colorectal cancer (CRC) services within the English National Health Service (NHS) following the COVID-19 pandemic. The aim of this study was to evaluate recovery according to patient age and socioeconomic status. METHOD: Using routinely collected data, CRC patients diagnosed and treated in the English NHS were identified for two timeframes: the 'initial pandemic period' (April-June 2020) and the 'pandemic period' (April 2020-March 2022). Poisson models evaluated changes in numbers of diagnoses, major resections, adjuvant chemotherapy and neoadjuvant radiotherapy use for each timeframe, relative to the equivalent pre-pandemic timeframe (April-June 2019 and April 2018-March 2020, respectively), stratified by age and socioeconomic status. Tumour stage at presentation was evaluated over time. RESULTS: Substantial deficits in diagnoses, major resections and adjuvant chemotherapy were identified in the initial pandemic period, whilst the use of neoadjuvant radiotherapy increased. Overall, these deficits recovered. Patients outside screening age, and in the most deprived group, had greater deficits in diagnoses and major resections. There was no evidence of stage migration by June 2021. CONCLUSIONS: CRC services showed recovery to baseline during the pandemic. However, evident inequalities must be addressed in ongoing recovery efforts. Long-term outcomes will fully establish the impact of the pandemic on CRC patients.

Description

Publication status: Published

Keywords

COVID‐19, colorectal cancer, deprivation, health services research, Humans, COVID-19, Pandemics, State Medicine, Chemotherapy, Adjuvant, Colorectal Neoplasms

Journal Title

Colorectal Dis

Conference Name

Journal ISSN

1462-8910
1463-1318

Volume Title

Publisher

Wiley