Fewer head and neck cancer diagnoses and faster treatment initiation during COVID-19 in 2020: A nationwide population-based analysis. (February 2022)

• Record Type: Journal Article
• Authors: Schoonbeek, Rosanne C.; de Jel, Dominique V.C.; van Dijk, Boukje A.C.; Willems, Stefan M.; Bloemena, Elisabeth; Hoebers, Frank J.P.; van Meerten, Esther; Verbist, Berit M.; Smeele, Ludi E.; Halmos, György B.; Merkx, Matthias A.W.; Siesling, Sabine; De Bree, Remco; Takes, Robert P.
• Is Part Of: Radiotherapy and oncology. Volume 167(2022)
• Page Start: 42
• Page End: 48
• Publication Date: 2022-02
• Subjects: Head and neck cancer -- COVID-19 -- Delay -- Time-to-treatment -- Cancer incidence; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2021.12.005
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: The head and neck cancer incidence was nearly 25% less during the first COVID wave. The lower incidence was mainly observed in oral cavity and laryngeal cancer. During COVID, tumor stage and treatment distribution did not differ. The expected increase in incidence during the remainder of 2020 was not observed. Time-to-treatment was significantly shorter, regardless of first treatment modality. Abstract: Background: Inevitably, the emergence of COVID-19 has impacted non-COVID care. Because timely diagnosis and treatment are essential, especially for patients with head and neck cancer (HNC) with fast-growing tumours in a functionally and aesthetically important area, we wished to quantify the impact of the COVID-19 pandemic on HNC care in the Netherlands. Material and Methods: This population-based study covered all, in total 8468, newly diagnosed primary HNC cases in the Netherlands in 2018, 2019 and 2020. We compared incidence, patient and tumour characteristics, primary treatment characteristics, and time-to-treatment in the first COVID-19 year 2020 with corresponding periods in 2018 and 2019 (i.e. pre-COVID). Results: The incidence of HNC was nearly 25% less during the first wave ( n = 433) than in 2019 ( n = 595) and 2018 ( n = 598). In April and May 2020, the incidence of oral cavity and laryngeal carcinomas was significantly lower than in pre-COVID years. There were no shifts in tumour stage or alterations in initial treatment modalities. Regardless of the first treatment modality and specific period, the median number of days between first visit to a HNC centre and start of treatment was significantly shorter during the COVID-19 year (26–28 days) than pre-COVID (31–32 days, p < 0.001). Conclusion: The incidence of HNC during the Netherlands' first COVID-19 wave was significantly lower than expected. The expected increase in incidence during the remainder of 2020 was not observed. Despite the overloaded healthcare system, the standard treatment for HNC patients could be delivered within a shorter time interval.