- 期刊
Effects of the COVID-19 Pandemic on Colorectal Cancers in Taiwan: A Retrospective Study
新型冠狀病毒大流行對於台灣大腸直腸癌的影響，回溯型研究
摘要
Introduction. The novel coronavirus disease in 2019 had spread rapidly worldwide and had a strong impact to health care society. After the first case of COVID19 in Taiwan, decrease activities of healthcare systems put colorectal cancer patients in greater risk. We conduct a retrospective study of a tertiary hospital and investigate the impacts of COVID19 for CRC. Methods & Materials. All patients age greater than 18 years old diagnosed with colorectal cancers from our hospital since 2016 to 2021 were included. Final pathology of non-adenocarcinoma diseases was excluded. We divided the patients into two groups (group A: 2016-2019; group B: 2020-2021) according to the date of initial diagnosed. Results. There were no statistical significance in between age, sex, tumor locations, and treatment methods. Group B presented with higher percentage of local advanced disease in clinical stage. 31 patients (14.8%) with T1 stage and 56 patients (26.8%) were presented with T2 stage. Clinical presentation of obstruction was found in 191 (34.9%) patients and 92 (43.8%) patients in each group respectively (p-value = 0.023). Initial visit of hospital with colon perforation were found in 18 (3.3%) patients and 15 (7.1%) patients in each group (p-value = 0.020). Discussion. Despite a retrospective study and many limitations, we illustrate delay diagnosis; postpone treatment, and more patients present with more severe symptoms. Incidentally, we also found CEA elevate in colon cancers but not rectal cancers. Conclusion. COVID19 pandemic had great impact on the screening and diagnosis of CRC. In consequence of more advance disease occasionally combine with more severe clinical symptoms.
並列摘要
介紹：2019年新型冠狀病毒疫情在全球迅速蔓延，對醫療社會產生了強烈影響。台灣出現首例新冠肺炎病例後，醫療系統活動的減少使大腸直腸癌患者面臨更大的風險。我們針對一家三級醫院進行回顧性研究，調查新冠肺炎對大腸癌的影響。方法與材料：納入2016年至2021年期間在本院確診的所有年齡大於18歲的大腸直腸癌患者。排除非腺癌疾病的最終病理。我們根據初次診斷日期將患者分為兩組（A組：2016-2019年；B組：2020-2021年）。結果：年齡、性別、腫瘤部位和治療方法之間沒有統計意義。B組臨床階段局部晚期疾病的比例較高。31名患者（14.8%）為T1期，56名患者（26.8%）為T2期。每組分別有191例（34.9%）和92例（43.8%）患者出現阻塞臨床表現（p = 0.023）。各組首次就診的結腸穿孔患者分別為18例（3.3%）和15例（7.1%）（p = 0.020）。討論：儘管進行了回顧性研究並存在許多局限性，但我們仍說明了延遲診斷；延後治療，更多患者出現更嚴重的症狀。順便說一句，我們還發現結腸癌中CEA升高，但直腸癌中則沒有升高。結論：新冠肺炎疫情對大腸直腸癌的篩檢和診斷產生了很大影響。由於病情進展，有時會出現更嚴重的臨床症狀。