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Advancing head and neck cancer following the coronavirus disease 2019 pandemic

Published online by Cambridge University Press:  21 April 2022

W Flynn*
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
R Maqsood
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
T Maseland
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
J Montgomery
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
C Douglas
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Author for correspondence: Mr W Flynn, ENT Department, Queen Elizabeth University Hospital, 1345 Govan Road, GlasgowG51 4TF, Scotland, UK E-mail: wpflynn@doctors.org.uk

Abstract

Objective

Delay in the diagnosis of head and neck cancer can result in significant excess morbidity and mortality. How the pandemic has affected patient presentation in Scotland is unknown.

Method

This retrospective cohort study compared all presentations of head and neck cancer between June and October of 2019 with the same period following the peak of the pandemic in 2020 in West Scotland, a region populated by 2.5 million people.

Results

A total of 528 patients met our inclusion criteria. Compared with 2019, patients in 2020 were more likely to present with a higher American Joint Committee on Cancer stage (odds ratio, 1.67 (95 per cent confidence interval = 1.20 to 2.31); p = 0.002), a longer preceding symptom duration (odds ratio, 2.03 (95 per cent confidence interval = 1.44 to 2.87; p < 0.001) and to have an emergency presentation (odds ratio, 2.53, (95 per cent confidence interval = 1.15 to 5.55; p = 0.017).

Conclusion

Patients are presenting later with more advanced head and neck cancer following the coronavirus disease 2019 pandemic.

Type
Main Article
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr W Flynn takes responsibility for the integrity of the content of the paper

References

Longo, DL, Chow, LQM. Head and Neck Cancer. NEJM 2020;382:6072Google Scholar
Bray, F, Ferlay, J, Soerjomataram, I, Siegel, RL, Torre, LA, Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394424CrossRefGoogle ScholarPubMed
Montgomery, J, Douglas, C, Begbie, F, Hitchings, A, MacKenzie, K. ‘Urgent suspicion of cancer’ referrals to a head and neck clinic – what do patients expect? J Laryngol Otol 2019;133:782–7CrossRefGoogle ScholarPubMed
NHS Providers. NHS Activity Tracker. In: https://nhsproviders.org/nhs-activity-tracker/june-2021 [14 July 2021]Google Scholar
Czeisler, , Marynak, K, Clarke, KEN, Salah, Z, Shakya, I, Thierry, JM et al. Delay or avoidance of medical care because of covid-19–related concerns. MMWR Morb Mortal Wkly Rep 2020;69:1250–7CrossRefGoogle ScholarPubMed
Werner, MT, Carey, RM, Albergotti, WG, Lukens, JN, Brody, RM. Impact of the COVID-19 pandemic on the management of head and neck malignancies. Otolaryngol Head Neck Surg 2020;162:816–7CrossRefGoogle ScholarPubMed
Sud, A, Jones, ME, Broggio, J, Loveday, C, Torr, B, Garrett, A et al. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Ann Oncol 2020;31:1065–74CrossRefGoogle ScholarPubMed
Jensen, AR, Nellemann, HM, Overgaard, L. Tumor progression in waiting time for radiotherapy in head and neck cancer. Radiother Oncol 2007;84:510CrossRefGoogle ScholarPubMed
Mackillop, WJ, Bates, JH, O'Sullivan, B, Withers, HR. The effect of delay in treatment on local control by radiotherapy. Int J Radiat Oncol Biol Phys 1996;34:243–50CrossRefGoogle ScholarPubMed
Wyatt, RM, Beddoe, AH, Dale, RG. The effects of delays in radiotherapy treatment on tumour control. Phys Med Biol 2003;48:139–55CrossRefGoogle ScholarPubMed
O'Sullivan, B, Huang, SH, Su, J, Garden, AS, Sturgis, EM, Dahlstrom, K et al. Development and validation of a staging system for HPV-related oropharyngeal cancer by the International Collaboration on Oropharyngeal Cancer Network for Staging (ICON-S): a multicentre cohort study. Lancet Oncol 2016;17:440–51CrossRefGoogle Scholar
Adelstein, D, Gillison, ML, Pfister, DG, Spencer, S, Adkins, D, Brizel, DM et al. NCCN guidelines insights: head and neck cancers, Version 2. J Natl Compr Canc Netw 2017;15:761–70CrossRefGoogle ScholarPubMed
Maringe, C, Spicer, J, Morris, M, Purushotham, A, Nolte, E, Sullivan, R et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol 2020;21:1023–34CrossRefGoogle ScholarPubMed
West of Scotland Cancer Network. Annual Report April 2020 to March 2021. In: https://www.woscan.scot.nhs.uk/wp-content/uploads/WoSCAN-Annual-Report-2020-21-1.pdf [14 July 2021]Google Scholar
NHS Scotland. Scottish Referral Guidelines for Suspected Cancer. In: http://www.cancerreferral.scot.nhs.uk/head-and-neck-cancers/?alttemplate=guideline [14 July 2021]Google Scholar
Macmillan Cancer Support. Deprivation and Survival from Head and Neck Cancer in Scotland. In: https://www.macmillan.org.uk/_images/Head-and-neck-Cancer-Survival-and-Deprivation-Brief_tcm9-308831.pdf [14 July 2021]Google Scholar
Hartman, HE, Sun, Y, Devasia, TP, Chase, EC, Jairath, NK, Dess, RT et al. Integrated survival estimates for cancer treatment delay among adults with cancer during the Covid-19 pandemic. JAMA Oncol 2020;6:1881–9CrossRefGoogle ScholarPubMed
Tevetoğlu, F, Kara, S, Aliyeva, C, Yıldırım, R, Yener, HM. Delayed presentation of head and neck cancer patients during Covid-19 pandemic. Eur Arch Otorhinolaryngol 2021;278:5081–5CrossRefGoogle ScholarPubMed
Kiong, KL, Diaz, EM, Gross, ND, Diaz, EM Jr, Hanna, EY. The impact of Covid-19 on head and neck cancer diagnosis and disease extent. Head Neck 2021;43:1890–7CrossRefGoogle ScholarPubMed
Wilkie, MD, Gaskell, P, Hall, B, Jones, TM, Kinshuck, AJ. Emergency presentations of head and neck cancer: our experience in the wake of the Covid-19 pandemic. Clin Otolaryngol 2021;46:1237–41CrossRefGoogle ScholarPubMed
Iqbal, MS, Uzzaman, L, Fox, H, Munro, S, Kelly, C. The impact of Covid-19 on the presentation, stage and management of head and neck cancer patients: a real-time assessment. Clin Otolaryngol 2022;47:251–3CrossRefGoogle ScholarPubMed
BBC News. Coronavirus: dental practices to reopen from 8 June. In: https://www.bbc.co.uk/news/health-52838072 [9 September 2021]Google Scholar
Murphy, M, Scott, LJ, Salisbury, C, Turner, A, Scott, A, Denholm, R et al. Implementation of remote consulting in UK primary care following the Covid-19 pandemic: a mixed-methods longitudinal study. Br J Gen Pract 2021;71:e166e177CrossRefGoogle ScholarPubMed
Turner, A, Scott, A, Horwood, J, Salisbury, C, Denholm, R, Scott, L et al. Maintaining face-to-face contact during the Covid-19 pandemic: a longitudinal qualitative investigation in UK primary care. BJGP Open 2021;5:BJGPO.2021.0036CrossRefGoogle ScholarPubMed
Public Health England. Campaign Resource Centre. In: https://campaignresources.phe.gov.uk/resources/campaigns [9 September 2021]Google Scholar