The COVID-19 pandemic has not changed stage at presentation nor treatment patterns of head and neck cancer: a retrospective cohort study

Clements, K., Cowell, A., White, G., Flynn, W., Conway, D. I. , Douglas, C. M. and Paterson, C. (2023) The COVID-19 pandemic has not changed stage at presentation nor treatment patterns of head and neck cancer: a retrospective cohort study. Clinical Otolaryngology, 48(4), pp. 587-594. (doi: 10.1111/coa.14048) (PMID:36929626)

Abstract

Objectives: To evaluate the impact of the COVID-19 lockdown measures on HNC, by comparing the stage at presentation and treatment of HNC before and after the most severe COVID-19 restrictions. Design: A retrospective cohort study. Setting: A regional cancer network serving a patient population of 2.4 million. Participants: Newly diagnosed patients with HNC between June and October 2019 (pre-pandemic) and June and October 2021 (post-pandemic). Main outcome measures: Symptom duration before diagnosis, stage at diagnosis, patient performance status (PS) and intent of treatment delivered (palliative vs. curative). Results: Five hundred forty-five patients were evaluated—250 in the 2019 and 295 in the 2021 cohort. There were no significant differences in symptom duration between the cohorts (p = .359) or patient PS (p = .821). There were no increased odds of presenting with a late (Stage III or IV) AJCC cancer stage in 2021 compared with 2019 (odds ratio [OR] = 0.90; 95% confidence interval [CI]: 0.76–1.08); nor increased odds of receiving palliative rather than curative treatment in 2021 compared with 2019 (OR = 0.68; 95% CI: 0.45–1.03). Conclusion: The predicted stage shift to more advanced disease at the time of diagnosis of HNC due to the COVID-19 pandemic has not been realised in the longer term. In keeping with this, there was no difference in symptom duration, patient PS, or treatment patterns between the 2019 and 2021 cohorts.

• Item Type: Articles
• Additional Information: DC worked on this as part of Public Health Scotland COVID-19 Dental Recovery Analyses award and the Head and Neck Cancer in South America and Europe (HEADSpAcE) – European Union Horizon 2020 Research and Innovation Programme Grant agreement no. 825771. Academic activities of CP are supported by funding from NHS Greater Glasgow & Clyde Research & Innovation Department, the Beatson Cancer Charity and CRUK RadNet Glasgow. Academic activities of CD are supported by a Chief Scientist Office NRS Fellowship and an MRC CARP Award. AC was supported by the Royal College of Radiologists Karol Sicher Cancer Research Fellowship 2022. KC received funding from the Carnegie Trust for this project.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Paterson, Dr Claire and White, Dr Gillian and Douglas, Miss Catriona and Conway, Professor David
• Authors: Clements, K., Cowell, A., White, G., Flynn, W., Conway, D. I., Douglas, C. M., and Paterson, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: Clinical Otolaryngology
• Publisher: Wiley
• ISSN: 1749-4478
• ISSN (Online): 1749-4486
• Published Online: 16 March 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Clinical Otolaryngology 48(4):587-594
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
303648		HEADSPACE	David Conway	European Commission (EC)	825771	Med - Dental School