Colorectal cancer screening in the COVID-19 era

Colorectal cancer (CRC) is the third most diagnosed form of cancer and second most deadly cancer worldwide. Introduction of better screening has improved both incidence and mortality. However, as the coronavirus disease 2019 (COVID-19) pandemic began, healthcare resources were shunted away from cancer screening services resulting in a sharp decrease in CRC screening and a backlog of patients awaiting screening tests. This may have significant effects on CRC cancer mortality, as delayed screening may lead to advanced cancer at diagnosis. Strategies to overcome COVID-19 related disruption include utilizing stool-based cancer tests, developing screening protocols based on individual risk factors, expanding telehealth, and increasing open access colonoscopies. In this review, we will summarize the effects of COVID-19 on CRC screening, the potential long-outcomes, and ways to adapt CRC screening during this global pandemic.     

Management of patients with ovarian cancer in the COVID-19 era

At the beginning of 2020, coronavirus disease 2019 (COVID-19) spreads worldwide. Patients with ovarian cancer should be considered at high-risk of developing severe morbidity related to COVID-19. Most of them are diagnosed in advanced stages of disease, and they are fragile. Here, we evaluated the major impact of COVID-19 on patients with ovarian cancer, discussing the effect of the outbreak on medical and surgical treatment.     

COVID-19 Outcomes Among Patients With Cancer: Observations From the University of California Cancer Consortium COVID-19 Project Outcomes Registry

BackgroundThe risks associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated illness, coronavirus disease 2019 (COVID-19), among patients with a cancer diagnosis have not been fully characterized. This study leverages data from a multi-institutional cohort study, the University of California Cancer COVID Consortium, to evaluate outcomes associated with SARS-CoV-2 infection among patients with cancer.MethodsClinical data were collected from March to November 2020 and included patient demographics, cancer history and treatment, SARS-CoV-2 exposure and testing, and COVID-19 clinical management and outcomes. Multivariate ordinal logistic regression permitting unequal slopes was used to evaluate the impact of demographic, disease, and treatment factors on SARS-CoV-2 related hospitalization, intensive care unit (ICU) admission, and mortality.FindingsAmong all evaluated patients (n = 303), 147 (48%) were male, 118 (29%) were older adults (≥65 years old), and 104 (34%) were non-Hispanic white. A subset (n = 63, 21%) had hematologic malignancies and the remaining had solid tumors. Patients were hospitalized for acute care (n = 79, 26%), ICU-level care (n = 28, 9%), or died (n = 21, 7%) due to COVID-19. Patients with ≥2 comorbidities were more likely to require acute care (odds ratio [OR] 2.09 [95% confidence interval (CI), 1.23-3.55]). Cough was identified as a significant predictor of ICU hospitalization (OR 2.16 [95% CI, 1.03-4.57]). Importantly, mortality was associated with an active cancer diagnosis (OR 3.64 [95% CI, 1.40-9.5]) or advanced age (OR 3.86 [95% CI, 1.2-12.44]).InterpretationThis study observed that patients with active cancer or advanced age are at an increased risk of death from COVID-19. These study observations can inform risk counseling related to COVID-19 for patients with a cancer diagnosis.     

Decreased Global Interest in Oral Cancer During the COVID-19 Pandemic

Objective: Oral cancer is one of the most common malignancies in developing countries, but studies using global data are scarce. The aim of this study is to analyze the search interests for oral cancer using mouth cancer, tongue cancer, gum cancer, and lip cancer as common keywords. Methods: Internet searches relating to oral cancer from 2010 to 2020, from 250 countries and dependent areas, were retrieved from Google Trends. Color densities in a heat map were used to show geographic differences. Kruskal-Wallis test with post hoc Dunn’s analysis was used to perform yearly comparisons of searches for mouth cancer, tongue cancer, gum cancer, and lip cancer. Search results within 2020 were also compared to determine differences. Forecasting searches from 2021 to 2022 were done by fitting time series models. Results: From 29 of 250 (11.6%) countries, the highest search values were observed for mouth cancer in Sri Lanka, Qatar, Bangladesh, Finland, Netherlands, Spain, and France. Compared to 2020, greater searches were seen in 2018 (Mdn = 91%, P = 0.023) and 2019 (Mdn = 94%, P = 0.012) for mouth cancer, and 2019 (Mdn = 17%, P = 0.035) for lip cancer. The relative search volumes for gum cancer and lip cancer were substantially lower than mouth cancer during the COVID-19 pandemic. Conclusion: Higher-income countries tend to be more interested in seeking information about oral cancer. Noteworthy decline in the interest in seeking information online for oral cancer may have crucial implications during the COVID-19 pandemic. Google Trends offer an invaluable and inexpensive means for oral cancer surveillance and health-seeking behavior.