Head and Neck Cancer During Covid-19 Pandemic: Was there a Diagnostic Delay?

Abstract

The aim of the present study is to investigate a possible delay in diagnosis and therapy administration for Head and Neck oncological patients, during the Sars-Cov2 pandemic and to compare the median tumor stage (MTS) at presentation. This is a retrospective review on patients who presented at the University Hospital of Modena with a newly diagnosis of Head and Neck cancer (HNC), comparing the first pandemic period (from March 1st, to October 15th 2020) to the same period of 2019. The time in days from the diagnostic suspicion to the beginning of the treatment, hereafter referred to as delay in treatment initiation (DTI), and the tumor stage were calculated for all the enrolled patients. Mean percentage of reduction of the clinical and surgical activities was - 25.8% (range: - 66-1.5%), with higher percentages in phase 1 for all the analyzed activities. 125 HNC patients were enrolled in the analysis as the study group, compared with a cohort of 140 patients from the previous year. The MTS was III for both groups, however a significant statistical difference was determined in the stage comparison, p = 0.023. When DTI was analyzed no statistically significant differences were appreciated. A more advanced stage at presentation was demonstrated at our institution for HNC patients during the first phase of the Covid-19 pandemic in 2020. However, a statistically significant delay in time between diagnosis and therapy administration was not assessed, thus confirming the maintenance of a high level of care even in the COVID-19 era.

Keywords: Delayed diagnosis; Head and Neck cancer; Health care systems; Pandemics; SARS-CoV-2.

Fig. 1

distribution of the percentages of patients’ referral over the 3 phases in 2020 e 2019

Fig. 2

Comparison of median tumor stage in 2019 and 2020 groups

Fig. 3

distribution of the delay in treatment initiation over the 3 phases in 2020 e 2019