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Review
. 2024 Jul;49(4):363-375.
doi: 10.1111/coa.14152. Epub 2024 Mar 21.

Impact of the COVID-19 pandemic on stage and incidence of head and neck cancer: A rapid review and meta-analysis

Kelten Clements  1 , Alekh Thapa  1 , Anna Cowell  2 , David Conway  1   3 , Catriona M Douglas  3   4 , Claire Paterson  2   3
Affiliations
Review

Impact of the COVID-19 pandemic on stage and incidence of head and neck cancer: A rapid review and meta-analysis

Kelten Clements et al. Clin Otolaryngol. 2024 Jul.

Abstract

Objectives: This rapid review aims to evaluate the impact of the COVID-19 pandemic on incidence of head and neck cancer (HNC) and stage distribution at diagnosis.

Design: Rapid review and meta-analysis.

Participants: Comparative data for new HNC patients between a pre-pandemic cohort (before March 2020) and a pandemic cohort (after March 2020 during the lockdown period).

Main outcomes measured: Data on tumour stage, incidence, referral pathway (number of new patient referrals), or workload levels (number of HNC treatments). Data on stage were summarised as odds ratios (OR) with 95% confidence intervals (CI), and data related to changes in numbers of diagnoses, referrals, and workload levels were summarised as a narrative synthesis.

Results: A total of 31 reports were included in this review. Individually 16 out of 23 studies did not show a significant impact on stage relative to the pre-pandemic period. However, the meta-analysis revealed that patients diagnosed with HNC during the pandemic were 16% more likely to have nodal involvement (OR = 1.16; 95% CI 1.00-1.35), 17% more likely to have a late overall stage (OR = 1.17; 95% CI 1.01-1.36), and 32% more likely to present with advanced tumour extent (T3 and T4 stage) (OR = 1.32; 95% CI 1.08-1.62). Data on incidence was extremely limited and not currently sufficient to assess trends in burden of disease.

Conclusions: This review indicates that during the COVID-19 pandemic, there was upstaging of HNC at diagnosis, suggesting the provision of care to HNC patients was significantly affected.

Keywords: COVID‐19; COVID‐19 pandemic; head and neck cancer.

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References

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