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Showing content from https://pubmed.ncbi.nlm.nih.gov/33865430/ below:

Impact of the COVID-19 pandemic on diagnosis, stage, and initial treatment of breast cancer in the Netherlands: a population-based study

doi: 10.1186/s13045-021-01073-7. Impact of the COVID-19 pandemic on diagnosis, stage, and initial treatment of breast cancer in the Netherlands: a population-based study Linda de Munck¹, Marie-Jeanne T F D Vrancken Peeters^{2 3}, Mireille J M Broeders^{4 5}, Luc J A Strobbe⁶, Monique E M M Bos⁷, Marjanka K Schmidt⁸, Cristina Guerrero Paez⁹, Marjolein L Smidt^{10 11}, Maud Bessems¹², Janneke Verloop¹, Sabine Linn^{13 14}, Marc B I Lobbes^{11 15 16}, Aafke H Honkoop¹⁷, Desirée H J G van den Bongard¹⁸, Pieter J Westenend¹⁹, Jelle Wesseling^{13 20}, C Willemien Menke-van der Houven van Oordt²¹, Vivianne C G Tjan-Heijnen²², Sabine Siesling^{23 24}; NABON COVID-19 Consortium and the COVID and Cancer-NL Consortium

Collaborators, Affiliations

Collaborators

NABON COVID-19 Consortium and the COVID and Cancer-NL Consortium: Jolanda C van Hoeve, Matthias A W Merkx, Niek J de Wit, Irene Dingemans, Iris D Nagtegaal, A Wilbrink, Carla H van Gils, Henk C P M van Weert, Marcel Verheij, Ernest J T Luiten, A Elise van Leeuwen-Stok, Agnes Jager, Linetta B Koppert, Maartje J Hooning, Liesbeth J Boersma, Carolien P Schröder, Helena M Verkooijen, Quirine C van Rossum-Schornagel, Susanne van der Velde, Eveliene Manten-Horst, Nicolien T van Ravensteyn, Joke C Korevaar, Ester J M Siemerink, Thijs van Dalen, Annette W G van der Velden, Marc A M Mureau

Affiliations

¹ Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands.
² Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
³ Department of Surgery, Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
⁴ Department for Health Evidence, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
⁵ Dutch Expert Centre for Screening, Wijchenseweg 101, 6538 SW, Nijmegen, The Netherlands.
⁶ Department of Surgical Oncology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.
⁷ Department of Medical Oncology, Erasmus Medical Centre Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
⁸ Division of Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
⁹ Dutch Breast Cancer Society (BVN), Godebaldkwartier 363, 3511 DT, Utrecht, The Netherlands.
¹⁰ Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
¹¹ GROW School for Oncology and Development Biology, Maastricht University, Univeristeitssingel 40, 6220 ER, Maastricht, the Netherlands.
¹² Department of Surgery, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, 's-Hertogenbosch, The Netherlands.
¹³ Division of Diagnostic Oncology and Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
¹⁴ Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
¹⁵ Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Dr. H. van der Hoffplein 1, 6162 BG, Geleen, The Netherlands.
¹⁶ Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
¹⁷ Department of Medical Oncology, Isala Clinics, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
¹⁸ Department of Radiation Oncology, Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
¹⁹ Laboratory of Pathology, Karel Lotsyweg 145, 3318 AL, Dordrecht, The Netherlands.
²⁰ Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
²¹ Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
²² Department of Medical Oncology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
²³ Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands. s.siesling@utwente.nl.
²⁴ Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands. s.siesling@utwente.nl.

PMID: 33865430
PMCID: PMC8052935
DOI: 10.1186/s13045-021-01073-7

Item in Clipboard

Impact of the COVID-19 pandemic on diagnosis, stage, and initial treatment of breast cancer in the Netherlands: a population-based study

Anouk H Eijkelboom et al. J Hematol Oncol. 2021.

doi: 10.1186/s13045-021-01073-7. Authors Anouk H Eijkelboom¹, Linda de Munck¹, Marie-Jeanne T F D Vrancken Peeters^{2 3}, Mireille J M Broeders^{4 5}, Luc J A Strobbe⁶, Monique E M M Bos⁷, Marjanka K Schmidt⁸, Cristina Guerrero Paez⁹, Marjolein L Smidt^{10 11}, Maud Bessems¹², Janneke Verloop¹, Sabine Linn^{13 14}, Marc B I Lobbes^{11 15 16}, Aafke H Honkoop¹⁷, Desirée H J G van den Bongard¹⁸, Pieter J Westenend¹⁹, Jelle Wesseling^{13 20}, C Willemien Menke-van der Houven van Oordt²¹, Vivianne C G Tjan-Heijnen²², Sabine Siesling^{23 24}; NABON COVID-19 Consortium and the COVID and Cancer-NL Consortium Collaborators

NABON COVID-19 Consortium and the COVID and Cancer-NL Consortium: Jolanda C van Hoeve, Matthias A W Merkx, Niek J de Wit, Irene Dingemans, Iris D Nagtegaal, A Wilbrink, Carla H van Gils, Henk C P M van Weert, Marcel Verheij, Ernest J T Luiten, A Elise van Leeuwen-Stok, Agnes Jager, Linetta B Koppert, Maartje J Hooning, Liesbeth J Boersma, Carolien P Schröder, Helena M Verkooijen, Quirine C van Rossum-Schornagel, Susanne van der Velde, Eveliene Manten-Horst, Nicolien T van Ravensteyn, Joke C Korevaar, Ester J M Siemerink, Thijs van Dalen, Annette W G van der Velden, Marc A M Mureau

Affiliations

¹ Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands.
² Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
³ Department of Surgery, Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
⁴ Department for Health Evidence, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
⁵ Dutch Expert Centre for Screening, Wijchenseweg 101, 6538 SW, Nijmegen, The Netherlands.
⁶ Department of Surgical Oncology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.
⁷ Department of Medical Oncology, Erasmus Medical Centre Cancer Institute, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
⁸ Division of Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
⁹ Dutch Breast Cancer Society (BVN), Godebaldkwartier 363, 3511 DT, Utrecht, The Netherlands.
¹⁰ Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
¹¹ GROW School for Oncology and Development Biology, Maastricht University, Univeristeitssingel 40, 6220 ER, Maastricht, the Netherlands.
¹² Department of Surgery, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, 's-Hertogenbosch, The Netherlands.
¹³ Division of Diagnostic Oncology and Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
¹⁴ Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
¹⁵ Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Dr. H. van der Hoffplein 1, 6162 BG, Geleen, The Netherlands.
¹⁶ Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
¹⁷ Department of Medical Oncology, Isala Clinics, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
¹⁸ Department of Radiation Oncology, Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
¹⁹ Laboratory of Pathology, Karel Lotsyweg 145, 3318 AL, Dordrecht, The Netherlands.
²⁰ Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
²¹ Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
²² Department of Medical Oncology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
²³ Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands. s.siesling@utwente.nl.
²⁴ Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands. s.siesling@utwente.nl.

PMID: 33865430
PMCID: PMC8052935
DOI: 10.1186/s13045-021-01073-7

Item in Clipboard

Abstract

Background: The onset of the COVID-19 pandemic forced the Dutch national screening program to a halt and increased the burden on health care services, necessitating the introduction of specific breast cancer treatment recommendations from week 12 of 2020. We aimed to investigate the impact of COVID-19 on the diagnosis, stage and initial treatment of breast cancer.

Methods: Women included in the Netherlands Cancer Registry and diagnosed during four periods in weeks 2-17 of 2020 were compared with reference data from 2018/2019 (averaged). Weekly incidence was calculated by age group and tumor stage. The number of women receiving initial treatment within 3 months of diagnosis was calculated by period, initial treatment, age, and stage. Initial treatment, stratified by tumor behavior (ductal carcinoma in situ [DCIS] or invasive), was analyzed by logistic regression and adjusted for age, socioeconomic status, stage, subtype, and region. Factors influencing time to treatment were analyzed by Cox regression.

Results: Incidence declined across all age groups and tumor stages (except stage IV) from 2018/2019 to 2020, particularly for DCIS and stage I disease (p < 0.05). DCIS was less likely to be treated within 3 months (odds ratio [OR]_wks2-8: 2.04, OR_wks9-11: 2.18). Invasive tumors were less likely to be treated initially by mastectomy with immediate reconstruction (OR_wks12-13: 0.52) or by breast conserving surgery (OR_wks14-17: 0.75). Chemotherapy was less likely for tumors diagnosed in the beginning of the study period (OR_wks9-11: 0.59, OR_wks12-13: 0.66), but more likely for those diagnosed at the end (OR_wks14-17: 1.31). Primary hormonal treatment was more common (OR_wks2-8: 1.23, OR_wks9-11: 1.92, OR_wks12-13: 3.01). Only women diagnosed in weeks 2-8 of 2020 experienced treatment delays.

Conclusion: The incidence of breast cancer fell in early 2020, and treatment approaches adapted rapidly. Clarification is needed on how this has affected stage migration and outcomes.

Keywords: Breast cancer; COVID-19; Incidence; Population-based; Screening; Stage; Treatment.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures
Fig. 1

Incidence of breast cancer per…

Fig. 1

Incidence of breast cancer per week. Incidence is expressed per 1 million women…

Fig. 1

Incidence of breast cancer per week. Incidence is expressed per 1 million women living in the Netherlands at the start of the year. *The week only includes four working days due to public holidays

Fig. 2

Incidence of screen- and non-screen-detected…

Fig. 2

Incidence of screen- and non-screen-detected tumors per week. Incidence is expressed per 1…

Fig. 2

Incidence of screen- and non-screen-detected tumors per week. Incidence is expressed per 1 million women aged 50–74 years living in the Netherlands at the start of the year. *The week only includes four working days due to public holidays. ^‡The week only includes on average four and a half working days due to public holidays in 2018

Fig. 3

Average weekly incidence, per 1…

Fig. 3

Average weekly incidence, per 1 million women of that specific age category, stratified…

Fig. 3

Average weekly incidence, per 1 million women of that specific age category, stratified by period. Incidence is expressed per 1 million women of that specific age category living in the Netherlands at the start of the year. *The incidence in that period is significantly lower compared to the average incidence in the same period of 2018/2019 (p < 0.05)

Fig. 4

Average weekly incidence of different…

Fig. 4

Average weekly incidence of different stage tumors, per 1 million women, stratified by…

Fig. 4

Average weekly incidence of different stage tumors, per 1 million women, stratified by period. Incidence is expressed per 1 million women living in the Netherlands at the start of the year. *The incidence in that period is significantly lower compared to the average incidence in the same period of 2018/2019 (p < 0.05)

Fig. 5

Average weekly incidence and average…

Fig. 5

Average weekly incidence and average weekly number of hospitalized COVID-19 patients per region…

Fig. 5

Average weekly incidence and average weekly number of hospitalized COVID-19 patients per region and period. Breast cancer incidence is expressed per 1 million women living in that specific region of the Netherlands at the start of the year. *The incidence in that period is significantly lower compared to the average incidence in the same period of 2018/2019 (p < 0.05)