648P - Medium to long-term effects of the COVID-19 pandemic on colorectal cancer diagnosis and management in Italy: Preliminary findings from an updated analysis of the real-world multicenter COVID-DELAY study

Background

As extended analysis of the COVID-DELAY study, we aimed to assess COVID-19 impact on diagnosis, staging and treatment outcomes of CRC patients in 2021 and 2022 compared to 2019 and 2020.

Methods

All consecutive newly diagnosed CRC patients referred to 8 Italian Oncology Departments between March and December 2019, 2020, 2021, and 2022 were evaluated. Access rate (number of patients/year), demographic characteristics, diagnostic and therapeutic temporal intervals (between date of symptoms onset, radiological and cytohistological diagnosis, treatment start, and first radiological evaluation), as well as PFS and OS were assessed and compared.

Results

Compared to 2019 (n=485), a reduction in new CRC cases was found in 2020 (n=390, -19.6%). On the other hand, a progressive increase in new CRC diagnosis was found in 2021 (n= 461, +18.2%) and 2022 (n= 509, +30.5%), compared to 2020. A higher rate of stage IV tumours was diagnosed in 2020 (31.3%) and 2021 (29.6%) compared to 2019 (20.8%), with a normalization in 2022 (22.8%) (p<0.001); a lower number of patients has been discussed in multidisciplinary tumor boards in 2020 (22.1%) compared to 2019 (34.9%), 2021 (37.0%), and 2022 (47.6%) (p<0.001). A significant difference in terms of temporal interval between histological diagnosis and first oncological examination (median of 31 vs. 38 days, respectively, p=0.004), cytohistological diagnosis and systemic treatment start (median of 52 vs. 58 day, p<0.001), first oncological appointment and systemic treatment start (median of 52 compared to 58 days, p=0.034), was found between 2020 and 2021-2022 years, respectively. At multivariate analysis, the 2021-2022 years confirmed to be associated with a reduction in the risk of disease progression compared to 2020 (HR=0.71 (0.53-0-97); p=0.031).

Conclusions

A worsening drop in CRC diagnosis in 2020, with a progressive increase in 2021 and 2022, in parallel with a higher incidence of late-stage CRC diagnosed in 2020 and 2021. This might have affected some diagnostic-therapeutic time intervals in 2021-2022 years compared to 2020.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.