Effect of lockdown on digestive system cancer care among older patients during the first wave of COVID-19: the CADIGCOVAGE multicentre cohort study

Aparicio, Thomas; Layese, Richard; Hemery, François; Tournigand, Christophe; Paillaud, Elena; De Angelis, Nicola; Quero, Laurent; Ganne, Nathalie; Prat, Fredéric; Pachev, Atanas; Galula, Gilles; Benderra, Marc-Antoine; Canouï-Poitrine, Florence

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on cancer diagnosis and treatment. Most patients newly diagnosed with digestive system cancer are aged 65 and over. METHODS: We performed a retrospective, observational, multicentre cohort study based on prospectively collected electronic health records. All adults aged 65 or over and having been newly treated for a digestive system cancer between January 2018 until August 2020 were enrolled. RESULTS: Data on 7,882 patients were analyzed. The first COVID-19 lockdown period led to a 42.4% decrease in newly treated digestive system cancers, and the post-lockdown period was associated with a 17% decrease. The decrease in newly treated digestive system cancer did not differ as a function of age, sex, comorbidities, primary tumour site, and disease stage. The proportion of patients admitted to an emergency department increased during the lockdown period. We do not observe a higher 3-month mortality rate in 2020, relative to the corresponding calendar periods in 2018 and 2019. CONCLUSION: To avoid a decrease in newly treated cancers during future lockdown periods, access to healthcare will have to be modified. Although 3-month mortality did not increase in any of the patient subgroups, the 2020 cohort must be followed up for long-term mortality.