Impact of the COVID-19 Pandemic on Colorectal Cancer Patients at a Major Brazilian Cancer Center: An Increase in Metastatic Patients upon Presentation?

Abstract The years 2020 and 2021 were peculiar due to the coronavirus disease 2019 (COVID-19) pandemic, which may also have had an impact on people with colorectal cancer (CRC). In the state of Bahia, Brazil, Hospital Aristides Maltez (HAM) is responsible for most of the oncological care, including malignant neoplasms of colon and rectum. Considering that most of metastatic CRC cases are no longer curable, evaluate if there was an increase in the proportion of that stage of disease can serve as a metric of the impact of this epidemic. Retrospective analysis of HAM's electronic medical records of patients with CRC that had their first consultation during the first 12 months of COVID-19 epidemic at Bahia, in comparison to those that had their first consultation during the 12 previous months. Main characteristics of both groups were similar. Median age was 63 years old, with near representation of both genders, and predominance of brown skin color and a low level of education. However, in the first year of COVID-19 epidemic, there was a 26.89% increase of subjects with already metastatic CRC in the first medical evaluation at HAM (although without statistical significance). We found a numerical increase in metastatic CRC in the COVID period cohort. In consonance with this, another Brazilian study found an increase in the proportion of new cases of advanced CRC, between March and July 2020, in comparison to the same period in 2019. Moreover, in another publication, an increase in colorectal cancer mortality in USA is projected due to delays in screening and diagnosing during the COVID-19 pandemic. These results urge attention to CRC in the following years and in the next pandemic.