Retrospective analysis of survival among patients with high-risk gastrointestinal cancers during the COVID-19 pandemic

A retrospective cohort study using data from the National Cancer Database evaluated the incidence, stage and survival of high-risk gastrointestinal cancers during the COVID-19 pandemic in the USA. There was substantial underdiagnosis during the first months of the pandemic, with no proportional increase in newly diagnosed cases or stage migration throughout the remainder of 2020. For stage, there was a proportional decrease in the diagnose of stage I (-3.9%) and stage II 9-2.3%) disease, with an increase in stage IV disease (+7.1%) during the early months of the pandemic. Despite a slight decrease in 1-year survival rates in 2020 (47.4%) compared with 2018 and 2019 (50.7%), survival curves remained unchanged (p>0.05). After adjusting for confounders, diagnosis in 2020 was not associated with increased 1-year mortality compared with 2018 and 2019 (HR 0.99 ; 95% CI 0.97-1.01). Rates of 30-day and 90-day operative mortality also remained similar. The authors conclude that a period of underdiagnosis and increase in stage IV disease was observed for HRGI cancer during the pandemic; however, there was no change in 1-year survival or operative mortality.