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Abstract：
BACKGROUND: The COVID-19 pandemic has disrupted regular health care with potential consequences for non-COVID diseases like cancer. To ensure continuity of oncological care, guidelines were temporarily adapted.
OBJECTIVE: To evaluate the impact of the COVID-19 outbreak on bladder cancer care in the Netherlands.
METHODS: The number of bladder cancer (BC) diagnoses per month during 2020-2021 was compared to 2018-2019 based on preliminary data from the Netherlands Cancer Registry (NCR). Additionally, detailed data were retrieved from the NCR for the cohort diagnosed between March 1st-May 31st 2020 (first COVID wave) and 2018-2019 (reference cohort). BC diagnoses, changes in age and stage at diagnosis, and time to first-line treatment were compared between both periods. Changes in treatment were evaluated using logistic regression.
RESULTS: During the first COVID wave (week 9-22), the number of BC diagnoses decreased by 14%, corresponding with approximately 300 diagnoses, but increased again in the second half of 2020. The decline was most pronounced from week 13 onwards in patients≥70 years and patients with non-muscle invasive BC. Patients with muscle-invasive disease were less likely to undergo a radical cystectomy (RC) in week 17-22 (OR = 0.62, 95% CI = 0.40-0.97). Shortly after the start of the outbreak, use of neoadjuvant chemotherapy decreased from 34% to 25% but this (non-significant) effect disappeared at the end of April. During the first wave, 5% more RCs were performed compared to previous years. Time from diagnosis to RC became 6 days shorter. Overall, a 7% reduction in RCs was observed in 2020.
CONCLUSIONS: The number of BC diagnoses decreased steeply by 14% during the first COVID wave but increased again to pre-COVID levels by the end of 2020 (i.e. 600 diagnoses/month). Treatment-related changes remained limited and followed the adapted guidelines. Surgical volume was not compromised during the first wave. Altogether, the impact of the first COVID-19 outbreak on bladder cancer care in the Netherlands appears to be less pronounced than was reported for other solid tumors, both in the Netherlands and abroad. However, its impact on bladder cancer stage shift and long-term outcomes, as well as later pandemic waves remain so far unexamined.
OBJECTIVE: To evaluate the impact of the COVID-19 outbreak on bladder cancer care in the Netherlands.
METHODS: The number of bladder cancer (BC) diagnoses per month during 2020-2021 was compared to 2018-2019 based on preliminary data from the Netherlands Cancer Registry (NCR). Additionally, detailed data were retrieved from the NCR for the cohort diagnosed between March 1st-May 31st 2020 (first COVID wave) and 2018-2019 (reference cohort). BC diagnoses, changes in age and stage at diagnosis, and time to first-line treatment were compared between both periods. Changes in treatment were evaluated using logistic regression.
RESULTS: During the first COVID wave (week 9-22), the number of BC diagnoses decreased by 14%, corresponding with approximately 300 diagnoses, but increased again in the second half of 2020. The decline was most pronounced from week 13 onwards in patients≥70 years and patients with non-muscle invasive BC. Patients with muscle-invasive disease were less likely to undergo a radical cystectomy (RC) in week 17-22 (OR = 0.62, 95% CI = 0.40-0.97). Shortly after the start of the outbreak, use of neoadjuvant chemotherapy decreased from 34% to 25% but this (non-significant) effect disappeared at the end of April. During the first wave, 5% more RCs were performed compared to previous years. Time from diagnosis to RC became 6 days shorter. Overall, a 7% reduction in RCs was observed in 2020.
CONCLUSIONS: The number of BC diagnoses decreased steeply by 14% during the first COVID wave but increased again to pre-COVID levels by the end of 2020 (i.e. 600 diagnoses/month). Treatment-related changes remained limited and followed the adapted guidelines. Surgical volume was not compromised during the first wave. Altogether, the impact of the first COVID-19 outbreak on bladder cancer care in the Netherlands appears to be less pronounced than was reported for other solid tumors, both in the Netherlands and abroad. However, its impact on bladder cancer stage shift and long-term outcomes, as well as later pandemic waves remain so far unexamined.
摘要：
背景：COVID-19大流行扰乱了常规医疗保健，对癌症等非COVID疾病有潜在影响。为了确保肿瘤护理的连续性，指导方针暂时适应。
目的：评估COVID-19疫情对荷兰膀胱癌治疗的影响。
方法：根据荷兰癌症登记处（NCR）的初步数据，将2020-2021年期间每月诊断膀胱癌（BC）的数量与2018-2019年进行了比较。此外,我们从NCR检索了2020年3月1日至5月31日(第一次COVID波)至2018-2019年(参考队列)期间诊断的队列的详细数据.BC诊断,诊断时年龄和阶段的变化，并比较两个时期的一线治疗时间。使用逻辑回归评估治疗的变化。
结果：在第一次COVID波中（第9-22周），BC的诊断数量减少了14%,对应于大约300个诊断，但在2020年下半年再次增加。从第13周开始，在≥70岁的患者和非肌肉侵入性BC患者中，下降最为明显。肌肉浸润性疾病患者在第17-22周接受根治性膀胱切除术（RC）的可能性较小（OR=0.62，95％CI=0.40-0.97）。疫情开始后不久,新辅助化疗的使用率从34%降至25%,但这种(非显著)效应在4月底消失.在第一波中，与前几年相比，进行的RC增加了5%。从诊断到RC的时间缩短了6天。总的来说,在2020年，RCs减少了7%。
结论：在第一次COVID波中，BC诊断的数量急剧下降了14%，但到2020年底再次增加到COVID前水平(即600次诊断/月)。与治疗相关的变化仍然有限，并遵循适应的指南。在第一波期间手术体积没有受到损害。总之,第一次COVID-19疫情对荷兰膀胱癌治疗的影响似乎没有其他实体肿瘤的报道那么明显，在荷兰和国外。然而,它对膀胱癌分期转移和长期结果的影响，以及后来的大流行浪潮迄今仍未得到审查。
目的：评估COVID-19疫情对荷兰膀胱癌治疗的影响。
方法：根据荷兰癌症登记处（NCR）的初步数据，将2020-2021年期间每月诊断膀胱癌（BC）的数量与2018-2019年进行了比较。此外,我们从NCR检索了2020年3月1日至5月31日(第一次COVID波)至2018-2019年(参考队列)期间诊断的队列的详细数据.BC诊断,诊断时年龄和阶段的变化，并比较两个时期的一线治疗时间。使用逻辑回归评估治疗的变化。
结果：在第一次COVID波中（第9-22周），BC的诊断数量减少了14%,对应于大约300个诊断，但在2020年下半年再次增加。从第13周开始，在≥70岁的患者和非肌肉侵入性BC患者中，下降最为明显。肌肉浸润性疾病患者在第17-22周接受根治性膀胱切除术（RC）的可能性较小（OR=0.62，95％CI=0.40-0.97）。疫情开始后不久,新辅助化疗的使用率从34%降至25%,但这种(非显著)效应在4月底消失.在第一波中，与前几年相比，进行的RC增加了5%。从诊断到RC的时间缩短了6天。总的来说,在2020年，RCs减少了7%。
结论：在第一次COVID波中，BC诊断的数量急剧下降了14%，但到2020年底再次增加到COVID前水平(即600次诊断/月)。与治疗相关的变化仍然有限，并遵循适应的指南。在第一波期间手术体积没有受到损害。总之,第一次COVID-19疫情对荷兰膀胱癌治疗的影响似乎没有其他实体肿瘤的报道那么明显，在荷兰和国外。然而,它对膀胱癌分期转移和长期结果的影响，以及后来的大流行浪潮迄今仍未得到审查。
