eP574 - The Impact of the COVID‐19 Pandemic on Time to Surgery for Colon Cancer: A National Cancer Database Review

ePoster Presenter(s)

• 

  Majed El Hechi, MD

  Resident Physician
  MedStar Georgetown University Hospital
  MedStar Georgetown University Hospital
  Washington, DC, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• LS

  Leah Starks, MD

  Resident
  Medstar Washington Hospital Center
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• 

  Timothy J. Holleran, MD

  Resident Physician
  MedStar Georgetown University Hospital
  Washington, DC, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.
• DD

  Deirde A. Dulak, MD

  Colon & Rectal Surgeon
  Virtua
  Cherry Hill, New Jersey, United States

  Disclosure information not submitted.
• AF

  Anne Fabrizio, MD

  Colorectal Surgeon
  Medstar Georgetown University Hospital
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• PA

  Preetha Ali, MD

  Colon & Rectal Surgeon
  Medstar Washington Hospital Center
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• 

  Brian L. Bello, MD

  Division Chief
  Department of Colon & Rectal Surgery, MedStar Washington Hospital Center
  MedStar Washington Hospital Center
  Washington, District of Columbia, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.
• ZS

  Zhifei Sun, MD

  Assistant Professor of Surgery
  MedStar Georgetown University Hospital
  Falls Church, Virginia, United States

  Disclosure information not submitted.

Senior Author(s)

• SB

  Sara Berkey, MD

  Colon and Rectal Surgeon
  Medstar Health
  Washington, District of Columbia, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: The COVID-19 pandemic delayed nonemergent healthcare. We aimed to evaluate whether patients undergoing colon cancer resection during the pandemic had a delay in time to surgery.Methods/Interventions: The 2018-2020 National Cancer Database (NCDB) was queried for stage I-III colon cancer patients. Patients in the Pre-Pandemic cohort underwent surgery in 2018-2019, and patients in the Pandemic cohort underwent surgery in 2020 where a COVID test was performed. The primary outcome was time to surgery among Pre-Pandemic and Pandemic patients. The secondary outcome was time to surgery between COVID+ and COVID- patients within the Pandemic group. Multivariable linear regression models were constructed to evaluate the independent impact of the Pandemic and COVID+ status on the primary and secondary outcomes, respectively.Results/Outcomes: A total of 99,841 patients were included, of which 13,775 (13.8%) were in the Pandemic group. On univariable analysis, stage III disease at presentation was higher in the pandemic group (38.6 vs 37.1%, p < 0.001). Pandemic patients had a longer median time to surgery as compared to Pre-Pandemic patients (26[12-44] vs 26[11-42] days, p < 0.001). However, there was no difference in time to adjuvant chemotherapy, where applicable (62[40-84] vs 63[45-84] days, p=0.28). On multivariable linear regression, Pandemic patients had a longer time to surgery as compared to Pre-pandemic patients [Coefficient: 1.8 days, CI:1.0–2.5, p < 0.001]. Within the Pandemic group, 805 (6.2%) were COVID+. Within the Pandemic group, COVID+ status had no difference in median time to surgery on univariable analysis (25[9-49] vs 26[12-44] days, p=0.98), but had a longer duration on multivariable analysis accounting for measured confounders [Coefficient: 5.4 days, CI 2.0–8.9, p=0.002]. While statistically significant, these delays have minimal clinical impact.Conclusion/

Discussion: During the early stages of the pandemic, colon cancer patients experienced a slight but clinically insignificant delay in care, suggesting commitment to timely surgical care in the United States. Further studies are warranted as more NCDB data becomes available to assess the long-term impact of the pandemic on colon cancer patient outcomes.Visual Abstract