Influence of COVID-19 Pandemic on Colon Cancer Presentations

Arina Cipriana Pietreanu¹Antonia Ioana Vasile^1*Cornel Cheregi²Simona Trifu¹Bogdan Mihai Cristea¹Bogdan Socea¹

• ¹Universitatea de Medicina si Farmacie Carol Davila din Bucuresti Facultatea de Medicina, Bucharest, Romania
• ²Universitatea din Oradea, Oradea, Romania

Aim: We assumed that patients would present during the pandemic with more advanced, more disseminated, and more symptomatic forms of colon cancer. Materials and Methods: We did a retrospective observational study that analyzed the database of the General Surgery Department of a tertiary care center in Romania, analyzing information about the patients from their clinical charts. The study was conducted on 204 patients diagnosed with colon cancer, subdivided into the pre-pandemic group (2019) and the pandemic group (2020). The ages varied between 27 and 95 years old, male and female. We measured: age, gender, year of admission, tumor localization, admission reasons, colon cancer emergencies, post-operative colon cancer complications, endoscopic tumor characteristics, histopathologic result, concomitant colonoscopy finding, presence and sites of metastases, and discharge status. Results: The number of presentations was lower in the pandemic year, but non-significant. During the pandemic, patients presented more with abdominal bloating, infiltrative tumors, multiple metastases, especially peritoneal metastases, indicating a more advanced local disease. As for colon cancer emergencies, inferior digestive hemorrhage occurred more frequently, consistent with more locally aggressive tumor behavior. Conclusions: During the pandemic, more patients presented with more oncologically advanced forms of colon cancer, but the cancer-related in-hospital mortality was not influenced. While the pandemic did not increase overall emergency presentations or short-term mortality, it was associated with delayed diagnosis and a higher burden of locally advanced and metastatic colon cancer at presentation.