# Influence of COVID-19 pandemic on colon cancer presentations

## TL;DR

The study found that during the pandemic, more colon cancer patients presented with advanced and metastatic disease, likely due to delayed diagnosis.

## Contribution

This study provides evidence of delayed colon cancer diagnosis during the pandemic, leading to more advanced presentations.

## Key findings

- Patients during the pandemic presented with more advanced and metastatic colon cancer.
- There was an increase in peritoneal metastases and infiltrative tumors during the pandemic.
- In-hospital mortality was not significantly affected despite more advanced presentations.

## Abstract

We assumed that patients would present during the pandemic with more advanced, more disseminated, and more symptomatic forms of colon cancer.

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.

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.

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.