Changes in clinical presentation, management, and survival outcomes in patients affected by colorectal cancer following COVID-19 pandemic

As an extended analysis of the COVID-DELAY study, we aimed to assess the impact of the COVID-19 pandemic on diagnosis, staging, and survival outcomes among patients with colorectal cancer (CRC) diagnosis performed from 2019 to 2022. All consecutive newly diagnosed CRC patients referred to 11 Italian...

Full description

Saved in:
Bibliographic Details
Published in:The oncologist (Dayton, Ohio) Ohio), 2024-11
Main Authors: Parisi, Alessandro, Giampieri, Riccardo, Villani, Silvia, Magnarini, Alice, Gelsomino, Fabio, Traisci, Donatella, Barbin, Francesca, Salvatore, Lisa, Zichi, Clizia, Di Pietro, Francesca Romana, Zoratto, Federica, Lanese, Andrea, Petrillo, Angelica, Zurlo, Ina Valeria, Spallanzani, Andrea, D'Ostilio, Nicola, Ghidini, Michele, Bensi, Maria, Schietroma, Francesco, Rognone, Chiara, Panepinto, Olimpia, Paparo, Jessica, Gamba, Teresa, Bisonni, Renato, Di Lorenzo, Sara, Daniele, Bruno, Mentrasti, Giulia, Berardi, Rossana
Format: Article
Language:English
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites cdi_FETCH-LOGICAL-c220t-22ddf218f83daf74be39ca3f30c6004e036b9c531fb51bd6984aaf119c7e9e143
container_end_page
container_issue
container_start_page
container_title The oncologist (Dayton, Ohio)
container_volume
creator Parisi, Alessandro
Giampieri, Riccardo
Villani, Silvia
Magnarini, Alice
Gelsomino, Fabio
Traisci, Donatella
Barbin, Francesca
Salvatore, Lisa
Zichi, Clizia
Di Pietro, Francesca Romana
Zoratto, Federica
Lanese, Andrea
Petrillo, Angelica
Zurlo, Ina Valeria
Spallanzani, Andrea
D'Ostilio, Nicola
Ghidini, Michele
Bensi, Maria
Schietroma, Francesco
Rognone, Chiara
Panepinto, Olimpia
Paparo, Jessica
Gamba, Teresa
Bisonni, Renato
Di Lorenzo, Sara
Daniele, Bruno
Mentrasti, Giulia
Berardi, Rossana
description As an extended analysis of the COVID-DELAY study, we aimed to assess the impact of the COVID-19 pandemic on diagnosis, staging, and survival outcomes among patients with colorectal cancer (CRC) diagnosis performed from 2019 to 2022. All consecutive newly diagnosed CRC patients referred to 11 Italian Oncology Departments between March and December 2019, 2020, 2021, and 2022 were enrolled. Access rate, demographics, diagnostic-therapeutic temporal intervals, and first-line progression-free survival (PFS) and OS among metastatic patients were assessed. Compared to 2019 (n = 690), an initial global reduction in new CRC cases in 2020 (n = 564, -18.3%) was observed, followed by a progressive increase in new CRC diagnoses in 2021 (n = 748, + 8.4%) and 2022 (n = 756, + 9.6%); a higher rate of TNM stage IV tumors was diagnosed in 2020 (35.4%) and 2021 (31.0%) compared to 2019 (29.6%), with normalization in 2022 (26.4%) (P 
doi_str_mv 10.1093/oncolo/oyae310
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3133416500</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3133416500</sourcerecordid><originalsourceid>FETCH-LOGICAL-c220t-22ddf218f83daf74be39ca3f30c6004e036b9c531fb51bd6984aaf119c7e9e143</originalsourceid><addsrcrecordid>eNo9kEtPwzAQhC0E4n3liHzkQMCbTdr6iMpTqtQLIG6R46yLUWIXOwH1J_CvcdXCaWdX34xWw9gZiCsQEq-90771136lCEHssEMoC5kVUrztJi0mmI2hlAfsKMYPIZLEfJ8doCwlgMBD9jN9V25BkVvHdWud1arly0CRXK96690l75RTC-rS4ZIr1_A4hC_7lTA_9Np3G-8ywYmIXBlDuqeG1yu-fi2kLbFaOU2BG9-2_tu6BZ_OX59uM5DJ6RrqrD5he0a1kU6385i93N89Tx-z2fzhaXozy3Seiz7L86YxOUzMBBtlxkVNKLVCg0KPhChI4KiWukQwdQl1M5KTQikDIPWYJEGBx-xik7sM_nOg2FedjZraVjnyQ6wQEAsYlUIk9GqD6uBjDGSqZbCdCqsKRLWuv9rUX23rT4bzbfZQd9T843994y-8uoW7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3133416500</pqid></control><display><type>article</type><title>Changes in clinical presentation, management, and survival outcomes in patients affected by colorectal cancer following COVID-19 pandemic</title><source>Oxford Open</source><source>PubMed Central</source><source>EZB Electronic Journals Library</source><creator>Parisi, Alessandro ; Giampieri, Riccardo ; Villani, Silvia ; Magnarini, Alice ; Gelsomino, Fabio ; Traisci, Donatella ; Barbin, Francesca ; Salvatore, Lisa ; Zichi, Clizia ; Di Pietro, Francesca Romana ; Zoratto, Federica ; Lanese, Andrea ; Petrillo, Angelica ; Zurlo, Ina Valeria ; Spallanzani, Andrea ; D'Ostilio, Nicola ; Ghidini, Michele ; Bensi, Maria ; Schietroma, Francesco ; Rognone, Chiara ; Panepinto, Olimpia ; Paparo, Jessica ; Gamba, Teresa ; Bisonni, Renato ; Di Lorenzo, Sara ; Daniele, Bruno ; Mentrasti, Giulia ; Berardi, Rossana</creator><creatorcontrib>Parisi, Alessandro ; Giampieri, Riccardo ; Villani, Silvia ; Magnarini, Alice ; Gelsomino, Fabio ; Traisci, Donatella ; Barbin, Francesca ; Salvatore, Lisa ; Zichi, Clizia ; Di Pietro, Francesca Romana ; Zoratto, Federica ; Lanese, Andrea ; Petrillo, Angelica ; Zurlo, Ina Valeria ; Spallanzani, Andrea ; D'Ostilio, Nicola ; Ghidini, Michele ; Bensi, Maria ; Schietroma, Francesco ; Rognone, Chiara ; Panepinto, Olimpia ; Paparo, Jessica ; Gamba, Teresa ; Bisonni, Renato ; Di Lorenzo, Sara ; Daniele, Bruno ; Mentrasti, Giulia ; Berardi, Rossana</creatorcontrib><description>As an extended analysis of the COVID-DELAY study, we aimed to assess the impact of the COVID-19 pandemic on diagnosis, staging, and survival outcomes among patients with colorectal cancer (CRC) diagnosis performed from 2019 to 2022. All consecutive newly diagnosed CRC patients referred to 11 Italian Oncology Departments between March and December 2019, 2020, 2021, and 2022 were enrolled. Access rate, demographics, diagnostic-therapeutic temporal intervals, and first-line progression-free survival (PFS) and OS among metastatic patients were assessed. Compared to 2019 (n = 690), an initial global reduction in new CRC cases in 2020 (n = 564, -18.3%) was observed, followed by a progressive increase in new CRC diagnoses in 2021 (n = 748, + 8.4%) and 2022 (n = 756, + 9.6%); a higher rate of TNM stage IV tumors was diagnosed in 2020 (35.4%) and 2021 (31.0%) compared to 2019 (29.6%), with normalization in 2022 (26.4%) (P &lt; .001). Not clinically relevant differences between histological diagnosis and first oncological examination, cytohistological diagnosis and systemic treatment start, first oncological appointment and systemic treatment start, treatment start and first radiological assessment between 2020 and 2021-2022 years were found. After propensity score matching according to the year of diagnosis, median OS was significantly worse in 2020, 2021, and 2022 compared to 2019 (27.6 vs 24.8 vs not reached vs 38.9 months, respectively) (P &lt; .001). Concordantly, the median PFS was significantly worse with each passing year: 13.0 vs 11.1 vs 9.2 vs 7.2 months in 2019, 2020, 2021, and 2022, respectively (P = .00027). A progressive normalization in the rate of new CRC diagnosis as well as TNM stages at diagnosis, in 2021 and 2022 compared to 2020 and 2019, was found. The increase in new CRC cases might have affected some diagnostic-therapeutic time intervals in 2021-2022 years compared to 2020. Significantly, compared to the pre-pandemic phase, pandemic years were independently associated with worse PFS and OS outcomes in patients affected by metastatic disease.</description><identifier>ISSN: 1083-7159</identifier><identifier>ISSN: 1549-490X</identifier><identifier>EISSN: 1549-490X</identifier><identifier>DOI: 10.1093/oncolo/oyae310</identifier><identifier>PMID: 39591103</identifier><language>eng</language><publisher>England</publisher><ispartof>The oncologist (Dayton, Ohio), 2024-11</ispartof><rights>The Author(s) 2024. Published by Oxford University Press.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c220t-22ddf218f83daf74be39ca3f30c6004e036b9c531fb51bd6984aaf119c7e9e143</cites><orcidid>0000-0003-4629-7762</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39591103$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Parisi, Alessandro</creatorcontrib><creatorcontrib>Giampieri, Riccardo</creatorcontrib><creatorcontrib>Villani, Silvia</creatorcontrib><creatorcontrib>Magnarini, Alice</creatorcontrib><creatorcontrib>Gelsomino, Fabio</creatorcontrib><creatorcontrib>Traisci, Donatella</creatorcontrib><creatorcontrib>Barbin, Francesca</creatorcontrib><creatorcontrib>Salvatore, Lisa</creatorcontrib><creatorcontrib>Zichi, Clizia</creatorcontrib><creatorcontrib>Di Pietro, Francesca Romana</creatorcontrib><creatorcontrib>Zoratto, Federica</creatorcontrib><creatorcontrib>Lanese, Andrea</creatorcontrib><creatorcontrib>Petrillo, Angelica</creatorcontrib><creatorcontrib>Zurlo, Ina Valeria</creatorcontrib><creatorcontrib>Spallanzani, Andrea</creatorcontrib><creatorcontrib>D'Ostilio, Nicola</creatorcontrib><creatorcontrib>Ghidini, Michele</creatorcontrib><creatorcontrib>Bensi, Maria</creatorcontrib><creatorcontrib>Schietroma, Francesco</creatorcontrib><creatorcontrib>Rognone, Chiara</creatorcontrib><creatorcontrib>Panepinto, Olimpia</creatorcontrib><creatorcontrib>Paparo, Jessica</creatorcontrib><creatorcontrib>Gamba, Teresa</creatorcontrib><creatorcontrib>Bisonni, Renato</creatorcontrib><creatorcontrib>Di Lorenzo, Sara</creatorcontrib><creatorcontrib>Daniele, Bruno</creatorcontrib><creatorcontrib>Mentrasti, Giulia</creatorcontrib><creatorcontrib>Berardi, Rossana</creatorcontrib><title>Changes in clinical presentation, management, and survival outcomes in patients affected by colorectal cancer following COVID-19 pandemic</title><title>The oncologist (Dayton, Ohio)</title><addtitle>Oncologist</addtitle><description>As an extended analysis of the COVID-DELAY study, we aimed to assess the impact of the COVID-19 pandemic on diagnosis, staging, and survival outcomes among patients with colorectal cancer (CRC) diagnosis performed from 2019 to 2022. All consecutive newly diagnosed CRC patients referred to 11 Italian Oncology Departments between March and December 2019, 2020, 2021, and 2022 were enrolled. Access rate, demographics, diagnostic-therapeutic temporal intervals, and first-line progression-free survival (PFS) and OS among metastatic patients were assessed. Compared to 2019 (n = 690), an initial global reduction in new CRC cases in 2020 (n = 564, -18.3%) was observed, followed by a progressive increase in new CRC diagnoses in 2021 (n = 748, + 8.4%) and 2022 (n = 756, + 9.6%); a higher rate of TNM stage IV tumors was diagnosed in 2020 (35.4%) and 2021 (31.0%) compared to 2019 (29.6%), with normalization in 2022 (26.4%) (P &lt; .001). Not clinically relevant differences between histological diagnosis and first oncological examination, cytohistological diagnosis and systemic treatment start, first oncological appointment and systemic treatment start, treatment start and first radiological assessment between 2020 and 2021-2022 years were found. After propensity score matching according to the year of diagnosis, median OS was significantly worse in 2020, 2021, and 2022 compared to 2019 (27.6 vs 24.8 vs not reached vs 38.9 months, respectively) (P &lt; .001). Concordantly, the median PFS was significantly worse with each passing year: 13.0 vs 11.1 vs 9.2 vs 7.2 months in 2019, 2020, 2021, and 2022, respectively (P = .00027). A progressive normalization in the rate of new CRC diagnosis as well as TNM stages at diagnosis, in 2021 and 2022 compared to 2020 and 2019, was found. The increase in new CRC cases might have affected some diagnostic-therapeutic time intervals in 2021-2022 years compared to 2020. Significantly, compared to the pre-pandemic phase, pandemic years were independently associated with worse PFS and OS outcomes in patients affected by metastatic disease.</description><issn>1083-7159</issn><issn>1549-490X</issn><issn>1549-490X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNo9kEtPwzAQhC0E4n3liHzkQMCbTdr6iMpTqtQLIG6R46yLUWIXOwH1J_CvcdXCaWdX34xWw9gZiCsQEq-90771136lCEHssEMoC5kVUrztJi0mmI2hlAfsKMYPIZLEfJ8doCwlgMBD9jN9V25BkVvHdWud1arly0CRXK96690l75RTC-rS4ZIr1_A4hC_7lTA_9Np3G-8ywYmIXBlDuqeG1yu-fi2kLbFaOU2BG9-2_tu6BZ_OX59uM5DJ6RrqrD5he0a1kU6385i93N89Tx-z2fzhaXozy3Seiz7L86YxOUzMBBtlxkVNKLVCg0KPhChI4KiWukQwdQl1M5KTQikDIPWYJEGBx-xik7sM_nOg2FedjZraVjnyQ6wQEAsYlUIk9GqD6uBjDGSqZbCdCqsKRLWuv9rUX23rT4bzbfZQd9T843994y-8uoW7</recordid><startdate>20241126</startdate><enddate>20241126</enddate><creator>Parisi, Alessandro</creator><creator>Giampieri, Riccardo</creator><creator>Villani, Silvia</creator><creator>Magnarini, Alice</creator><creator>Gelsomino, Fabio</creator><creator>Traisci, Donatella</creator><creator>Barbin, Francesca</creator><creator>Salvatore, Lisa</creator><creator>Zichi, Clizia</creator><creator>Di Pietro, Francesca Romana</creator><creator>Zoratto, Federica</creator><creator>Lanese, Andrea</creator><creator>Petrillo, Angelica</creator><creator>Zurlo, Ina Valeria</creator><creator>Spallanzani, Andrea</creator><creator>D'Ostilio, Nicola</creator><creator>Ghidini, Michele</creator><creator>Bensi, Maria</creator><creator>Schietroma, Francesco</creator><creator>Rognone, Chiara</creator><creator>Panepinto, Olimpia</creator><creator>Paparo, Jessica</creator><creator>Gamba, Teresa</creator><creator>Bisonni, Renato</creator><creator>Di Lorenzo, Sara</creator><creator>Daniele, Bruno</creator><creator>Mentrasti, Giulia</creator><creator>Berardi, Rossana</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4629-7762</orcidid></search><sort><creationdate>20241126</creationdate><title>Changes in clinical presentation, management, and survival outcomes in patients affected by colorectal cancer following COVID-19 pandemic</title><author>Parisi, Alessandro ; Giampieri, Riccardo ; Villani, Silvia ; Magnarini, Alice ; Gelsomino, Fabio ; Traisci, Donatella ; Barbin, Francesca ; Salvatore, Lisa ; Zichi, Clizia ; Di Pietro, Francesca Romana ; Zoratto, Federica ; Lanese, Andrea ; Petrillo, Angelica ; Zurlo, Ina Valeria ; Spallanzani, Andrea ; D'Ostilio, Nicola ; Ghidini, Michele ; Bensi, Maria ; Schietroma, Francesco ; Rognone, Chiara ; Panepinto, Olimpia ; Paparo, Jessica ; Gamba, Teresa ; Bisonni, Renato ; Di Lorenzo, Sara ; Daniele, Bruno ; Mentrasti, Giulia ; Berardi, Rossana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c220t-22ddf218f83daf74be39ca3f30c6004e036b9c531fb51bd6984aaf119c7e9e143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Parisi, Alessandro</creatorcontrib><creatorcontrib>Giampieri, Riccardo</creatorcontrib><creatorcontrib>Villani, Silvia</creatorcontrib><creatorcontrib>Magnarini, Alice</creatorcontrib><creatorcontrib>Gelsomino, Fabio</creatorcontrib><creatorcontrib>Traisci, Donatella</creatorcontrib><creatorcontrib>Barbin, Francesca</creatorcontrib><creatorcontrib>Salvatore, Lisa</creatorcontrib><creatorcontrib>Zichi, Clizia</creatorcontrib><creatorcontrib>Di Pietro, Francesca Romana</creatorcontrib><creatorcontrib>Zoratto, Federica</creatorcontrib><creatorcontrib>Lanese, Andrea</creatorcontrib><creatorcontrib>Petrillo, Angelica</creatorcontrib><creatorcontrib>Zurlo, Ina Valeria</creatorcontrib><creatorcontrib>Spallanzani, Andrea</creatorcontrib><creatorcontrib>D'Ostilio, Nicola</creatorcontrib><creatorcontrib>Ghidini, Michele</creatorcontrib><creatorcontrib>Bensi, Maria</creatorcontrib><creatorcontrib>Schietroma, Francesco</creatorcontrib><creatorcontrib>Rognone, Chiara</creatorcontrib><creatorcontrib>Panepinto, Olimpia</creatorcontrib><creatorcontrib>Paparo, Jessica</creatorcontrib><creatorcontrib>Gamba, Teresa</creatorcontrib><creatorcontrib>Bisonni, Renato</creatorcontrib><creatorcontrib>Di Lorenzo, Sara</creatorcontrib><creatorcontrib>Daniele, Bruno</creatorcontrib><creatorcontrib>Mentrasti, Giulia</creatorcontrib><creatorcontrib>Berardi, Rossana</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The oncologist (Dayton, Ohio)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Parisi, Alessandro</au><au>Giampieri, Riccardo</au><au>Villani, Silvia</au><au>Magnarini, Alice</au><au>Gelsomino, Fabio</au><au>Traisci, Donatella</au><au>Barbin, Francesca</au><au>Salvatore, Lisa</au><au>Zichi, Clizia</au><au>Di Pietro, Francesca Romana</au><au>Zoratto, Federica</au><au>Lanese, Andrea</au><au>Petrillo, Angelica</au><au>Zurlo, Ina Valeria</au><au>Spallanzani, Andrea</au><au>D'Ostilio, Nicola</au><au>Ghidini, Michele</au><au>Bensi, Maria</au><au>Schietroma, Francesco</au><au>Rognone, Chiara</au><au>Panepinto, Olimpia</au><au>Paparo, Jessica</au><au>Gamba, Teresa</au><au>Bisonni, Renato</au><au>Di Lorenzo, Sara</au><au>Daniele, Bruno</au><au>Mentrasti, Giulia</au><au>Berardi, Rossana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in clinical presentation, management, and survival outcomes in patients affected by colorectal cancer following COVID-19 pandemic</atitle><jtitle>The oncologist (Dayton, Ohio)</jtitle><addtitle>Oncologist</addtitle><date>2024-11-26</date><risdate>2024</risdate><issn>1083-7159</issn><issn>1549-490X</issn><eissn>1549-490X</eissn><abstract>As an extended analysis of the COVID-DELAY study, we aimed to assess the impact of the COVID-19 pandemic on diagnosis, staging, and survival outcomes among patients with colorectal cancer (CRC) diagnosis performed from 2019 to 2022. All consecutive newly diagnosed CRC patients referred to 11 Italian Oncology Departments between March and December 2019, 2020, 2021, and 2022 were enrolled. Access rate, demographics, diagnostic-therapeutic temporal intervals, and first-line progression-free survival (PFS) and OS among metastatic patients were assessed. Compared to 2019 (n = 690), an initial global reduction in new CRC cases in 2020 (n = 564, -18.3%) was observed, followed by a progressive increase in new CRC diagnoses in 2021 (n = 748, + 8.4%) and 2022 (n = 756, + 9.6%); a higher rate of TNM stage IV tumors was diagnosed in 2020 (35.4%) and 2021 (31.0%) compared to 2019 (29.6%), with normalization in 2022 (26.4%) (P &lt; .001). Not clinically relevant differences between histological diagnosis and first oncological examination, cytohistological diagnosis and systemic treatment start, first oncological appointment and systemic treatment start, treatment start and first radiological assessment between 2020 and 2021-2022 years were found. After propensity score matching according to the year of diagnosis, median OS was significantly worse in 2020, 2021, and 2022 compared to 2019 (27.6 vs 24.8 vs not reached vs 38.9 months, respectively) (P &lt; .001). Concordantly, the median PFS was significantly worse with each passing year: 13.0 vs 11.1 vs 9.2 vs 7.2 months in 2019, 2020, 2021, and 2022, respectively (P = .00027). A progressive normalization in the rate of new CRC diagnosis as well as TNM stages at diagnosis, in 2021 and 2022 compared to 2020 and 2019, was found. The increase in new CRC cases might have affected some diagnostic-therapeutic time intervals in 2021-2022 years compared to 2020. Significantly, compared to the pre-pandemic phase, pandemic years were independently associated with worse PFS and OS outcomes in patients affected by metastatic disease.</abstract><cop>England</cop><pmid>39591103</pmid><doi>10.1093/oncolo/oyae310</doi><orcidid>https://orcid.org/0000-0003-4629-7762</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1083-7159
ispartof The oncologist (Dayton, Ohio), 2024-11
issn 1083-7159
1549-490X
1549-490X
language eng
recordid cdi_proquest_miscellaneous_3133416500
source Oxford Open; PubMed Central; EZB Electronic Journals Library
title Changes in clinical presentation, management, and survival outcomes in patients affected by colorectal cancer following COVID-19 pandemic
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T19%3A19%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Changes%20in%20clinical%20presentation,%20management,%20and%20survival%20outcomes%20in%20patients%20affected%20by%20colorectal%20cancer%20following%20COVID-19%20pandemic&rft.jtitle=The%20oncologist%20(Dayton,%20Ohio)&rft.au=Parisi,%20Alessandro&rft.date=2024-11-26&rft.issn=1083-7159&rft.eissn=1549-490X&rft_id=info:doi/10.1093/oncolo/oyae310&rft_dat=%3Cproquest_cross%3E3133416500%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c220t-22ddf218f83daf74be39ca3f30c6004e036b9c531fb51bd6984aaf119c7e9e143%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3133416500&rft_id=info:pmid/39591103&rfr_iscdi=true