Reduction in healthcare services during the COVID-19 pandemic: Patient screening based on symptoms is an effective strategy for avoiding delayed laryngeal cancer diagnosis

• Published in: American journal of otolaryngology 2021-11, Vol.42 (6), p.103162-103162, Article 103162
• Main Authors: Murri, Domenico, Botti, Cecilia, Bassano, Edoardo, Fornaciari, Martina, Crocetta, Francesco Maria, Ghidini, Angelo
• Format: Article
• Language: English
• Subjects: Aged; Appointments and Schedules; Cancer; Cancer therapies; Coronaviruses; COVID-19; Delayed diagnosis; Delayed Diagnosis - prevention & control; Delivery of Health Care - statistics & numerical data; Diagnosis; Dysphagia; Dyspnea; Female; Head & neck cancer; Head and neck cancer; Health care; Health services; Hospitals; Humans; Laryngeal cancer; Laryngeal Neoplasms - diagnosis; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - prevention & control; Laryngeal Neoplasms - surgery; Male; Malignancy; Medical diagnosis; Medical prognosis; Middle Aged; Neoplasm Staging; Normal distribution; Otolaryngology; Outpatient care facilities; Pandemics; Patients; Physical examinations; Radiation; Severe acute respiratory syndrome coronavirus 2; Signs and symptoms; Software; Statistical analysis; Strategy; Surgery; Time Factors; Tumors
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2021.103162

Restriction in healthcare services during the COVID-19 pandemic caused delays in the diagnosis and treatment of several diseases. To overcome the risk of missed diagnosis of head and neck cancers, before deleting the scheduled appointments, we have introduced a selection of the patients by examining the clinical presenting issue and previous medical history. The aim of this study is to show the effects of the abovementioned strategy on the diagnosis and management of laryngeal cancer. Data were extracted from the Hospital software regarding the new diagnosis of laryngeal SCC in the periods from March 2020 to December 2020 during the pandemic (study group) and from March 2019 to December 2019 (control group) were collected. Data were compared regarding: TNM stage, time from first medical examination to histological diagnosis (Time-1), and time form histological diagnosis to beginning of treatments (Time-2). The final study group was composed by 19 laryngeal cancers, the control group by 25 cases. No significant differences were found in the tumour stage between the groups. In the study group, Time-1 was shorter (24 days versus 43 days, p = 0.012), while Time-2 in surgically-treated patients was longer (20 days versus 9 days, p = 0.012). During the pandemic, there was a dramatic lack of medical and nurse staff needed for surgical procedures. As consequence, the time between the diagnosis of malignancy and surgical treatment increased. In our unit, an efficient patient selection strategy to reschedule medical appointments avoided a dangerous shift toward higher laryngeal cancer stages.