Delay to Diagnosis in Digestive Cancerology by the General Practitioner Related to Covid-19 Pandemic Confinement

Delay to Diagnosis and Management in Digestive Cancerology by the General Practitioner Within the City-hospital Network in the Context of Confinement Related to the Covid-19 Pandemic

Objective: the pre-hospital management of cancers is little known in General Medicine. The first lockdown related to the COVID-19 pandemic led to the closure of health facilities. Investigators were interested in the diagnosis and care pathway of digestive cancers in post-confinement in General Medicine in Nouvelle-Aquitaine.

Study Overview

• Status: Completed
• Conditions: Advanced Cancer; Pandemic, COVID-19; Diagnosis; Neoplasms, Colorectal; Neoplasms Pancreatic; General Practitioner; Neoplasm, Liver

Detailed Description

Method: patient records discussed in Digestive Oncology CPR of Bordeaux University Hospital for the first time from June 1 to August 31, 2020 and over the same period in 2019 were included. A questionnaire on the dates of the first symptoms, first consultation with the general practitioner, imaging examination and access to the specialist was sent to the general practitioner. The primary outcome was time from onset to date of first MDT.

• Study Type: Observational
• Enrollment (Actual): 376

Contacts and Locations

Study Locations

• France
  • Bordeaux, France, 33076
    • Blanc-Bisson Christele

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Male and female under 18 years old

• residing in New Aquitaine and
• whose general practitioner practiced in New Aquitaine
• malignant tumors of the esophagus, stomach, small intestine, colon, recto-sigmoid junction, rectum, anus and anal canal, liver and intrahepatic bile ducts, extrahepatic bile ducts, gallbladder and pancreas.
• to have had at least one consultation or hospitalization in the digestive pole of the Bordeaux University Hospital within 6 months after the MDT.

Description

Inclusion Criteria:

• residing in New Aquitaine and
• whose general practitioner practiced in New Aquitaine
• malignant tumors of the esophagus, stomach, small intestine, colon, recto-sigmoid junction, rectum, anus and anal canal, liver and intrahepatic bile ducts, extrahepatic bile ducts, gallbladder and pancreas.
• to have had at least one consultation or hospitalization in the digestive pole of the Bordeaux University Hospital within 6 months after the MDT.

Exclusion Criteria:

• Patients under 18 years of age,
• who had already had a MDT for this cancer,
• whose date of first MDT was outside the inclusion dates,
• whose new cancer was a digestive metastasis of a primary of another location,
• who did not have French health insurance

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
2019; patients diagnosed in 2019
2020; patients diagnosed in 2020

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
time from date of first symptoms of cancer to the date of first MDT	time from date of first symptoms of cancer to the date of first MDT	DAYS

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
time from date of first symptoms to date of first consultation with a general practitioner,	time from date of first symptoms to date of first consultation with a general practitioner,	DAYS
time from date of first symptoms to first imaging or specific examination,	difficulties in referral to imaging,	DAYS
time from date of first symptoms to consultation with a specialist,	difficulties in referral to a specialist,	DAYS
stage of pathology by type of cancer,	stage of pathology by type of cancer according to TNM classification (tumor, node, metastatic status)	at inclusion
frequency of different types of cancer,	PERCENTAGE of each type of cancers in this study	at inclusion
overall survival.	overall survival.	MONTHS, time from from date of first symptoms to date of death

Collaborators and Investigators

• Sponsor: University of Bordeaux

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2019
• Primary Completion (Actual): September 1, 2022
• Study Completion (Actual): September 1, 2022

Study Registration Dates

• First Submitted: October 25, 2023
• First Submitted That Met QC Criteria: November 1, 2023
• First Posted (Actual): November 7, 2023

Study Record Updates

• Last Update Posted (Actual): November 7, 2023
• Last Update Submitted That Met QC Criteria: November 1, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: digestive cancer, covid
• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; Neoplasms by Site; Gastrointestinal Neoplasms; Digestive System Neoplasms; Gastrointestinal Diseases; Liver Diseases; Colonic Diseases; Intestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Neoplasms; COVID-19; Disease; Colorectal Neoplasms; Liver Neoplasms
• Other Study ID Numbers: 2023-A02271-44

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No