Assessing the Influence of the COVID-19 Pandemic on Gastric Cancer Mortality Risk

Author:

Shigenobu Yuya1,Miyamori Daisuke1ORCID,Ikeda Kotaro1,Yoshida Shuhei1,Kikuchi Yuka1,Kanno Keishi1ORCID,Kashima Saori23ORCID,Ito Masanori1

Affiliation:

1. Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan

2. Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Hiroshima University, 1-5-1 Kagamiyama, Higashi-Hiroshima 739-8511, Japan

3. Center for the Planetary Health and Innovation Science, The IDEC Institute, Hiroshima University, 1-5-1 Kagamiyama, Higashi-Hiroshima 739-8511, Japan

Abstract

Background: The global impact of the coronavirus disease 2019 (COVID-19) pandemic on public health has been significant. Upper gastrointestinal endoscopy for screening and diagnosis decreased along with new gastric cancer (GC) diagnoses. Methods: This study assesses how the pandemic affected GC mortality using data from Hiroshima Prefecture, comparing mortality rates between patients diagnosed during the pandemic (2020 and 2021) and pre-pandemic (2018 and 2019) periods. The crude hazard ratios (HRs) and HRs adjusted for age, sex, clinical stage, treatment status, and travel distance to the nearest GC screening facility were estimated using Cox regression models. Subgroup and sensitivity analyses were also performed. Results: A total of 9571 patients were diagnosed, with 4877 eligible for follow-up. The median age was 74 years, and 69% were male. The median follow-up period was 157 days, with events per 1000 person-years at 278 and 374 in the pre-pandemic and pandemic periods, respectively (crude HR, 1.37; adjusted HR, 1.17). The sensitivity and subgroup analyses yielded consistent results. Conclusions: The COVID-19 pandemic increased mortality risk in patients with GC. Further studies are required to observe long-term outcomes and identify the disparities contributing to the increased mortality risk.

Funder

JSPS KAKENHI

Publisher

MDPI AG

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