Regarding the new diagnosis of gastrointestinal cancer, we investigated the changes before and during the COVID-19 epidemic, and found that the number of diagnoses of early gastric cancer and early colorectal cancer decreased significantly, especially for colorectal cancer. It was found that the number of cases found in the advanced stage increased.Yokohama City University School of Medicine reported for the first time in Japan.

 It has become clear overseas that the number of new cancer diagnoses has decreased significantly due to lockdown and medical collapse caused by COVID-19, and it has been reported that the number of people dying from cancer will increase in the future.Therefore, the research group of Yokohama City University School of Medicine, Department of Hepatobiliary and Pancreatic Gastroenterology, Takuma Higurashi, Professor Atsushi Nakajima, and Kento Kuzuo of the same university (currently affiliated with the Department of Gastroenterology, Yokohama Medical Center) has been established in Japan. A study was conducted to clarify the effects of the COVID-19 epidemic on gastrointestinal cancer.

 The research group has newly established gastrointestinal cancer (esophageal cancer, stomach cancer, colon cancer, pancreatic cancer) in the four years from 2 to 2017 at two hospitals, Yokohama City University Hospital and National Hospital Organization Yokohama Medical Center. , Liver cancer, biliary tract cancer) were investigated in all 2020 patients at the time of diagnosis.

 Comparing the pre-epidemic period with the period after March 19, when the COVID-2020 epidemic began in earnest in Japan, the number of new cancer diagnoses was 3% for gastric cancer and 26.9% for colorectal cancer. It decreased significantly.

 When compared by stage, a significant decrease was observed in Stage I for gastric cancer, 35.5% for Stage 0 for colorectal cancer, 32.9% for Stage I, and 34.0% for Stage II, while Stage III for colorectal cancer was 35.3% significant. A significant increase was observed.No significant changes were observed in other pancreatic cancer, esophageal cancer, liver cancer, and biliary tract cancer.

 In Japan, lockdown was not carried out, and an emergency declaration was issued and infection control measures were taken in the form of a request for self-restraint.In addition, the medical system was not restricted except in some areas, and in fact, the number of revisited patients did not decrease significantly before and after the epidemic in this study.On the other hand, the number of first-time patients decreased significantly, and although the number of first-time patients was not restricted, it is considered that the number of first-time patients decreased as a result of refraining from seeing asymptomatic and mildly symptomatic patients.

 However, most of the cases of gastric cancer and colorectal cancer do not show symptoms at an early stage, and it is possible that the number of diagnoses of early gastric cancer and early colorectal cancer has decreased due to refraining from consultation.In addition, it has been increasing in recent years, and it is possible that the number of cases of colorectal cancer, which has a large number of patients, is found in advanced stages due to the delay in the timing of colonoscopy.

 The incidence of cancer is not expected to change significantly around COVID-19, but the decrease in the number of diagnoses may lead to more cases of advanced cancer being detected in the future.It is important not to postpone examinations such as hospital visits, gastrocamera examinations, and colonoscopy examinations at appropriate times, and to call for the importance of early detection of cancer.

* Stage is a stage that indicates the degree of cancer progression.The larger the value, the more progress is made.Stage 0-1 is often early cancer, although it varies slightly depending on the type of cancer.

Reference: [JAMA network open] Gastrointestinal Cancer Stage at Diagnosis Before and During the COVID-19 Pandemic in Japan

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