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Gynecologic oncology treatment modifications or delays in response to the COVID-19 pandemic in a publicly funded versus privately funded North American tertiary cancer center
Gynecologic oncology treatment modifications or delays in response to the COVID-19 pandemic in a publicly funded versus privately funded North American tertiary cancer center
- Source :
- Gynecologic Oncology
- Publication Year :
- 2021
-
Abstract
- OBJECTIVE: To compare gynecologic oncology surgical treatment modifications and delays during the first wave of the COVID-19 pandemic between a publicly funded Canadian versus a privately funded American cancer center. METHODS: This is a retrospective cohort study of all planned gynecologic oncology surgeries at University Health Network (UHN) in Toronto, Canada and Brigham and Women's Hospital (BWH) in Boston, USA, between March 22,020 and July 302,020. Surgical treatment delays and modifications at both centers were compared to standard recommendations. Multivariable logistic regression was performed to adjust for confounders. RESULTS: A total of 450 surgical gynecologic oncology patients were included; 215 at UHN and 235 at BWH. There was a significant difference in median time from decision-to-treat to treatment (23 vs 15 days, p < 0.01) between UHN and BWH and a significant difference in treatment delays (32.56% vs 18.29%; p < 0.01) and modifications (8.37% vs 0.85%; p < 0.01), respectively. On multivariable analysis adjusting for age, race, treatment site and surgical priority status, treatment at UHN was an independent predictor of treatment modification (OR = 9.43,95% CI 1.81-49.05, p < 0.01). Treatment delays were higher at UHN (OR = 1.96,95% CI 1.14-3.36 p = 0.03) and for uterine disease (OR = 2.43, 95% CI 1.11-5.33, p = 0.03). CONCLUSION: During the first wave of COVID-19 pandemic, gynecologic oncology patients treated at a publicly funded Canadian center were 9.43 times more likely to have a surgical treatment modification and 1.96 times more likely to have a surgical delay compared to an equal volume privately funded center in the United States.
- Subjects :
- 0301 basic medicine
Time Factors
COVID19
Logistic regression
Medical Oncology
Tertiary Care Centers
0302 clinical medicine
Gynecologic Surgical Procedures
Volume reductions
Young adult
Aged, 80 and over
Obstetrics and Gynecology
Cancer Care Facilities
Middle Aged
Oncology
Elective Surgical Procedures
030220 oncology & carcinogenesis
Female
Elective Surgical Procedure
Adult
medicine.medical_specialty
Canada
Genital Neoplasms, Female
Treatment delays cancer surgery
Gynecologic oncology
Article
Hospitals, Private
Time-to-Treatment
03 medical and health sciences
Young Adult
medicine
Humans
Pandemics
Aged
Retrospective Studies
Pandemic
business.industry
Hospitals, Public
Cancer
COVID-19
Retrospective cohort study
medicine.disease
Triage
United States
030104 developmental biology
Gynecology
Emergency medicine
Communicable Disease Control
business
Subjects
Details
- ISSN :
- 10956859
- Volume :
- 162
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Gynecologic oncology
- Accession number :
- edsair.doi.dedup.....f57867e73d9989aec9cd0404e987b561