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Impact of the COVID-19 pandemic on Stage and Incidence of Head and Neck Cancer: A Rapid Review and Meta-Analysis
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  • Catriona Douglas,
  • Kelten Clements,
  • Alekh Thapa,
  • David Conway,
  • Claire Paterson
Catriona Douglas
NHS Greater Glasgow and Clyde

Corresponding Author:[email protected]

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Kelten Clements
University of Glasgow School of Medicine Dentistry and Nursing
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Alekh Thapa
University of Glasgow School of Medicine Dentistry and Nursing
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David Conway
University of Glasgow School of Medicine Dentistry and Nursing
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Claire Paterson
NHS Greater Glasgow and Clyde
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Objectives: This rapid review aims to evaluate the impact of the COVID-19 pandemic on incidence of head and neck cancer (HNC) and stage distribution at diagnosis. Design: Rapid Review and Meta-analysis Participants: comparative data for new HNC patients between a pre-pandemic cohort (before March 2020) and a pandemic cohort (after March 2020 during the lockdown period). Main Outcomes Measured: data on tumour stage, incidence, referral pathway (number of new patient referrals) or workload levels (number of HNC treatments). Data on stage were summarised as odds ratios (OR) with 95% confidence intervals (CI), data related to changes in numbers of diagnoses, referrals and workload levels were summarised as a narrative synthesis. Results: 31 reports were included in this review. Individually 16 out of 23 studies did not show a significant impact on stage relative to the pre-pandemic period. However, the meta-analysis revealed that patients diagnosed with HNC during the pandemic were 16% more likely to have nodal involvement (OR=1.16; 95% CI 1.00–1.35), 17% more likely to have a late overall stage (OR=1.17; 95% CI 1.01–1.36), and 32% more likely to present with advanced tumour extent (T3 and T4 stage) (OR=1.32; 95% CI 1.08–1.62). Data on incidence was extremely limited and not currently sufficient to assess trends in burden of disease. Conclusions: This review indicates that during the COVID-19 pandemic there was upstaging of HNC at diagnosis, suggesting the provision of care to HNC patients was significantly affected.
27 Feb 2023Submitted to Clinical Otolaryngology
16 May 2023Submission Checks Completed
16 May 2023Assigned to Editor
28 Jun 2023Reviewer(s) Assigned
24 Jul 2023Review(s) Completed, Editorial Evaluation Pending
26 Jul 2023Editorial Decision: Revise Minor
21 Aug 20231st Revision Received
26 Sep 2023Assigned to Editor
26 Sep 2023Submission Checks Completed