Change in cancer diagnosis during the COVID-19 pandemic: Trends estimated from FDG-PET/CT

Ryogo Minamimoto; Masatoshi Hotta; Takashi Okafuji; Soichiro Tsutui; Masaaki Tsukuda; Hidetsugu Nakayama; Yoshitaka Shida; Tsuyoshi Tajima

doi:10.35772/ghm.2022.01016

Change in cancer diagnosis during the COVID-19 pandemic: Trends estimated from FDG-PET/CT

Glob Health Med. 2022 Apr 30;4(2):108-115. doi: 10.35772/ghm.2022.01016.

Authors

Ryogo Minamimoto¹, Masatoshi Hotta^{1

2}, Takashi Okafuji², Soichiro Tsutui², Masaaki Tsukuda², Hidetsugu Nakayama³, Yoshitaka Shida², Tsuyoshi Tajima²

Affiliations

¹ Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan.
² Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan.
³ Department of Radiation Oncology, National Cancer Center for Global Health and Medicine, Tokyo, Japan.

Abstract

The aim of this study is to clarify changes in the circumstances of cancer diagnoses during the COVID-19 pandemic in Tokyo, Japan, estimated from [¹⁸F]-2-fluoro-2-deoxy-D-glucose (FDG) -positron emission tomography/ computed tomography (PET/CT) for cancer patients. Cancer diagnosis in pandemic status (PANS) was evaluated by retrospective review of the findings of FDG-PET/CT examinations performed between 11 March 2020 and 28 December 2021 for initial staging and restaging for malignancy. Evaluation of cancer diagnosis in pre-pandemic status (pPANS) was conducted similarly in FDG-PET/CT examinations performed between 4 January 2018 and 10 March 2020. Of these, patients with malignant lymphoma (ML), lung cancer, esophageal cancer, and colorectal cancer who had a pathologically proven diagnosis or clinical diagnosis following therapy of the disease were selected for analysis. Initial cancer staging was determined by the diagnostic report of FDG-PET/CT. Change in cancer stage and in the number of FDG-PET/CT examinations performed was evaluated between pPANS and PANS, and according to term of the pandemic and vaccination status. The COVID-19 epidemic influenced the number of cancer patients who underwent FDG-PET/CT. There was a marked decrease in the number of cancer patients receiving FDG-PET/CT in Terms 1-3 (March 2020 to February 2021), but it recovered in Terms 4-6 (March 2021 to December 2021). There was no significant difference between PANS and pPANS in terms of the initial stage of cancer, but Stage IV ML and Stage II esophageal cancer were more frequent in PANS. Initial staging of ML, lung cancer, and esophageal cancer revealed more advanced cancer stages in Terms 4-6 compared with Terms 1-3. The number of patients receiving FDG-PET/CT in Tokyo was influenced by the COVID-19 epidemic. Staging based on FDG-PET/CT shifted to more advanced cancer stage during the pandemic compared with pre-pandemic.

Keywords: COVID-19; FDG-PET/CT; Japan; cancer stage; pandemic; vaccination.

2022, National Center for Global Health and Medicine.