Imperial College London
Portrait Picture

Dr James Kinross

Faculty of Medicine, Department of Surgery & Cancer

Reader in General Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1947j.kinross

 
 
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Location

 

1029Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mason:2020:10.1371/journal.pone.0240397,
author = {Mason, SE and Scott, AJ and Markar, SR and Clarke, JM and Martin, G and Winter, Beatty J and Sounderajah, V and Yalamanchili, S and Denning, M and Arulampalam, T and Kinross, JM},
doi = {10.1371/journal.pone.0240397},
journal = {PLoS One},
pages = {1--13},
title = {Insights from a global snapshot of the change in elective colorectal practice due to the COVID-19 pandemic},
url = {http://dx.doi.org/10.1371/journal.pone.0240397},
volume = {15},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThere is a need to understand the impact of COVID-19 on colorectal cancer care globally and determine drivers of variation.ObjectiveTo evaluate COVID-19 impact on colorectal cancer services globally and identify predictors for behaviour change.DesignAn online survey of colorectal cancer service change globally in May and June 2020.ParticipantsAttending or consultant surgeons involved in the care of patients with colorectal cancer.Main outcome measuresChanges in the delivery of diagnostics (diagnostic endoscopy), imaging for staging, therapeutics and surgical technique in the management of colorectal cancer. Predictors of change included increased hospital bed stress, critical care bed stress, mortality and world region.Results191 responses were included from surgeons in 159 centers across 46 countries, demonstrating widespread service reduction with global variation. Diagnostic endoscopy was reduced in 93% of responses, even with low hospital stress and mortality; whilst rising critical care bed stress triggered complete cessation (p = 0.02). Availability of CT and MRI fell by 40–41%, with MRI significantly reduced with high hospital stress. Neoadjuvant therapy use in rectal cancer changed in 48% of responses, where centers which had ceased surgery increased its use (62 vs 30%, p = 0.04) as did those with extended delays to surgery (p<0.001). High hospital and critical care bed stresses were associated with surgeons forming more stomas (p<0.04), using more experienced operators (p<0.003) and decreased laparoscopy use (critical care bed stress only, p<0.001). Patients were also more actively prioritized for resection, with increased importance of co-morbidities and ICU need.ConclusionsThe COVID-19 pandemic was associated with severe restrictions in the availability of colorectal cancer services on a global scale, with significant variation in behaviours which cannot be fully accounted for by hospital burden or mortality.
AU  - Mason,SE
AU  - Scott,AJ
AU  - Markar,SR
AU  - Clarke,JM
AU  - Martin,G
AU  - Winter,Beatty J
AU  - Sounderajah,V
AU  - Yalamanchili,S
AU  - Denning,M
AU  - Arulampalam,T
AU  - Kinross,JM
DO  - 10.1371/journal.pone.0240397
EP  - 13
PY  - 2020///
SN  - 1932-6203
SP  - 1
TI  - Insights from a global snapshot of the change in elective colorectal practice due to the COVID-19 pandemic
T2  - PLoS One
UR  - http://dx.doi.org/10.1371/journal.pone.0240397
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000581809800004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0240397
UR  - http://hdl.handle.net/10044/1/85299
VL  - 15
ER  -
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