Impact of the COVID-19 Epidemic on the Hospital Journey of Patients With Cancer of the Digestive System

The hospital care of patients with cancerous pathology is part of a multidisciplinary care path that includes many stages. The treatment conditions in this course vary depending on the reasons that led to suspect the existence of a cancerous pathology: accidental discovery, screening, warning signs (sometimes expressed in an acute form) or referral for treatment in charge after the diagnosis has already been made. As soon as the patient presents to the hospital, various expertises are mobilized to establish the diagnosis, carry out the extension assessment and assess the comorbidities and conditions that may have an impact on the choice of treatments. During this initial evaluation, each file is evaluated in a Multidisciplinary Consultation Meeting to define the optimal therapeutic strategy which will often include several stages involving surgery, radiotherapy, medical oncology (chemotherapy, immunotherapy, targeted therapy, etc. hormone therapy), interventional radiology, and / or supportive oncological care (nutrition, pain treatment, correction of metabolic abnormalities, palliative care, etc.). This treatment path is considered to be very complex and the fluidity of its organization determines the processing times. The management of patients in a cancer department may vary depending on the organization specific to each hospital. The health crisis induced by the COVID-19 epidemic, associated with the containment measures put in place from March 19 to May 11, 2020, have limited the use of patients in hospitals, even for emergency activities. It has also led to a reorganization of scheduled activities within establishments, with a concentration of resources around unscheduled care, in particular COVID patients. In many establishments, the other activities were, for many, deprogrammed with postponed appointments. The impact of this epidemic on the hospital journey of patients with cancerous pathology is the subject of questions at the national level. The delays in diagnosis and treatment induced have possibly had an impact on the quality of the care and on the delays with, as a corollary, a possible loss of opportunity for the patient.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Patients aged ≥ 18 years
* Patients with primary cancer of the digestive system: cancer of the esophagus, stomach, small intestine, colon, rectosigmoid junction, rectum, anal canal, liver , gall bladder, bile ducts and pancreas;
* Patients hospitalized for the first time in the medical oncology department in full hospitalization, week or day;
* Patients hospitalized between January 1, 2019 and October 31, 2020
* French-speaking patient

Exclusion Criteria:

* Patients with secondary cancer or a relapse of cancer of the digestive system
* Patients who do not require hospitalization in medical oncology
* Patient under guardianship or curatorship
* Patient deprived of liberty
* Patient under legal protection
* Patient objecting to the use of their medical data in the context of this study.

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