{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T17:45:54Z","timestamp":1776015954069,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006069","name":"Krebsliga Beider Basel","doi-asserted-by":"publisher","award":["KLbB\u20105330\u201003\u20102021"],"award-info":[{"award-number":["KLbB\u20105330\u201003\u20102021"]}],"id":[{"id":"10.13039\/501100006069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Healthcare across Europe was affected by COVID\u201019 pandemic lockdowns. How different national healthcare systems coped with this impact remains unclear. Healthcare in Switzerland differs significantly from that in Scotland, for example, in terms of centralization. The aim of this study was to assess the impact of the COVID\u201019 pandemic on the diagnosis and surgical treatment of colorectal cancer (CRC) in contrasting healthcare systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted in south\u2013east Scotland and in the extended north\u2013west of Switzerland from January 1st, 2019 to February 28th, 2023. All patients diagnosed with CRC were included. The primary outcomes were the time from CRC diagnosis to treatment and the UICC stage at diagnosis, assessed prior to, during, and following the period of lockdown. The lockdown in Scotland lasted from March 2020 to October 2020 and in Switzerland from March 2020 to April 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 6745 patients were included (4127 from Scotland and 2618 from Switzerland). Median time from diagnosis to treatment remained unaltered during the lockdown period in both countries. However, after the lockdown, the median time from diagnosis to treatment increased from 59 to 76\u00a0days in Scotland. The median number of patients who were diagnosed per annual quarter declined from 177 (IQR: 171\u2013190) to 152 (IQR: 150\u2013154), and the median number of who received treatment from declined from 256 (IQR: 253\u2013259) to 203 (IQR: 186\u2013218) during lockdown in Scotland. In multivariable logistic regression, the odds of being diagnosed with UICC stage IV increased by 42% for patients diagnosed during lockdown (95%\u2010CI: 12%\u201381%). In Switzerland, the time from diagnosis to treatment increased slightly after the pandemic. However, the other effects described above were not observed in Switzerland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This descriptive study demonstrated that the impact of the pandemic on colorectal cancer care was less pronounced in Switzerland, but considerable in Scotland. Because separate subgroup analyses were conducted, direct comparisons cannot be made between Scotland and Switzerland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      This trial is registered on\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      as part of the EvaCol study (NCT04550156)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70294","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:02:25Z","timestamp":1772989345000},"page":"818-828","source":"Crossref","is-referenced-by-count":0,"title":["How Is Colorectal Cancer Care Impacted by Global Crisis in Contrasting Healthcare Systems?\u2014A Descriptive Study From Scotland and Switzerland During the COVID\u201019 Pandemic"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2994-0237","authenticated-orcid":false,"given":"B.","family":"Wiesler","sequence":"first","affiliation":[{"name":"Clarunis, Department of Visceral Surgery University Digestive Health Care Center, St. Clara Hospital and University Hospital Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Worni","sequence":"additional","affiliation":[{"name":"Clarunis, Department of Visceral Surgery University Digestive Health Care Center, St. Clara Hospital and University Hospital Basel  Basel Switzerland"},{"name":"Stiftung Lindenhof I Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine  Berne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Studer","sequence":"additional","affiliation":[{"name":"Stiftung Lindenhof I Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine  Berne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.\u2010M.","family":"Gass","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery Cantonal Hospital of Lucerne  Lucerne Switzerland"},{"name":"Department of Health Sciences and Medicine University of Lucerne  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Metzger","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery Cantonal Hospital of Lucerne  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Hartel","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery Cantonal Hospital of Aarau  Aarau Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Nebiker","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery Cantonal Hospital of Aarau  Aarau Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery Cantonal Hospital of Basel\u2010Land  Liestal Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery Cantonal Hospital of Basel\u2010Land  Liestal Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Eisner","sequence":"additional","affiliation":[{"name":"Department of Surgery Cantonal Hospital of Olten  Olten Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Andreou","sequence":"additional","affiliation":[{"name":"Department of Surgery Cantonal Hospital of Olten  Olten Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.","family":"Zingg","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery Spital Limmattal  Schlieren Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Stimpfle","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery Spital Limmattal  Schlieren Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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