{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T23:06:12Z","timestamp":1782428772415,"version":"3.54.5"},"reference-count":42,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Sunnybrook Research Institute","doi-asserted-by":"publisher","award":["#179892"],"award-info":[{"award-number":["#179892"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Due to the ramping down of cancer surgery in early pandemic, many newly diagnosed patients received other treatments first. We aimed to quantify the pandemic-related shift in rate of surgery following chemotherapy. This is a retrospective population-based cohort study involving adults diagnosed with cancer between 3 January 2016 and 7 November 2020 in Ontario, Canada who received chemotherapy as first treatment within 6-months of diagnosis. Competing-risks regression models with interaction effects were used to quantify the association between COVID-19 period (receiving a cancer diagnosis before or on\/after 15 March 2020) and receipt of surgical reSection 9-months after first chemotherapy. Among 51,653 patients, 8.5% (n = 19,558) of them ultimately underwent surgery 9-months after chemotherapy initiation. Receipt of surgery was higher during the pandemic than before (sHR 1.07, 95% CI 1.02\u20131.13). Material deprivation was independently associated with lower receipt of surgery (least vs. most deprived quintile: sHR 1.11, 95% CI 1.04\u20131.17), but did not change with the pandemic. The surgical rate increase was most pronounced for breast cancer (sHR 1.13, 95% CI 1.06\u20131.20). These pandemic-related shifts in cancer treatment requires further evaluations to understand the long-term consequences. Persistent material deprivation-related inequity in cancer surgical access needs to be addressed.<\/jats:p>","DOI":"10.3390\/curroncol29100611","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:04:55Z","timestamp":1665965095000},"page":"7732-7744","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cancer Patients First Treated with Chemotherapy: Are They More Likely to Receive Surgery in the Pandemic?"],"prefix":"10.3390","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0577-2830","authenticated-orcid":false,"given":"Rui","family":"Fu","sequence":"first","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinku","family":"Sutradhar","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Dare","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Li","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3228-6042","authenticated-orcid":false,"given":"Timothy P.","family":"Hanna","sequence":"additional","affiliation":[{"name":"Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen\u2019s University, Kingston, ON K7L 3N6, Canada"},{"name":"Ontario Institute for Cancer Research (OICR), Toronto, ON M5G 0A3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin K. W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre\u2014Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Ontario Health\u2014Cancer Care Ontario, Toronto, ON M5G 2L7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C.","family":"Irish","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Otolaryngology\u2014Head & Neck Surgery\/Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Coburn","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Ontario Health\u2014Cancer Care Ontario, Toronto, ON M5G 2L7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Hallet","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Odette Cancer Centre\u2014Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simron","family":"Singh","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambica","family":"Parmar","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig C.","family":"Earle","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-6719","authenticated-orcid":false,"given":"Lauren","family":"Lapointe-Shaw","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5533-7418","authenticated-orcid":false,"given":"Monika K.","family":"Krzyzanowska","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Finelli","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander V.","family":"Louie","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5612-481X","authenticated-orcid":false,"given":"Ian J.","family":"Witterick","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada"},{"name":"Odette Cancer Centre\u2014Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"},{"name":"Ontario Health\u2014Cancer Care Ontario, Toronto, ON M5G 2L7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyson","family":"Mahar","sequence":"additional","affiliation":[{"name":"School of Nursing, Queen\u2019s University, Kingston, ON K7L 3N6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Urbach","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Surgery, Women\u2019s College Hospital, Toronto, ON M5S 1B2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel I.","family":"McIsaac","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Enepekides","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole J.","family":"Look Hong","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-1393","authenticated-orcid":false,"given":"Antoine","family":"Eskander","sequence":"additional","affiliation":[{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e228855","DOI":"10.1001\/jamanetworkopen.2022.8855","article-title":"Delivery of Cancer Care in Ontario, Canada, during the First Year of the COVID-19 Pandemic","volume":"5","author":"Walker","year":"2022","journal-title":"JAMA Netw. 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