我们旨在评估COVID-19大流行对HPV阳性口咽癌（OPC）诊断延迟的潜在影响，并描述其潜在原因。所有在2019年6月至12月之间（流行前队列）和2020年6月至12月之间被诊断为HPV阳性口咽癌并转介至三级癌症中心的病患均进行了回顾性研究。比较了两组之间的TNM分期、肿瘤体积（GTV）以及从症状出现到治疗开始的间隔时间。根据临床医师的记录，记录了诊断确立的延迟原因（从症状出现到主肿瘤活检阳性的时间大于6个月或病历中专门提到的延迟），并将其分类为与COVID-19相关或非COVID-19相关。共识别了157例连续的HPV阳性口咽癌患者（流行前:92例; 流行时:65例）。与流行前队列相比，流行期患者在报道时具有N2-N3（32% vs. 15%，P = 0.019）和III期（38% vs. 23%，P = 0.034）的疾病比例较高。出现症状到确立诊断的延迟时间大于6个月（29% vs. 20%，P = 0.16）或首次治疗的延迟时间（49% vs. 38%，P = 0.22）的比例差异在统计学上没有显著差异。流行期的诊断延迟中，47%可能与COVID-19有关。我们观察到COVID-19大流行对HPV阳性口咽癌护理的间接影响，表现为报道时的晚期疾病和不显著但数字上更长的诊断延迟时间。这可能不利于患者的预后和未来的资源分配。COVID-19相关和无关的因素均会导致诊断延迟。应该采取有针对性的干预措施来减少延迟时间。版权所有©2023 Elsevier Ltd。保留所有权利。

We aim to assess the potential impact of the COVID-19 pandemic on diagnostic delays in HPV-positive oropharyngeal cancer (OPC), and to describe their underlying reasons.All HPV + OPC referred to a tertiary cancer centre and diagnosed between June-December 2019 (Pre-Pandemic cohort) vs June-December 2020 (Pandemic cohort) were reviewed. TNM classification, gross-tumor-volumes (GTV) and intervals between sign/symptom onset and treatment initiation were compared between the cohorts. Reasons for delay (>6 months from onset of signs/symptoms to a positive biopsy of the primary tumor, or a delay specifically mentioned in the patient chart) in establishing the diagnosis were recorded per clinician's documentation, and categorized as COVID-related or non-COVID-related.A total of 157 consecutive HPV + OPC patients were identified (Pre-Pandemic: 92; Pandemic: 65). Compared to the Pre-Pandemic cohort, Pandemic cohort patients had a higher proportion of N2-N3 (32 % vs 15 %, p = 0.019) and stage III (38 % vs 23 %, p = 0.034) disease at presentation. The differences in proportions with > 6 months delay from symptom onset to establishing the diagnosis (29 % vs 20 %, p = 0.16) or to first treatment (49 % vs 38 %, p = 0.22) were not statistically different. 47 % of diagnostic delays in the Pandemic cohort were potentially attributable to COVID-19.We observed a collateral impact of the COVID-19 pandemic on HPV + OPC care through more advanced stage at presentation and a non-significant but numerically longer interval to diagnosis. This could adversely impact patient outcomes and future resource allocation. Both COVID-19-related and unrelated factors contribute to diagnostic delays. Tailored interventions to reduce delays are warranted.Copyright © 2023 Elsevier Ltd. All rights reserved.