Delayed Diagnosis and Evolving Trends in Gastric Cancer During and After COVID-19: A Comparative Study of Staging, <i>Helicobacter pylori</i> Infection and Bleeding Risk in Western Romania
<b>Background and Objectives:</b> Gastric cancer (GC) remains a leading cause of cancer mortality worldwide, and the COVID-19 pandemic posed new barriers in diagnosis and management. This study aimed to assess whether pandemic-related healthcare disruptions resulted in more advanced GC s...
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2025-04-01
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| author | Patricia Serena Bogdan Miutescu Eyad Gadour Calin Burciu Ruxandra Mare Renata Bende Edward Seclăman Giovanni Aragona Luca Serena Roxana Sirli |
| author_facet | Patricia Serena Bogdan Miutescu Eyad Gadour Calin Burciu Ruxandra Mare Renata Bende Edward Seclăman Giovanni Aragona Luca Serena Roxana Sirli |
| author_sort | Patricia Serena |
| collection | DOAJ |
| description | <b>Background and Objectives:</b> Gastric cancer (GC) remains a leading cause of cancer mortality worldwide, and the COVID-19 pandemic posed new barriers in diagnosis and management. This study aimed to assess whether pandemic-related healthcare disruptions resulted in more advanced GC stages at presentation. We additionally examined the role of <i>Helicobacter pylori</i> (<i>H. pylori</i>) across non-cardia GC (NCGC) versus cardia GC (CGC) and evaluated the risk factors of upper gastrointestinal (GI) bleeding. <b>Methods:</b> A retrospective cohort of 121 adult patients with GC was enrolled from a tertiary Gastroenterology Unit in Western Romania, spanning pre-pandemic (March 2018–February 2020), pandemic (March 2020–February 2022), and post-pandemic (March 2022–February 2024) periods. Demographic profiles, TNM staging, histopathology, <i>H. pylori</i> status, and clinical outcomes—including GI bleeding—were extracted from medical records. <b>Results:</b> An increase in advanced GC (Stage III–IVB) was noted in the post-pandemic period (69.4% vs. 53.3% pre-pandemic; <i>p</i> = 0.021). <i>H. pylori</i> positivity remained higher in NCGC (70.6%) compared to CGC (44.6%; overall <i>p</i> = 0.041); however, CGC cases showed a rise in <i>H. pylori</i> prevalence post-pandemic (36.4% to 55.6%). One-year mortality was driven by an advanced stage (hazard ratio [HR] = 2.74, <i>p</i> = 0.002), diagnosis during the COVID-19 pandemic (HR = 1.66, <i>p</i> = 0.010), and age ≥70 years (HR = 1.88, <i>p</i> = 0.043). <b>Conclusions:</b> Our findings demonstrate that delayed diagnostic endoscopy correlated with a higher proportion of advanced GC in the post-pandemic phase. <i>H. pylori</i> was strongly linked to NCGC, though CGC showed an increasing trend in <i>H. pylori</i> prevalence. Patients on antithrombotic agents faced increased GI bleeding risks. |
| format | Article |
| id | doaj-art-0a4b5f9138b2444abc484db791d6fc7e |
| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-04-01 |
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| spelling | doaj-art-0a4b5f9138b2444abc484db791d6fc7e2025-08-20T02:17:19ZengMDPI AGDiagnostics2075-44182025-04-0115895010.3390/diagnostics15080950Delayed Diagnosis and Evolving Trends in Gastric Cancer During and After COVID-19: A Comparative Study of Staging, <i>Helicobacter pylori</i> Infection and Bleeding Risk in Western RomaniaPatricia Serena0Bogdan Miutescu1Eyad Gadour2Calin Burciu3Ruxandra Mare4Renata Bende5Edward Seclăman6Giovanni Aragona7Luca Serena8Roxana Sirli9Division of Gastroenterology and Hepatology, Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDivision of Gastroenterology and Hepatology, Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaMulti-Organ Transplant Centre of Excellence, Liver Transplantation Unit, King Fahad Specialist Hospital, Dammam 32253, Saudi ArabiaAdvanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDivision of Gastroenterology and Hepatology, Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDivision of Gastroenterology and Hepatology, Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDepartment IV—Biochemistry and Pharmacology, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Square, 300041 Timisoara, RomaniaGastroenterology and Hepatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, ItalyAnaesthesia and Intensive Care Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, ItalyDivision of Gastroenterology and Hepatology, Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania<b>Background and Objectives:</b> Gastric cancer (GC) remains a leading cause of cancer mortality worldwide, and the COVID-19 pandemic posed new barriers in diagnosis and management. This study aimed to assess whether pandemic-related healthcare disruptions resulted in more advanced GC stages at presentation. We additionally examined the role of <i>Helicobacter pylori</i> (<i>H. pylori</i>) across non-cardia GC (NCGC) versus cardia GC (CGC) and evaluated the risk factors of upper gastrointestinal (GI) bleeding. <b>Methods:</b> A retrospective cohort of 121 adult patients with GC was enrolled from a tertiary Gastroenterology Unit in Western Romania, spanning pre-pandemic (March 2018–February 2020), pandemic (March 2020–February 2022), and post-pandemic (March 2022–February 2024) periods. Demographic profiles, TNM staging, histopathology, <i>H. pylori</i> status, and clinical outcomes—including GI bleeding—were extracted from medical records. <b>Results:</b> An increase in advanced GC (Stage III–IVB) was noted in the post-pandemic period (69.4% vs. 53.3% pre-pandemic; <i>p</i> = 0.021). <i>H. pylori</i> positivity remained higher in NCGC (70.6%) compared to CGC (44.6%; overall <i>p</i> = 0.041); however, CGC cases showed a rise in <i>H. pylori</i> prevalence post-pandemic (36.4% to 55.6%). One-year mortality was driven by an advanced stage (hazard ratio [HR] = 2.74, <i>p</i> = 0.002), diagnosis during the COVID-19 pandemic (HR = 1.66, <i>p</i> = 0.010), and age ≥70 years (HR = 1.88, <i>p</i> = 0.043). <b>Conclusions:</b> Our findings demonstrate that delayed diagnostic endoscopy correlated with a higher proportion of advanced GC in the post-pandemic phase. <i>H. pylori</i> was strongly linked to NCGC, though CGC showed an increasing trend in <i>H. pylori</i> prevalence. Patients on antithrombotic agents faced increased GI bleeding risks.https://www.mdpi.com/2075-4418/15/8/950gastric canceroncology<i>Helicobacter pylori</i> |
| spellingShingle | Patricia Serena Bogdan Miutescu Eyad Gadour Calin Burciu Ruxandra Mare Renata Bende Edward Seclăman Giovanni Aragona Luca Serena Roxana Sirli Delayed Diagnosis and Evolving Trends in Gastric Cancer During and After COVID-19: A Comparative Study of Staging, <i>Helicobacter pylori</i> Infection and Bleeding Risk in Western Romania Diagnostics gastric cancer oncology <i>Helicobacter pylori</i> |
| title | Delayed Diagnosis and Evolving Trends in Gastric Cancer During and After COVID-19: A Comparative Study of Staging, <i>Helicobacter pylori</i> Infection and Bleeding Risk in Western Romania |
| title_full | Delayed Diagnosis and Evolving Trends in Gastric Cancer During and After COVID-19: A Comparative Study of Staging, <i>Helicobacter pylori</i> Infection and Bleeding Risk in Western Romania |
| title_fullStr | Delayed Diagnosis and Evolving Trends in Gastric Cancer During and After COVID-19: A Comparative Study of Staging, <i>Helicobacter pylori</i> Infection and Bleeding Risk in Western Romania |
| title_full_unstemmed | Delayed Diagnosis and Evolving Trends in Gastric Cancer During and After COVID-19: A Comparative Study of Staging, <i>Helicobacter pylori</i> Infection and Bleeding Risk in Western Romania |
| title_short | Delayed Diagnosis and Evolving Trends in Gastric Cancer During and After COVID-19: A Comparative Study of Staging, <i>Helicobacter pylori</i> Infection and Bleeding Risk in Western Romania |
| title_sort | delayed diagnosis and evolving trends in gastric cancer during and after covid 19 a comparative study of staging i helicobacter pylori i infection and bleeding risk in western romania |
| topic | gastric cancer oncology <i>Helicobacter pylori</i> |
| url | https://www.mdpi.com/2075-4418/15/8/950 |
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