Objectives:We examined how incidence of pancreatic neuroendocrine and exocrine cancers changed during the COVID-19 pandemic. Methods:Using population-based cancer registry data from the Centers for Disease Control and Prevention's National Program of Cancer Registries and the National Cancer Institute's Surveillance Epidemiology, and End Results program, we examined incidence rates of pancreatic neuroendocrine and exocrine cancers before, during, and after the COVID-19 pandemic onset. Results:Age-adjusted incidence rates for both pancreatic neuroendocrine and exocrine cancer decreased from 2019-2020, rebounded from 2020-2021, and stabilized from 2021-2022. Differences were observed by sex, race, age, and stage at diagnosis. Notably, the proportion of pancreatic cancers diagnosed at localized stage increased from 2020 to 2021. Conclusion:Incidence rates of pancreatic neuroendocrine and exocrine cancers have returned to pre-pandemic levels. The increase in cases diagnosed at a localized stage from 2020-2021 suggests that people resumed their routine medical care following the onset of the COVID-19 pandemic, resulting in earlier detection and diagnosis of these cancers. Continuing to monitor pancreatic cancer incidence data is essential to better understand the pancreatic cancer disease burden.
Objective:The purpose of this study was to evaluate providing decision support access directly to patients, using contact information from a state cancer registry. Methods:The North Carolina (NC) Cancer Registry provided contacts for 720 NC men diagnosed with prostate cancer and their physicians. Letters to patients were to arrive at least 33 days after the biopsy. The patient letters included access codes for the Personal Patient Profile-Prostate (P3P), a web-based decision aid with efficacy in reducing decisional conflict. Follow-up calls were made if there was no access to the website. Our goals were 50% access, with 50% completing the intervention. Randomly selected users and non-users were contacted for a telephone interview to assess barriers and facilitators to decision aid access. Results:Of 720, 95 (13.2%) patients reported making a treatment decision before receiving the letter and were removed from the denominator. Eighty-four of 720 (13.4%; CI 13.4 - 16.4) accessed P3P and of those, 82 of 84 (97.6%) completed the questionnaire and 58 of 82 (69%) completed the intervention. White race predicted access to the decision aid. About half of 20 users recounted by telephone that the letter had arrived late; the decision had already been made. The users recounted benefits of the intervention: plain language, clarified concerns, confirmed choice. Conclusion:Providing access to P3P through a cancer registry resulted in a far lower access rate than expected. User completion rates of the intervention exceeded our expectations. The registry-required period between biopsy date and allowed patient contact may have led to a high ineligibility rate, and/or low access rates to the website.
