The impact of the COVID-19 pandemic upon pancreatic cancer treatment (CONTACT Study): a UK national observational cohort study
Authors: Hall Lewis A. , McKay Siobhan C. , Halle-Smith James , Soane Joshua , Osei-Bordom Daniel-Clement , Goodburn Lesley , Magill Laura , Pinkney Thomas , Radhakrishna Ganesh , Valle Juan W. , Corrie Pippa , Roberts Keith J. ,   The CONTACT Study Group,   Writing Group and Steering Committee, Goodburn Lesley ,   Data Managers, Hughes Terry , Perry Rita , Walters Michael ,   Meta-Coordinators, Acharya Radhika , Binnersly Thomas , Brown Samuel J. , Everitt Rebecca , Hargreaves Oscar , Hodgson Samuel , Parylo Jacek , Perrett Madeleine , Smith Daniel J. , Thorne Thomas ,   Regional Leads, Abouelazayem Mohamed , Bradley Alison , Currow Chelise , Fox Richard , Giles Benjamin , Kourdouli Amar , Mahmood Fahad , Moir John , Mowbray Nicholas , Shotton Rohan , Vivekananthan Cavitha , Zakeri Roxanna ,   Collaborators, Abbadi Reyad , Abbott Sian , Abdelrahim Hamza , Abukar Yusria , Adel Nader , Adwan Hussamuddin , Ahmed Marriam , Ahmed Shehzad , Ahmed Irfan , Akotat Ouiam , Al-Sarireh Bilal , Alamassi Amro , Aldous Gemma , Alkari Bassam , Almonib Ahmed , Amin Jasim , Anjum Muhammad Raheel , Aroori Somaiah , Arshad Ali , Arya Pallavi , Asfandyar Syed , Aslam Usama , Aspinall Richard , Athwal Tejinderjit , Azam Saima , Bailey Robert , Bandlamudi Nanda , Barker Sophie , Bashir Khalid , Bavikatte Akshay , Belchita Raluca , Beluso Ann , Bevan Katharine , Bhatti Imran , Boulbadaoui Amal , Boyce Tamsin , Bradley Neil , Brooks Corinne , Brown Christopher , Burns Stephanie , Butler Linda , Byrne Hannah , Canelo Ruben , Ceresa Carlo , Chadwick Georgina , Charlesworth Irene , Chase Thomas , Chen Patrick , Chhabra Raunaq , Chin Mei Ying , Choudhry Zeshan , Chung Yooyun , Ciocarlan Svetlana , Clark Jennifer , Clyde Danielle , Connolly Maureen , Connors Kathleen , Cormack Jonathan , Coyle Meghan , Crumley Andrew , Davies Nick , Davies Emma , de Liguori-Carino Nicola , Di Franco Filippo , Diong Kok , Doe Matt , Donovan Victoria , Downs Jennifer , Easton Trish , Ekong Tolu , Ekpenyong Utitofon , El-housseri Tarek , Elmaradny Ahmed , Elzubier Mohamed , Epanomeritakis Emmanouil , Erotocritou Marios , Ewing Iain , Fabelurin Christiana , Falk Stephen , Farrugia Alexia , Feretis Michael , Finch Guy , Findlay Alasdair , Fisher Simon , Fong Steven , Fox Katherine , Fung Xavier , Fusai Giuseppe , Gale Laura , Gall Tamara , Garcea Giuseppe , Gasem Jaber , Georgiades Fanourios , Geraghty Joe , Ghassemi Nader , Gherghab Mustafa , Giles Joanne , Gillmore Roopinder , Gilroy Leah , Goldsworthy Matthew , Grayston Alex , Green Jordan , Gurprashad Roy , Hajee-Adam Wafaa , Hajibandeh Shahin , Hallinan-Rhodes Clara , Hamed Adel , Hameed Waseem , Handa Siddartha , Hanna Michael , Hassan Mohammad , Havard Tim , Hayes Jennifer , Hayton Philip , Hebbar Madhu , Heenan Kerri-Marie , Higgins Christine , Ho Michael , Holroyd David , Howard Richard , Hughes Charlotte , Inayet Nashiz , Indayare Sahra , Ingmire Julie , Irving Glen , Ivimy Anita , Jackson Georgina , Jah Asif , Jamieson Nigel , Jaunoo Shameen , Javed Nasir , Jeevagan Arun , Jiao Long , Johnson Sarah , Jones Miriam , Jones Michael , Jones Claire , Jones Dylan , Jones Vicky , Jordan Caitlin , Jose Paul , Joshi Neerav , Joshi Kunal , Kane Daniel , Kapila Diya , Karim Syed , Kasimanickam Muthi , Kaur Mandeep , Kausar Ambareen , Keatley Ben , Kedzierski Adam , Kejariwal Deepak , Kelly Natasha , Khan Areeb , Khani Aria , Khokar Usman , Knibbs William , Kocher Hemant , Koumoutsos Ioannis , Kovammal Shemin , Kreppel Sarah , Kuganesan Tharsika , Kumar Yogesh , Kurien Reuben , Lal Nikhil , Lavelle Corina , Laverick Sophie , Laverty Lauren , Laxaman Hemant , Lee Alvin , Lloyd-Jones Karen , Lykoudis Pavlos , Mahalingam Aarini , Majkowska Agata , Majumdar Debasis , Malam Yogeshkumar , Mann Kulbir , Marsh Robyn , Martin Harry , Mcaleer Joseph , McCain Stephen , McCaughan Hannah , McCollum Catherine , McCormack Kieran , McDonald Claire , McGoran John , Mclellan Morag , Meilak Joseph , Menon Shyam , Menzies Donald , Milburn James , Millar Andrew , Minto Moeed , Mishra Amitabh , Mitha Zain , Mitra Vikramjit , Mogan Sathis , Mohamed Badreldin , Mohammadi-Zaniani Ghazaleh , Mohammed Yaser , Mohan Jaiganesh , Morris Samuel , Morrison Gary , Morrison Tamsin , Mortimer Matthew , Moulding Samuel , Mourad Moustafa , Mukherjee Sujit , Mustafa Ameer , Naik Keval , Naqvi Syed , Natarajan Deepika , Ngan Thomas , Noakes Tracey , Norris Tim , O’Connell Elizabeth , O’Kane Rebecca , O’Reilly David , O’Rourke William , Olabintan Olaolu , Ololade Samuel , Ong Seok Ling , Osunlusi Oluwafemi , Palejwala Altaf , Palepa Anna , Palmer Monica , Parisinos Constantinos , Parmar Chetan , Patel Panna , Pathak Samir , Pereira Stephen , Pericleous Stephanos , Phillips Rosemary , Pike Tom , Pillay Lushen , Pinheiro Joao , Pirjamali Parisa , Poolovadoo Yanish , Popa Mariuca , Powell-Brett Sarah , Prior-Ong Melissa , Propper David , Quinn Leonard , Radwan Khaled , Ralph Alyssa , Ramachandran Veena , Ramsamy Ganeshan , Rassam Hind , Ray-Chaudhuri Anjana , Reddy Srikanth , Reza Shahriar , Rezk Karim , Rice Paul , Richmond Lysia , Ripoll Brianda , Rizvi Syed , Robinson Sarah , Robson Natalie , Rogers Polly , Rowley Megan , Russell Thomas , Safarova Dana , Sagoo Harkiran , Samake Maurice , Sami Sharukh , Samraj Kumar , Sarmah Panchali , Saxton Edward , Scutt Bethany , Sellahewa Chaminda , Sen Gourab , Shaida Zara , Shandakumar Amrita , Sharer Nicholas , Shaukat Syed , Sheth Roosey , Shingler Guy , Shroll Amy , Siriwardena Ajith K. , Skipworth James , Slater Sarah , Smith Conor , Smith Andrew , Sogaolu Opeyemi , Stevens Claire , Stewart Duncan , Stupalkowska Weronika , Sud Vikas , Sultan Zain , Summers Luke , Suresh Nikhil , Sutton Jonathan , Tan Wei Jian , Tan Chew , Tanase Andrei , Tanase Andrei , Tanno Lulu , Taylor Luke , Taylor Mark , Thakkar Rohan , Thomas Donna , Thompson Emily , Tinsley Benjamin , Toy Elizabeth , Tsang David , Tsirekidze Archil , Tsironis Dimitrios , Tucker Sophie , Turner Tracey , Udayachandran Varu , van Laarhoven Stijn , Vandadi Lakshmi Deepa , Varley Rebecca , Veeramootoo Darmarajah , Venkatachalapathy Suresh Vasan , Verma Ashwin , Vipond Mark , Waite Daniel , Ward Amy , Warner Ben , Waters Justin , West Alexander , Whitelaw Douglas , Williams Matthew , Williams Rhys , Wilson Phoebe , Yershov Danylo , Young Alistair , Zafar Muneeb , Zaman Osama , Zhao Melissa 
Published: March 2023

Abstract
Introduction
CONTACT is a national multidisciplinary study assessing the impact of the COVID-19 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC).

Methods
The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID-19 pandemic cohort (07/01/2019-03/03/2019) were compared to a cohort diagnosed during the first wave of the UK pandemic (‘COVID’ cohort, 16/03/2020-10/05/2020), with 12-month follow-up.

Results
Among 984 patients (pre-COVID: n = 483, COVID: n = 501), the COVID cohort was less likely to receive staging investigations other than CT scanning (29.5% vs. 37.2%, p = 0.010). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (54.5% vs. 76.6%, p = 0.001) and increase in the proportion recommended upfront chemotherapy (45.5% vs. 23.4%, p = 0.002). Among patients on a non-curative pathway, fewer patients were recommended (47.4% vs. 57.3%, p = 0.004) or received palliative anti-cancer therapy (20.5% vs. 26.5%, p = 0.045). Ultimately, fewer patients in the COVID cohort underwent surgical resection (6.4% vs. 9.3%, p = 0.036), whilst more patients received no anti-cancer treatment (69.3% vs. 59.2% p = 0.009). Despite these differences, there was no difference in median overall survival between the COVID and pre-COVID cohorts, (3.5 (IQR 2.8–4.1) vs. 4.4 (IQR 3.6–5.2) months, p = 0.093).

Conclusion
Pathways for patients with PDAC were significantly disrupted during the first wave of the COVID-19 pandemic, with fewer patients receiving standard treatments. However, no significant impact on survival was discerned.