Prostate cancer diagnosis, staging, and treatment in Sweden during the first phase of the COVID-19 pandemic

Abstract

Introduction: The first case of COVID-19 in Sweden was diagnosed in late January 2020, the first recommendations against the spread of the virus were released in mid-March, and the peak of the first wave of the pandemic was reached in March-June. The aim of this cross-sectional study was to assess the short-term effects of the first wave of the COVID-19 pandemic on prostate cancer (PCa) diagnosis, staging, and treatment. Materials and methods: Data in the National Prostate Cancer Register (NPCR) of Sweden on newly diagnosed PCa cases and on the number of diagnostic and therapeutic procedures performed between 18 March 2020 and 2 June 2020 were compared with those in the corresponding time periods in 2017-2019, as reported until January 31 of the year after each study period. Results: During the study period in 2020, 36% fewer PCa cases were registered in NPCR compared with the corresponding time period in previous years: 1458 cases in 2020 vs a mean of 2285 cases in 2017-2019. The decrease in new PCa registrations was more pronounced in men above age 75 years, down 51%, than in men aged 70-75, down 37%, and in men below age 70, down 28%. There was no decrease in the number of radical prostatectomies and number of radical radiotherapy courses increased by 32%. Conclusions: During the peak of the first phase of the COVID-19 pandemic, the number of men diagnosed with PCa in Sweden decreased by one third compared with previous years, whereas there was no decrease in the number of curative treatments.

Effects of the COVID-19 pandemic on patients with inflammatory joint diseases in Sweden: from infection severity to impact on care provision

“…We are not aware of previous studies that have assessed the diagnostic intensity regarding comorbidities. Our results for the general population verified declines during Spring 2020 reported elsewhere9 10 23 and suggest a similar pattern in IJD.…”

Impact of the COVID-19 outbreak on prostate cancer care in the Netherlands

“…The extent of the decline in diagnoses during the first COVID-19 wave that we have observed in the Netherlands was smaller than what was observed in Sweden. [19] In Sweden the national cancer registry was also used to evaluate the effects of the first COVID-19 wave on prostate cancer care. They demonstrated an overall decline in diagnoses of 36% and found the largest decline (40%) in the low/intermediate-risk group.…”

“…With respect to different age-groups, they also observed the largest decline amongst elderly patients with a 51% decline in patients aged above 75 years. [19] …”

“…A similar observation was made in the previously mentioned Swedish study which demonstrated no decline in the number of radical prostatectomies, which was also explained by prioritizing oncological surgery. [19] …”

The Dilemma of Misclassification Rates in Senior Patients With Prostate Cancer, Who Were Treated With Robot-Assisted Radical Prostatectomy: Implications for Patient Counseling and Diagnostics

“…As we are in the middle of the COVID-19 pandemic, the trend of unfavorable characteristics of PCa will continue to develop, leading to a late diagnosis and a delayed treatment with histopathological signs of an advanced stage of cancer ( 27 ). We already observed a rise in the proportion of RARP patients with aggressive tumor characteristics in our daily practice.…”