The Covid-19 Pandemic Influence on the Main Indicators of Oncological, in Particular Oncogynecological, Morbidity and Mortality in Ukraine

Abstract

The COVID-19 pandemic, in addition to direct impact on the health care system due to high morbidity and mortality from coronavirus, also has an indirect impact due to reduced access to health care for the population. Thus, during the pandemic period, the number of preventive visits to doctors decreased significantly due to the fear of getting infected in the health care facility, on the way to it, in the queue for a doctor, etc. In many countries, patients have had difficulty accessing health care due to congestion of medical staff with coronavirus patients.
 The aim of the study: to analyse the dynamics of the main indicators of oncological, including oncogynecological, morbidity and mortality in Ukraine over a five-year period.
 Materials and methods: according to the National Cancer Registry of Ukraine, changes in the main indicators of oncological, in particular oncogynecological, morbidity and mortality during 2016-2020 were studied. In research we analysed: crude incidence rate and crude mortality rate per 100 000 populations, one-year mortality (% lived less than 1 year since the diagnosis) and part of patients diagnosed during the preventive medical examinations (%). These coefficients were analysed in general for all classes of diseases (C00-C96), for oncogynecological diseases (C50, C53, C54, C56), among the whole population, males and females, and also analysed their trends. Correlation-regression analysis was used to determine the strength, direction and reliability of the relationship between the frequency of preventive screening for and one-year mortality.
 Results: it was found that in 2020, during the COVID-19 pandemic, the incidence of all oncological diseases in Ukraine significantly decreased (loss rate -25.0%), including oncogynecological (-18.1-21.8%), as well as mortality from them (-11.9% and 8.9-11.6%, respectively). This indicates on detection deterioration and confirms oncopathology is a risk factor for death from coronavirus disease.
 It was found that, despite a slight decrease of one-year mortality from cancer in 2016-2019 (from 30.6% to 27.1%), continuous decrease (from 24.9% to 20.8% in 2020) of cancer part detected during preventive examinations, on the background of proven strong correlation between these indicators (rxy = -0.89) threatens to further increase the cancer detection in late stages. General practitioners are responsible for population coverage by various screening programs, especially now when people have been restricted a lot in access to preventive measures for two years during the COVID-19 pandemic for different objective and subjective reasons.
 It was found males are high risk group of cancer late diagnostic vs females, due to lower rates of cancer detection during preventive examinations (in 1.7 times) and higher rates of cancer one-year mortality (in 1.7 times) and cancer mortality (in 1.5 times); while the oncogynecological pathology trends, regardless of localization, did not differ from those for all oncological disease (C00-C-96).
 Conclusions: the results of our research indicate an alarming tendency of preventive measures quality declining, further complicated by the pandemic, and threatens to increase the oncological diseases detection in late stages in the coming years. So, it is necessary to work out and implement urgent management actions to improve the organization of the population coverage by target preventive examinations in time of pandemic, especially on primary health care level.