The impact of COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers: a tertiary center perspective

Abstract

Purpose The aim of the present study was to assess the impact of postponed screening examinations and lockdown measures on gynecological and breast cancer diagnoses throughout the year 2020 in a gynecological oncological center in Austria. Methods Data of 889 patients with either newly diagnosed gynecological or breast cancer between January 2019 and December 2020 were collected. Clinical parameters including symptoms, performance status, comorbidities and referral status were compared in patients, who were newly diagnosed with cancer in the period of the first lockdown from March 2020 to April 2020 and the second lockdown from November 2020 to December 2020 and compared to the same period in 2019. Results Our results showed a strong decline in newly diagnosed cancers during the lockdown periods: −45% in gynecological cancer and -52% in breast cancer compared to the same period in 2019. Compared to the analogue period of 2019, breast cancer patients reported significantly more tumor-associated symptoms (55% vs. 31%, p = 0.013) during and in between (48% vs. 32%, p = 0.022) the lockdowns. During the lockdown, periods in the group of breast cancer patients’ tumor stage varied significantly compared to 2019 (T2–T4; p = 0.047). Conclusion Both lockdowns led to a strong decrease in newly diagnosed gynecological and breast cancers. Treatment delays in potentially curable disease could lead to inferior clinical outcomes, with the risk of missing the optimal treatment window. As the COVID-19 pandemic will be a challenge for some time to come, new strategies in patient care are needed to optimize cancer screening and management during the pandemic.

Assessing the impact of the COVID-19 pandemic on breast cancer screening and diagnosis rates: A rapid review and meta-analysis

“…Therefore, 33 reports consisting of 31 studies formed the basis of this review. 18 – 50 A PRISMA flow diagram outlining the screening process is presented in Figure 1 . The list of excluded studies with reasons of exclusion is reported in Supplementary Table S2.…”

“…Reductions in the diagnosis rate of breast cancer were observed in all but one study, by Vardhanabhuti et al, 48 with reported rates ranging from 36.0% reduction to a 0.5% increase among registry-based studies 26 , 27 , 40 , 48 , 50 and 64.7% to 3.0% reduction in non-registry-based studies. 19 , 21 – 23 , 28 – 34 , 37 – 39 , 42 , 43 , 45 – 47 Figure 3 displays the results of the meta-analysis of the diagnosis rate ratios. Similar to the changes in mammogram screening rates, we noted an estimated 18% (RR: 0.82, 95% CI: 0.63–1.06) and 29% (RR: 0.71, 95% CI: 0.63–0.80) reduction in diagnosis rates between 2019 and 2020 based on data derived from 4 registry-based and 18 non-registry-based studies respectively.…”

Delayed visit and treatment of lung cancer during the coronavirus disease 2019 pandemic in Japan: a retrospective study

“…The percentage of referred cases was lower during the pandemic than the percentage of cases pre-pandemic, similar to the findings of a previous report suggesting more symptomatic cases with newly diagnosed breast cancer. 8 , 9 The reason for the reduction may be attributed to the decline in the number of screenings. For the referred cases, the longer pre-visit time of 5.6 days during the pandemic was because of the restricted visits to the hospital.…”

A retrospective cohort study of bladder cancer following the COVID-19 pandemic: Are patients presenting with more aggressive disease?

“…For several months following the pandemic, patients found themselves repeatedly being told to remain at home unless severely unwell. This necessary and widely issued public health precaution has unfortunately resulted in delayed presentations of several non-COVID related illnesses, including many malignancies [ 1 , 2 , 7 ]. As such, many publications issued recommendations on how services should prioritise the management of different malignancies during the pandemic in order to minimise the impact on patient outcomes [ 8 , 9 ].…”