The Impact of COVID-19 Pandemic on Gynecological and Breast Cancer Detection Rate: A Tertiary Center Perspective.

K. Knoll, E. Reiser, K. Leitner, J. Kögl, C. Ebner, C. Marth, I. Tsibulak
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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 detection rate 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 – April 2020 and the second lockdown from November 2020 – 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% versus 31%, p=0.013) during and in between (48% versus 32%, p=0.022) the lockdowns. During the lockdown periods breast cancer patients were diagnosed with a significantly higher tumor-stage (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.
COVID-19大流行对妇科和乳腺癌检出率的影响:三级中心视角
目的:本研究旨在评估奥地利一家妇科肿瘤中心推迟筛查检查和封锁措施对2020年全年妇科和乳腺癌检出率的影响。方法:收集2019年1月至2020年12月期间新诊断的889例妇科或乳腺癌患者的数据。将2020年3月至4月第一次封城期间和2020年11月至12月第二次封城期间新诊断的癌症患者的症状、体能状况、合并症、转诊情况等临床参数与2019年同期进行比较。结果:我们的研究结果显示,与2019年同期相比,封锁期间新诊断的癌症大幅下降:妇科癌症下降45%,乳腺癌下降52%。与2019年的类似时期相比,在封锁期间和期间(48%对32%,p=0.022),乳腺癌患者报告的肿瘤相关症状明显更多(55%对31%,p=0.013)。在封锁期间,乳腺癌患者被诊断为肿瘤分期明显较高(T2-T4;p = 0.047)。结论:两次封锁均显著降低了妇科和乳腺癌的新诊断率。潜在可治愈疾病的治疗延误可能导致较差的临床结果,有错过最佳治疗窗口的风险。由于COVID-19大流行将在未来一段时间内构成挑战,因此需要制定新的患者护理战略,以优化大流行期间的癌症筛查和管理。
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