COVID-19 Pandemic Impact on Delays in Diagnosis and Treatment for Cervical Cancer in Montreal, Canada.

Abstract

Introduction: The COVID-19 pandemic has been responsible for a major reorganization of healthcare systems, with less access for cancer screening. Few data exist on the impact of cervical cancer treatment during the pandemic.

Methods: The purpose of this study was to compare the cervical cancer stage at diagnosis and the surgical and medical treatment delays before and during the COVID-19 pandemic. This is a retrospective cohort study of all cervical cancers diagnosed at any stages between 1 January 2018 and 28 February 2022 at the Centre Hospitalier de l'Université de Montréal. Stage at diagnosis, time to initial referral, time from diagnosis to treatment before and during the COVID-19 pandemic were compared.

Results: A total of 244 cervical cancers were diagnosed during the study period. No differences were observed between the number of cases diagnosed before and after pandemic (p = 0.237). Most patients and disease characteristics did not differ between the study periods, but the patients were significantly younger (p = 0.007), with higher BMI (p = 0.024) in the pandemic period. The mean time between initial diagnosis and referral was longer during the pandemic by 13 days (p = 0.042). The mean time between diagnosis and MRI and diagnosis and PET CT was not longer during the pandemic (p = 0.481 and p = 0.384). There were no significant differences in the mean time from the initial referring to the first visit at the CHUM (p = 0.895) or in the mean time from diagnosis to treatment (0.668) and duration of treatment (p = 0.181) Conclusion. Minor delays were observed during the COVID-19 pandemic. Cervical cancer patients treated at the CHUM, a tertiary and quaternary Canadian public health center, were globally referred and treated similarly, as those who were treated before pandemic.