Impact of the COVID-19 Pandemic on Prostate Cancer: Perturbations in Screening and Diagnostic Patterns.

Abstract

Objectives: This study aimed to evaluate the impact of the COVID-19 pandemic on prostate cancer screening, patient characteristics, and clinical outcomes by comparing data before and after the pandemic at a Japanese institution.

Methods: A retrospective cohort study was conducted at Toho University Sakura Medical Center, including 955 patients who underwent prostate biopsy between March 2018 and May 2022. The study period was divided into pre-pandemic (March 2018 to March 2020) and post-pandemic (April 2020 to May 2022) phases. Data on demographic characteristics, referral patterns, clinical presentation, and biopsy results were collected. Statistical analyses were performed to evaluate differences in key clinical parameters before and after the onset of the pandemic.

Results: The median age of patients undergoing prostate biopsy increased significantly during the post-pandemic period (71.0 years before vs. 73.0 years after, p < 0.01). Referrals from PSA screening decreased significantly (13.5% before vs. 9.0% after, p = 0.03), whereas referrals from office urologists increased (29.8% before vs. 38.0% after, p < 0.01). The overall detection rate of prostate cancer remained stable (62.0% before vs. 67.0% after, p = 0.10). However, the proportion of higher Gleason grade groups (4 and 5) increased significantly after the pandemic (46.8% before vs. 68.1% after, p < 0.01).

Conclusions: The COVID-19 pandemic led to notable changes in prostate cancer screening practices and an increase in higher-grade cancer diagnoses. These findings highlight the importance of maintaining robust cancer screening programs and ensuring timely diagnosis during public health crises to mitigate adverse clinical outcomes.