Effects of the COVID-19 Pandemic on Prostate Cancer Screening and Diagnosis

Abstract

Background: COVID-19 pandemic clearly demonstrates that not only is it causing unprecedented morbidity and death worldwide, its almost unstoppable spread is affecting the diagnosis and treatment of many other acute and chronic diseases. These changes created by the COVID-19 pandemic have had a direct negative impact on cancer screening and new cancer diagnosis. Methods: We aimed to compare prostate specific antigen (PSA) requested, TRUS guided biopsy (TRUS-Bx) and new prostate cancer (PCa) diagnoses from 1 January 2019 to the end of 31 December 2021 both on an annual basis and as a monthly change, and evaluate the percentage change. Patients' age, prostate volume, PSA values, pathology results of biopsies were analyzed as basic demographic information. Results: From January 2019 through December 2021, there were 18618 PSA testing and 141 TRUS-Bx results from men in the hospital database. When we look at the distribution of PSA test requests by years, we see that 8473 in 2019, 4763 with a decrease of 44% in 2020 and a 12% increase in 2021 compared to 2020, but still 36.5% less in 2019. When we look at the number of TRUS-Bx, we see that we performed a total of 141 TRUS-Bx between January 2019 and December 2021. While we performed 65 TRUS-Bx in 2019 before the pandemic, this figure decreased to 40 with a 38.5% decrease in 2020, while we observed that the similar situation continued with 36 cases in 2021. Conclusions: As a result, our findings show that a significant number of PCa screening opportunities and cancer diagnoses are missed. Delays in cancer diagnosis will cause adverse clinical outcomes in the coming years. Considering that PCa does not pause due to the COVID-19 pandemic, it may cause patients to progress to more advanced disease stage at the time of diagnosis, require more aggressive treatment and even succumb to cancer due to the delays that occur. Further work is required to analyze the assessment of the clinical prognostic impact of cancer diagnosis delays.