Decrease in gynecological cancer diagnoses during the COVID-19 pandemic: an Austrian perspective.


Journal

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
ISSN: 1525-1438
Titre abrégé: Int J Gynecol Cancer
Pays: England
ID NLM: 9111626

Informations de publication

Date de publication:
11 2020
Historique:
received: 17 08 2020
revised: 14 09 2020
accepted: 16 09 2020
pubmed: 10 10 2020
medline: 13 11 2020
entrez: 9 10 2020
Statut: ppublish

Résumé

On March 16, 2020, the federal government of Austria declared a nationwide lockdown due to the COVID-19 pandemic. Since the lockdown, screening examinations and routine checkups have been restricted to prevent the spread of the virus and to increase the hospitals' bed capacity across the country. This resulted in a severe decline of patient referrals to the hospitals. To assess the impact of the COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers in Austria. Data of 2077 patients from 18 centers in Austria with newly diagnosed gynecological or breast cancer between January and May 2019 and January and May 2020 were collected. Clinical parameters, including symptoms, performance status, co-morbidities, and referral status, were compared between the time before and after the COVID-19 outbreak. Our results showed a slight increase of newly diagnosed cancers in January and February 2020 as compared with 2019 (+2 and +35%, respectively) and a strong decline in newly diagnosed tumors since the lockdown: -24% in March 2020 versus March 2019, -49% in April 2020 versus April 2019, -49% in May 2020 versus May 2019. Two-thirds of patients diagnosed during the pandemic presented with tumor-specific symptoms compared with less than 50% before the pandemic (p<0.001). Moreover, almost 50% of patients in 2020 had no co-morbidities compared with 35% in 2019 (p<0.001). Patients, who already had a malignant disease, were rarely diagnosed with a new cancer in 2020 as compared with 2019 (11% vs 6%; p<0.001). The lockdown led to a decreased number of newly diagnosed gynecological and breast cancers. The decreased accessibility of the medical services and postponed diagnosis of potentially curable cancers during the COVID-19 pandemic may be a step backwards in our healthcare system and might impair cancer treatment outcomes. Therefore, new strategies to manage early cancer detection are needed to optimize cancer care in a time of pandemic in the future.

Sections du résumé

BACKGROUND
On March 16, 2020, the federal government of Austria declared a nationwide lockdown due to the COVID-19 pandemic. Since the lockdown, screening examinations and routine checkups have been restricted to prevent the spread of the virus and to increase the hospitals' bed capacity across the country. This resulted in a severe decline of patient referrals to the hospitals.
OBJECTIVE
To assess the impact of the COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers in Austria.
METHODS
Data of 2077 patients from 18 centers in Austria with newly diagnosed gynecological or breast cancer between January and May 2019 and January and May 2020 were collected. Clinical parameters, including symptoms, performance status, co-morbidities, and referral status, were compared between the time before and after the COVID-19 outbreak.
RESULTS
Our results showed a slight increase of newly diagnosed cancers in January and February 2020 as compared with 2019 (+2 and +35%, respectively) and a strong decline in newly diagnosed tumors since the lockdown: -24% in March 2020 versus March 2019, -49% in April 2020 versus April 2019, -49% in May 2020 versus May 2019. Two-thirds of patients diagnosed during the pandemic presented with tumor-specific symptoms compared with less than 50% before the pandemic (p<0.001). Moreover, almost 50% of patients in 2020 had no co-morbidities compared with 35% in 2019 (p<0.001). Patients, who already had a malignant disease, were rarely diagnosed with a new cancer in 2020 as compared with 2019 (11% vs 6%; p<0.001).
CONCLUSIONS
The lockdown led to a decreased number of newly diagnosed gynecological and breast cancers. The decreased accessibility of the medical services and postponed diagnosis of potentially curable cancers during the COVID-19 pandemic may be a step backwards in our healthcare system and might impair cancer treatment outcomes. Therefore, new strategies to manage early cancer detection are needed to optimize cancer care in a time of pandemic in the future.

Identifiants

pubmed: 33033166
pii: ijgc-2020-001975
doi: 10.1136/ijgc-2020-001975
pmc: PMC7656153
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1667-1671

Informations de copyright

© IGCS and ESGO 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

Gynecol Oncol. 2013 Oct;131(1):15-20
pubmed: 23877013
Br J Cancer. 2015 Mar 31;112 Suppl 1:S92-107
pubmed: 25734382
N Engl J Med. 2020 Jun 11;382(24):2368-2371
pubmed: 32302076
Lancet Oncol. 2020 Jun;21(6):750-751
pubmed: 32359403

Auteurs

Irina Tsibulak (I)

Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.

Elisabeth Reiser (E)

Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.

Gerhard Bogner (G)

Department of Obstetrics and Gynecology, Paracelsus Medical University Salzburg, Salzburg, Austria.

Edgar Petru (E)

Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Styria, Austria.

Johanna Hell-Teutsch (J)

Department of Obstetrics and Gynecology, Hospital of Wels-Grieskirchen, Wels, Upper Austria, Austria.

Alexander Reinthaller (A)

Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.

Cornelia Weirather (C)

Department of Obstetrics and Gynecology, Leoben Regional Hospital, Leoben, Styria, Austria.

Tatjana Weiss (T)

Gynecological Cancer Center, Ordensklinikum Linz GmbH, Linz, Upper Austria, Austria.

Szabolcs Bozsa (S)

Department of Gynecology, Hospital St. John of God, Vienna, Austria.

Barbara Puschacher (B)

Department of Obstetrics and Gynecology, Hospital Ried im Innkreis, Ried im Innkreis, Austria.

Mirijam Hall (M)

Department of Obstetrics and Gynecology, Hospital Ottakring of the City of Vienna Hospitals Association, Vienna, Austria.

Doris Hittler (D)

Department of Obstetrics and Gynecology, Hospital Lienz, Lienz, Tyrol, Austria.

Katharina Hrauda (K)

Department of Obstetrics and Gynecology, Kepler University Hospital, Linz, Upper Austria, Austria.

Elisabeth Thell (E)

Department of Obstetrics and Gynecology, The State Hospital of Mödling, Mödling, Austria.

Sabine Clauss (S)

Department of Obstetrics and Gynecology, Hospital Oberpullendorf, Oberpullendorf, Austria.

Johanna Pozniak (J)

Department of Obstetrics and Gynecology, Kufstein Regional Hospital, Kufstein, Tyrol, Austria.

Sebastian Alicke (S)

Department of General Surgery, Kufstein Regional Hospital, Kufstein, Tyrol, Austria.

Daniela Gangl (D)

Department of Obstetrics and Gynecology, State Hospital Amstetten, Amstetten, Lower Austria, Austria.

Gottfried Gamperl (G)

Department of Obstetrics and Gynecology, Hainburg State Hospital, Hainburg an der Donau, Lower Austria, Austria.

Christoph Ebner (C)

Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.

Katharina Knoll (K)

Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.

Katharina Leitner (K)

Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.

Andrea Schilcher (A)

Department of Obstetrics and Gynecology, Paracelsus Medical University Salzburg, Salzburg, Austria.

Marina Schinnerl (M)

Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Styria, Austria.

Verena Sigl (V)

Department of Obstetrics and Gynecology, Hospital of Wels-Grieskirchen, Wels, Upper Austria, Austria.

Christian Singer (C)

Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Thomas Aigmüller (T)

Department of Obstetrics and Gynecology, Leoben Regional Hospital, Leoben, Styria, Austria.

Birgit Hofstätter (B)

Gynecological Cancer Center, Ordensklinikum Linz GmbH, Linz, Upper Austria, Austria.

Christian Marth (C)

Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria Christian.marth@tirol-kliniken.at.

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