Abstract 1618P
Background
The COVID-19 pandemic affected health services by overloading hospitals’ capacity, impacting cancer screening and treatment. Unfortunately, a late cancer diagnosis has a detrimental effect in prognosis. We aimed to assess the staging of breast cancer (BC) and cervical cancer (CC) patients (pts) during their first consultation, comparing the periods during and prior to the pandemic.
Methods
Data were collected from pts who started follow-up and treatment in a cancer center in Brazil from Sep/20-Jan/21 and from Sep/19-Jan/20. These periods were selected considering the beginning and duration of the COVID-19 pandemic in Brazil, which started on Feb/20 and is still ongoing. We considered the period (Sep/20-Jan/21) to be representative of the pandemic impact on cancer diagnosis. The primary endpoint was BC and CC stages at diagnosis. CC staging was defined according to 2018 FIGO staging. Clinical or pathological (for those with upfront surgery) BC stage was defined according to the TNM anatomic stage from AJCC 8th edition. The comparison of cancer stages between the two periods was performed using Chi-Square test.
Results
268 BC pts and 44 CC pts had their first consult from Sep/20-Jan/21; 457 and 60, respectively, occurred from Sep/19-Jan/20. Pts who attended their first consult during the pandemic period presented with higher BC (P<0.001) and CC (P=0.328) stages than those prior to the pandemic, although the difference was not statistically significant for cervical cancer. The proportion of CC pts diagnosed with locally advanced disease (stages III-IVA) was 56.8% (N=25) in Sep/20-Jan/21 compared to 43.3% (N=26) in Sep/19-Jan/20. Similarly, 37.3% (N=100) of BC pts had stage III disease in Sep/20-Jan/21 compared to 23.2% (N=106) in Sep/19-Jan/20. Fewer pts were diagnosed with stage I BC during the pandemic (9.3% vs 20.6%). Additionally, fewer BC pts were diagnosed due to screening tests during the pandemic (13.7%; N=36) than before it (25.5%; N=113) (P<0.001).
Conclusions
BC and CC pts presented with a higher stage in their first consultation at a cancer center during the period of the COVID-19 pandemic compared to a similar period prior to the pandemic, confirming the long-term negative impact of the pandemic for oncologic pts. Thus, efforts should be made not to compromise essential cancer services.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
R.R.D.C.C. Bonadio: Financial Interests, Personal, Expert Testimony: Aché; Financial Interests, Personal, Funding, financial support for attending symposia: Roche; Financial Interests, Personal, Funding, financial support for educational program: AstraZeneca. All other authors have declared no conflicts of interest.