Abstract 1366P
Background
Cancer diagnosis and treatment have been impacted globally by the COVID-19 pandemic. In England, prostate cancer accounted for over a third of all missed cancers, and public awareness campaigns to find these ‘missing men’ are ongoing. We aim to identify changes to the characteristics and outcomes of men diagnosed or treated during this period to inform future public health efforts and reduce the impact of COVID-19 on men with prostate cancer.
Methods
A retrospective observational cohort study was conducted using electronic secondary healthcare records from the Hospital Episode Statistics (HES) dataset. The cohort included men aged 45+ with a diagnosis of prostate cancer between 1st October 2018 and 31st March 2021 in England. Sociodemographic characteristics, and treatment and mortality trends of these men were analysed. Characteristics or outcomes pre-COVID-19 and during COVID-19 were compared using the chi squared test.
Results
82,897 men diagnosed pre-pandemic (October 2018-March 2020) and 40,556 diagnosed during the pandemic (April 2020-March 2021) were included in the study. We show a reduction in the proportion of younger men diagnosed with prostate cancer (X2=205.9, df=4, p<0.001). Treatment patterns also shifted. Men with advanced disease accessed novel hormonal therapies as an alternative to chemotherapy during the pandemic. However, more men with advanced disease received no treatment at all. There was an increase in death from any cause in men with prostate cancer (26% during the pandemic compared to 7% prior), which was not accounted for by COVID-19 deaths.
Conclusions
Men who missed a diagnosis of prostate cancer during the pandemic appear to be younger on average than men diagnosed pre-pandemic. Therefore, public health interventions should focus on raising awareness in men under 75. Our overall conclusion from this study is that COVID-19 changed diagnosis and treatment in ways that are likely to increase late diagnosis, increase prostate cancer deaths and reduce life expectancy for men with prostate cancer for many years. This study could help develop public health interventions to help reduce this impact. Currently it applies only to England, but replication in other countries would help to understand the global impact of COVID-19 on men with prostate cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
OPEN health/Prostate Cancer UK.
Funding
Prostate Cancer UK.
Disclosure
G. Hall: Financial Interests, Personal, Other, Research as a Subcontractor on Cancer Epidemiology Studies: Gillian Hall. All other authors have declared no conflicts of interest.