In addition to the predicted practical problems of conducting an RCT in an elderly frail population, it became clear that most clinicians are not in equipoise about the value of antidepressant medication despite the lack of strong evidence for its effectiveness.
Objective: To review the effect of the COVID-19 pandemic on the
presentation of Cervical cancer. Design/ Setting: Retrospective study
involving the Regional Cancer Centres in the M62 Group. Methods: Data
was collected for two equal time periods. All cervical cancers were
included and FIGO 2018 staging was used for the data collection. P
values were calculated using binomial hypothesis test for the difference
in staging. Time from symptoms to diagnosis was assessed using a normal
distribution test. All other calculations were performed using
chi-squared test. Statistical significance was considered if p values
were <0.05. Main outcome measures: Histology, stage at
diagnosis, date of onset of symptoms, investigation and type of
treatment. Results: A total of 406 cases of cervical cancer were
reviewed; 233 from May – October 2019 (pre-COVID) and 173 between May
– October 2020 (post COVID); representing a significant reduction in
new cervical cancer diagnoses of 25% post COVID (p<0.001)
There was a 42% increase in the delay from start of symptoms to
diagnosis Post COVID. Pre COVID, 27% of patients presented with Stage 3
or 4 disease, whilst during COVID this was 38%; statistically
significant (p <0.001). When we evaluated the treatments
received between the two time periods, this was also statistically
significant (chi-squared, p=0.0005). Conclusions: This study has
demonstrated a statistically significant increase in the stage of
cervical cancer at diagnosis and a change in treatment for cervical
cancer following the onset of COVID-19. The implications of this are
discussed.
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