Background and Objectives: The management of ovarian cancer requires complex surgical and medical interventions. Specialized care is associated with superior outcomes in early and advanced stages. This study aimed to estimate the effect of hospital characteristics on the overall survival of women with epithelial ovarian cancer. Methods: We established a cohort with data recorded by the Fundação Oncocentro de São Paulo cancer registry. We included 6111 women treated for ovarian cancer in the state of Sao Paulo from January 2000 to December 2018. From 76 hospitals analyzed, 7 were high volume (20 or more cases a year) and 69 low volume. Twenty-nine were teaching and 47 community hospitals. A 10-year survival was analyzed using the Kaplan-Meyer estimator and the Cox model. Results: Fifty-two percent of the epithelial ovarian cancer patients were treated in high-volume hospitals. High-volume-(HR, 0.86; 95% CI, 0.8-0.92; P < .001) and teaching-(HR, 0.91; 95% CI, 0.85-0.99; P = .019) were hospital characteristics associated with low risk of death in 10 years. Conclusions: High-volume and teaching hospitals are associated with better overall survival in ovarian cancer. Our data suggest that both hospital characteristics are important indicators of good quality of care in ovarian cancer treatment.

OBJECTIVE:The coronavirus disease 2019 pandemic has disrupted cancer screening worldwide. This study aims to analyze the changes in the rates of screening mammograms and BIRADS 4 or 5 mammograms during the coronavirus disease 2019 pandemic in the opportunistic scenario. METHODS: We integrated three different public databases from the state of São Paulo, Brazil, to obtain the rate of screening mammograms per 1,000, and the rate of BIRADS 4 or 5 mammograms per 100,000 women aged from 50 to 69 years in the years from January 2017 to December 2020. RESULTS: The mean monthly screening mammograms decreased from 14.8/1,000 in 2019 to 9.25/1,000 in 2020, with the lowest rates being recorded in May 2020 (3.1/1,000). The mean monthly high-risk mammograms decreased from 12.8/100,000 in 2019 to 9.1/100,000 in 2020, with the lowest rates being recorded in April 2020 (4.3/100,000). CONCLUSIONS: Coronavirus disease 2019 pandemic significantly decreased mammography screening in an opportunistic scenario, a warning sign for decreasing diagnosis of breast cancer in early stages, and increasing advanced stage diagnosis and mortality in the future.

Background and Objectives The coronavirus disease 2019 (COVID‐19) pandemic disrupted healthcare access and medical treatment, including oncological care. Treatment delay in ovarian cancer could impact survival. We aimed to assess if there were delays and treatment changes in a cohort of epithelial ovarian cancer patients. Methods A retrospective cohort of epithelial ovarian cancer patients included cases diagnosed during the first 22 months of the COVID‐19 pandemic in the state of Sao Paulo and those diagnosed in the 22 months preceding the outbreak. Time‐to‐treat was measured in days. In each group, surgery and chemotherapy proportions were assessed according to healthcare insurance status. Results A 56.2% reduction in epithelial ovarian cancer diagnosis was identified during the pandemic group compared to the prepandemic group; fewer patients were diagnosed in stage I ( p < 0.01). Time‐to‐treat increased from 18.9 to 23 days ( p < 0.01). Surgery in the public sector fell from 74.6% to 65.3% during the pandemic, compared to 87.1% to 68.8% in the private sector. Conclusion There were fewer overall diagnoses, reduced stage I diagnosis, increased time‐to‐treat, and a reduction in the proportion of patients submitted to surgery. Brazil's public healthcare system demonstrated a higher resiliency to treatment change than the private sector.

OBJECTIVE: This study aimed to evaluate how the pandemic might have affected the number of elective and urgent hysterectomies for benign gynecological pathologies in a single-care tertiary center in the State of São Paulo, Brazil, and to identify if there were any changes in the need for blood transfusions. METHODS: This is a single-center retrospective cohort study. It involved all non-puerperal and non-oncological hysterectomies from October 2018 to July 2021. Patients were divided into two groups, namely, the pandemic group (46 patients) and the control group (92 patients). Data were collected by reviewing the physical and electronic patient records. We carried out the statistical analysis using the RStudio software. RESULTS: The number of planned hysterectomies was 82 in the pre-pandemic group and 23 in the analysis group, representing a 71.9% decrease. When considering only urgent surgeries, 10 of them happened in the pre-pandemic group, while 23 occurred in the pandemic group, representing an increase of 130%. CONCLUSION: Elective hysterectomies may improve the quality of life of women, reducing abnormal bleeding and pelvic pain. Treatment delay can worsen patients' physiological and biological conditions, such as lower labor production, humor, and social aspects, increasing costs to the healthcare system.