COVID-19 Pandemic Effects on Cervical Cancer Diagnosis and Management: A Population-Based Study in Romania

Abstract

The Pap test plays a significant role worldwide in the early diagnosis of and high curability rates for cervical cancer. However, the coronavirus disease 2019 (COVID-19) pandemic necessitated the use of multiple drastic measures to stop the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, limiting women’s access to essential invasive and non-invasive investigations for cervical cancer diagnosis. Therefore, we aimed to determine the impact the COVID-19 pandemic had on cancer diagnosis and management in western Romania. A retrospective study design allowed us to compare the last 24 months of the pre-pandemic period with the first 24 months of the COVID-19 pandemic to determine the change in volume of cervical screening tests, the number of newly diagnosed cases and their severity, and the access to cancer care. A drastic 75.5% decrease in the volume of tests was observed in April 2020 during the first lockdown, after which the volume of cases decreased by up to 36.1% in December 2021. The total volume loss of tests during the first 24 months of the pandemic was 49.9%. The percentage of late-stage cervical cancers (III–IV) rose by 17%, while the number of newly diagnosed cancers in our outpatient clinic was significantly lower than the baseline, with a 45% drop. The access to cancer care was negatively influenced, with 9.2% more patients waiting longer to receive test results over four weeks, while taking longer to seek cancer care after diagnosis (6.4 months vs. 4.1 months pre-pandemic) and missing significantly more appointments. The COVID-19 pandemic had a significantly negative impact on cervical cancer diagnosis and management during the first 24 months compared with the same period before the pandemic. Although the numbers are now recovering, there is still a big gap, meaning that many cervical cancer cases were potentially missed. We recommend further interventions to reduce the gap between the pre-pandemic and pandemic period.

The Impact of SARS-CoV-2 Pandemic on Patients Undergoing Radiation Therapy for Advanced Cervical Cancer at a Romanian Academic Center: A Four-Year Retrospective Analysis

“…In the current study, it was demonstrated in a retrospective fashion how the COVID-19 pandemic in Romania influenced cervical cancer diagnosis and management among cervical cancer patients in the advanced and inoperable stages of the disease. These findings corroborate most of the predictions and conjecture suggesting that many cancer cases were missed throughout the ongoing pandemic, as previously observed in the entire population of patients with cervical cancer from Romania during the pandemic [ 33 ]. Additionally, we have considered that likely many patients skipped appointments or intentionally delayed or intentionally denied treatment after having a low-stage cervical cancer diagnosis that, although curable in an early phase, became inoperable, necessitating chemotherapy, radiotherapy, or combined therapy.…”

Evaluation of FIB-4, NFS, APRI and Liver Function Tests as Predictors for SARS-CoV-2 Infection in the Elderly Population: A Matched Case-Control Analysis

“…The respiratory illness, which was subsequently called ‘Coronavirus Disease 2019’ (COVID-19), spread rapidly to neighboring states and has turned into a worldwide pandemic [ 2 , 3 ]. The condition is caused by the RNA virus “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) and is spread mostly via respiratory droplets and intimate contact with an infected person [ 4 , 5 ]. As of April 2022, WHO has verified around 500 million cases of COVID-19 globally, with more than 6 million fatalities [ 6 ].…”

A Retrospective Analysis of the Challenges of Urothelial Cancer Management during the COVID-19 Pandemic at a Single Academic Center in Romania

“…As all the other medical specialties were in one way or another affected by the ongoing situation, the COVID-19 pandemic has influenced the urology practice as well, and the insights learned throughout the course of the pandemic should promote the development of suitable patient and pathology-related recommendations for current and future pandemics [ 7 , 8 ]. Since the first months of the COVID-19 outbreak, professional organizations have exerted great commitment to adapt to the worldwide pandemic effort in order to safeguard both doctors and patients.…”