It has been almost three years since the COVID-19 outbreak, yet evidence of its impact on the cancer care landscape remains scant. The present single-center study examines patterns in gynecological cancer diagnoses before and during the pandemic.
All female patients diagnosed in our academic hospital with gynecological cancer, between January 2017 and December 2020, were retrospectively identified. Pre-defined subgroup analyses were performed in patients who had been newly diagnosed during 2020 and in the pre-pandemic 3-year period. The study was approved by the Institutional Ethical Committee and was conducted in accordance with the Declaration of Helsinki and the International Conference on Harmonization for Good Clinical Practice.
In total, 1,193 women were included in this case-control study; 1,001 (83.91%) were identified in the pre-pandemic period as a control, while 192 (16.09%) cases were allocated in the pandemic group. The two cohorts were similar regarding demographic and clinical characteristics. For the pre-pandemic period, the mean yearly number of patients with newly identified cancer was highest for endometrial (149; 44.61%), followed by ovarian (92; 27.5%) carcinomas. During the first year of the pandemic, the number of new diagnoses significantly decreased by 42.5% (from 334 to 192) for all types of malignancies combined (one sample t-test p-value= 0.014). Declines ranged from 36.96% to 49% for ovarian and endometrial cancer, respectively.
This is the first study to appraise a timely snapshot of the effect of COVID-19 on newly diagnosed gynecological tumors in a European Society of Gynaecological Oncology (ESGO)-certified center in Greece, demonstrating an alarmingly sharp decline in the number of new cases during the pandemic. It is of utmost importance the gynecologic oncologists to ensure the continuum of care for their patients.
Demographic data for patients with newly diagnosed gynecological cancer, by time period
| Cancer type | Pre-pandemic period (01-12/2017) | Pre-pandemic period (01-12/2018) | Pre-pandemic period (01-12/2019) | Pandemic period (01-12/2020) | Total |
| Cervical | 73 (19.89%) | 61 (19.68%) | 56 (17.28%) | 39 (20.31%) | 229 (19.20%) |
| Endometrial | 174 (47.41%) | 129 (41.61%) | 145 (44.75%) | 76 (39.58%) | 524 (43.92%) |
| Ovarian | 84 (22.89%) | 92 (29.68%) | 101 (31.17%) | 58 (30.21%) | 335 (28.08%) |
| Vulvar | 30 (8.17%) | 21 (6.77%) | 20 (6.17%) | 14 (7.29%) | 85 (7.12%) |
| Other | 6 (1.63%) | 7 (2.26%) | 2 (0.62%) | 5 (2.60%) | 20 (1.68%) |
| Total | 367 (100%) | 310 (100%) | 324 (100%) | 192 (100%) | 1,193 (100%) |
Pearson chi2 (12) = 13.1806; Pr= 0.356