TY - JOUR
T1 - Radical hysterectomy case volume and cervical cancer treatment in the era of COVID-19
T2 - A multi-site analysis of National Cancer Institute-designated Comprehensive Cancer Centers
AU - Wickenheisser, Natalie E.
AU - Dillon, Mairead
AU - Broadwater, Gloria
AU - Zacherl, Kathleen
AU - Bixel, Kristin
AU - Levine, Monica
AU - Newton, Meredith
AU - Thel, Hannah
AU - Tucker, Katherine
AU - Gehrig, Paola
AU - Khetan, Varun U.
AU - Brunette-Masi, Laurie L.
AU - Matsuo, Koji
AU - Khouri, Olivia R.
AU - Duhon, Ashley
AU - Gowthaman, Divya
AU - Cowan, Matthew
AU - Mojdehbakhsh, Rachel
AU - Rose, Stephen
AU - Olawaiye, Alexander
AU - Davidson, Brittany A.
AU - Moss, Haley A.
AU - Havrilesky, Laura J.
N1 - Publisher Copyright:
© 2023
PY - 2023/12
Y1 - 2023/12
N2 - Objective: To compare radical hysterectomy case volume, cancer stage, and biopsy-to-treatment time of invasive cervical cancer diagnosed before and after onset of the COVID-19 pandemic. Methods: In a multi-institution retrospective cohort study conducted at 6 large, geographically diverse National Cancer Institute-designated cancer centers, patients treated for newly diagnosed invasive cervical cancer were classified into 2 temporal cohorts based on date of first gynecologic oncology encounter: (1) Pre-Pandemic: 3/1/2018–2/28/2020; (2) Pandemic & Recovery: 4/1/2020–12/31/2021. The primary outcome was total monthly radical hysterectomy case volume. Secondary outcomes were stage at diagnosis and diagnosis-to-treatment time. Statistical analyses used chi-squared and two sample t-tests. Results: Between 3/1/2018–12/31/2021, 561 patients were diagnosed with cervical cancer. The Pre-Pandemic and Pandemic & Recovery cohorts had similar age, race, ethnicity, smoking status, and Body Mass Index (BMI). During Pandemic & Recovery, the mean monthly radical hysterectomy case volume decreased from 7[SD 2.8] to 5[SD 2.0] (p = 0.001), the proportion of patients diagnosed with Stage I disease dropped from 278/561 (49.5%) to 155/381 (40.7%), and diagnosis of stage II-IV disease increased from 281/561 (50.1%) to 224/381 (58.8%). Primary surgical management was less frequent (38.3% Pandemic & Recovery versus 46.7% Pre-Pandemic, p = 0.013) and fewer surgically-treated patients received surgery within 6 weeks of diagnosis (27.4% versus 38.9%; p = 0.025). Conclusions: Lower radical hysterectomy case volume, a shift to higher cervical cancer stage, and delay in surgical therapy were observed across the United States following the COVID-19 outbreak. Decreased surgical volume may result from lower detection of early-stage disease or other factors.
AB - Objective: To compare radical hysterectomy case volume, cancer stage, and biopsy-to-treatment time of invasive cervical cancer diagnosed before and after onset of the COVID-19 pandemic. Methods: In a multi-institution retrospective cohort study conducted at 6 large, geographically diverse National Cancer Institute-designated cancer centers, patients treated for newly diagnosed invasive cervical cancer were classified into 2 temporal cohorts based on date of first gynecologic oncology encounter: (1) Pre-Pandemic: 3/1/2018–2/28/2020; (2) Pandemic & Recovery: 4/1/2020–12/31/2021. The primary outcome was total monthly radical hysterectomy case volume. Secondary outcomes were stage at diagnosis and diagnosis-to-treatment time. Statistical analyses used chi-squared and two sample t-tests. Results: Between 3/1/2018–12/31/2021, 561 patients were diagnosed with cervical cancer. The Pre-Pandemic and Pandemic & Recovery cohorts had similar age, race, ethnicity, smoking status, and Body Mass Index (BMI). During Pandemic & Recovery, the mean monthly radical hysterectomy case volume decreased from 7[SD 2.8] to 5[SD 2.0] (p = 0.001), the proportion of patients diagnosed with Stage I disease dropped from 278/561 (49.5%) to 155/381 (40.7%), and diagnosis of stage II-IV disease increased from 281/561 (50.1%) to 224/381 (58.8%). Primary surgical management was less frequent (38.3% Pandemic & Recovery versus 46.7% Pre-Pandemic, p = 0.013) and fewer surgically-treated patients received surgery within 6 weeks of diagnosis (27.4% versus 38.9%; p = 0.025). Conclusions: Lower radical hysterectomy case volume, a shift to higher cervical cancer stage, and delay in surgical therapy were observed across the United States following the COVID-19 outbreak. Decreased surgical volume may result from lower detection of early-stage disease or other factors.
KW - COVID-19
KW - Cervical cancer
KW - Coronavirus
KW - Pandemic
KW - Radical hysterectomy
UR - http://www.scopus.com/inward/record.url?scp=85175732805&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85175732805&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2023.10.010
DO - 10.1016/j.ygyno.2023.10.010
M3 - Article
C2 - 37944328
AN - SCOPUS:85175732805
SN - 0090-8258
VL - 179
SP - 70
EP - 78
JO - Gynecologic Oncology
JF - Gynecologic Oncology
ER -