Decrease in prostate cancer detection during COVID-19 pandemic

Background and objectives: The aim of this study was to evaluate the impact of the COVID-19 pandemic on the detection of prostate cancer in men considered at high risk. This was done by comparing data from the Mures County Clinical Hospital, Clinic of Urology one year before (non-pandemic, NP) and during (pandemic, P) the global COVID-19 pandemic.

Methods: A retrospective study was performed based on the Mures County Clinical Hospital database. The inclusion criteria were clinical suspicion (digital rectal examination) and elevated prostate-specific antigen (PSA) level (threshold 3.2 ng/mL). Statistical analysis was performed with STATA 11 Program. Mann-Whitney, Student and chi-square tests were used to compare median PSA, prostate volume, number of TRUSbx performed, number of core biopsies, Gleason Score values, and perineural invasion between the NP and P groups.

Results: A total of 440 patients were studied, comprising 271 in the NP group and 169 in the P group. The average number of TRUSbx procedures was 22.58 per month in 2019 (NP group) and 14.08 per month in 2020 (P group), representing a decrease of 37.65%. Analysis of data for the P and NP groups showed a median PSA of 10.48 vs 10.58, mean prostatic volume of 43.69 vs 43.26, number of core biopsies 11.39 vs 11.70, and Gleason score of 7.31 vs 7.15, respectively. Mann-Whitney U test revealed no statistically significant differences between the two groups, with only the Gleason Score showing a trend for significance (p = 0.065).

Conclusions: The COVID-19 pandemic led to a major decrease in the number of surgeries performed, with TRUSbx declining by almost 40%. No differences between P and NP periods were observed for median PSA, prostate volume, number of core biopsies, and perineural invasion. The Gleason Score showed a slightly higher incidence of advanced prostate cancer in the P group, but this did not reach statistical significance.

Global pandemic; COVID-19; TRUSbx; Prostate biopsy; Prostate cancer

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