Abstract
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.
Highlights
Prostate cancer (PCa) is a major worldwide health concern, being the sixth most common cause of cancer-related deaths and the second most common tumor type in the male population
No major differences were recorded between the two groups regarding prostate volume (Table 1)
The number of investigated patients was smaller in the P group, statistical analysis of all the data collected from the P and NP groups did not find any significant differences in terms of prostate-specific antigen (PSA), prostate volume, or number of biopsies
Summary
Prostate cancer (PCa) is a major worldwide health concern, being the sixth most common cause of cancer-related deaths and the second most common tumor type in the male population. Given the fact that older men represent the high-risk group for PCa, COVID19 infection may overlap with this population group, increasing the mortality. Even ignoring this overlap, a cancer diagnosis with other comorbidities may increase the risk of death from COVID-19 infection [6,7,8,9,10]. 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. The Gleason Score showed a slightly higher incidence of advanced prostate cancer in the P group, but this did not reach statistical significance
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