PD03-12 COVID-19 DISRUPTION TO PROSTATE CANCER MANAGEMENT IN A UK TERTIARY REFERRAL CENTRE

Abstract

You have accessJournal of UrologyCME1 May 2022PD03-12 COVID-19 DISRUPTION TO PROSTATE CANCER MANAGEMENT IN A UK TERTIARY REFERRAL CENTRE Matthew Byrne, Nithesh Ranasinha, Claudia Mercader, Mutie Raslan, Caroline Gordon, Kate Hutton, Sarah Head, Ruth MacPherson, Charlotte Minett, Louise Flaxman, Jessica Smyth, Natasha Young, Fergus Gleeson, Clare Verrill, Richard Colling, Francisco Lopez, Richard Bell, Tom Leslie, Richard Bryant, Freddie Hamdy, and Alastair D. Lamb Matthew ByrneMatthew Byrne More articles by this author , Nithesh RanasinhaNithesh Ranasinha More articles by this author , Claudia MercaderClaudia Mercader More articles by this author , Mutie RaslanMutie Raslan More articles by this author , Caroline GordonCaroline Gordon More articles by this author , Kate HuttonKate Hutton More articles by this author , Sarah HeadSarah Head More articles by this author , Ruth MacPhersonRuth MacPherson More articles by this author , Charlotte MinettCharlotte Minett More articles by this author , Louise FlaxmanLouise Flaxman More articles by this author , Jessica SmythJessica Smyth More articles by this author , Natasha YoungNatasha Young More articles by this author , Fergus GleesonFergus Gleeson More articles by this author , Clare VerrillClare Verrill More articles by this author , Richard CollingRichard Colling More articles by this author , Francisco LopezFrancisco Lopez More articles by this author , Richard BellRichard Bell More articles by this author , Tom LeslieTom Leslie More articles by this author , Richard BryantRichard Bryant More articles by this author , Freddie HamdyFreddie Hamdy More articles by this author , and Alastair D. LambAlastair D. Lamb More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002518.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Covid-19 caused major disruptions to cancer diagnosis and treatment. We aimed to evaluate the longitudinal disruption to prostate cancer management. METHODS: We completed a prospective service evaluation from 01/09/2019 to 31/08/2021 of all referrals, investigations, and treatments for prostate cancer at a single centre. The first UK Covid-19 lockdown occurred from 23/03/20 to 04/07/2020: monthly data for the time period before, during, and after the first UK lockdown were compared using ANOVA and Tukey HSD. RESULTS: We identified 4501 patients for inclusion. There was a profound decrease in all aspects of prostate cancer management during the first lockdown period. For pre-lockdown, lockdown, and post-lockdown periods respectively, the mean monthly rates were: 256 v 125 v 363 PSA tests (p=0.0003); 86 v 40 v 79 two-week-wait referrals (p=0.0005); 62 v 18 v 54 MRI imaging for possible cancer (p<0.0001); 32 v 15 v 36 diagnoses (p=0.002); 17 v 9 v 14 prostatectomies (p=0.06). In the period after the first lockdown, despite the previous drop, we did not observe an increase in the number of referrals, MRI imaging, diagnoses, or treatment required (including active monitoring, chemotherapy, radiotherapy, prostatectomy, and palliative care) in comparison to pre-lockdown levels (all p>0.05). However, interestingly, we did see an increase in the number of PSA tests performed (p=0.04), which continued through the two subsequent UK lockdowns. CONCLUSIONS: To our knowledge, this is the first study to provide an overview of the impact of COVID-19 national lockdowns on the whole prostate cancer management pathway - from initial referral to final treatment. Despite the disruption to prostate cancer management during the first UK Covid-19 lockdown leading to a decrease in referrals, diagnoses and treatment in the context of reduced PSA testing, we have not seen a subsequent increase in these numbers after lockdown despite a rise in PSA testing. The rise in the number PSA tests performed post-lockdown may suggest a degree of compensatory PSA observation in the community. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e47 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Byrne More articles by this author Nithesh Ranasinha More articles by this author Claudia Mercader More articles by this author Mutie Raslan More articles by this author Caroline Gordon More articles by this author Kate Hutton More articles by this author Sarah Head More articles by this author Ruth MacPherson More articles by this author Charlotte Minett More articles by this author Louise Flaxman More articles by this author Jessica Smyth More articles by this author Natasha Young More articles by this author Fergus Gleeson More articles by this author Clare Verrill More articles by this author Richard Colling More articles by this author Francisco Lopez More articles by this author Richard Bell More articles by this author Tom Leslie More articles by this author Richard Bryant More articles by this author Freddie Hamdy More articles by this author Alastair D. 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