A retrospective cohort study of bladder cancer following the COVID-19 pandemic: Are patients presenting with more aggressive disease?. (September 2022)

• Record Type: Journal Article
• Authors: Anderson, Steven; Rigney, Kate; Hayes, Leah; Ryan, Paul Christopher; Chaitanya, Vishwa; Jacob, Prem Thomas; Abdelrahman, Mamoun; Giri, Subhasis K.
• Is Part Of: Annals of medicine and surgery. Volume 81(2022)
• Publication Date: 2022-09
• Subjects: Bladder cancer -- Urothelial cancer -- COVID-19 -- Public health -- Urology -- Uro-oncology; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104430
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: The COVID-19 pandemic has resulted in delays in the treatment of patients with urological malignancies. The management of bladder cancer (BC) in particular poses a significant challenge given the recurrent nature of the disease and the intense follow-up regime required for many cases. The aim of this study was to evaluate potential changes in the presentation and operative management of BC in our hospital following the pandemic. Materials and methods: This is a retrospective cohort study. Potential BC cases were identified through the histopathology database between March 2019 and February 2021. Details were obtained on patient demographics, procedure type such as biopsy, resection or excision, grade and stage of BC. Cases were divided into two groups: period one (pre-COVID between March 2019 and February 2020) and period two (post-COVID between March 2020 and February 2021). Results: A total of 207 procedures for confirmed BC were performed during the study period, 126 in period one and 81 in period two. New cases accounted for 52.4% (n = 66) and 53.1% (n = 43) of cases during periods one and two respectively. There was a higher rate of invasive disease (43.2% vs 26.2%) as well as high grade disease (47.4% vs 35.8%) in period two than in period one. Conclusion: Fewer BC procedures were performed in the COVID period. The higher rate of more advanced stage and grade of disease seen in period two suggests patients are presenting later. This should be considered when allocating resources in the management of non-COVID related diseases. Further studies are needed to assess the long-term impact of COVID-19 on bladder cancer outcome. Highlights: Bladder cancer is a time-sensitive condition and delays in diagnosis are associated with worse outcomes. Fewer cases of bladder cancer were seen in the first year following the COVID-19 pandemic. There was no difference in waiting times from diagnosis to treatment in the year before and after the pandemic. In the year following COVID-19 patients presented with more aggressive bladder cancer than in the year before the pandemic. The more aggressive bladder cancer seen following COVID-19 is likely due to delays in patients presenting to primary care.