Cervical Cancer and COVID: A collaborative assessment of the effect of
the COVID pandemic on the presentation of Cervical cancer in the North
of England
Abstract
Objective: To review the effect of the COVID-19 pandemic on the
presentation of Cervical cancer. Design/ Setting: Retrospective study
involving the Regional Cancer Centres in the M62 Group. Methods: Data
was collected for two equal time periods. All cervical cancers were
included and FIGO 2018 staging was used for the data collection. P
values were calculated using binomial hypothesis test for the difference
in staging. Time from symptoms to diagnosis was assessed using a normal
distribution test. All other calculations were performed using
chi-squared test. Statistical significance was considered if p values
were <0.05. Main outcome measures: Histology, stage at
diagnosis, date of onset of symptoms, investigation and type of
treatment. Results: A total of 406 cases of cervical cancer were
reviewed; 233 from May – October 2019 (pre-COVID) and 173 between May
– October 2020 (post COVID); representing a significant reduction in
new cervical cancer diagnoses of 25% post COVID (p<0.001)
There was a 42% increase in the delay from start of symptoms to
diagnosis Post COVID. Pre COVID, 27% of patients presented with Stage 3
or 4 disease, whilst during COVID this was 38%; statistically
significant (p <0.001). When we evaluated the treatments
received between the two time periods, this was also statistically
significant (chi-squared, p=0.0005). Conclusions: This study has
demonstrated a statistically significant increase in the stage of
cervical cancer at diagnosis and a change in treatment for cervical
cancer following the onset of COVID-19. The implications of this are
discussed.