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Cervical cancer and COVID —an assessment of the initial effect of the pandemic and subsequent projection of impact for women in England: A cohort study
Author(s) -
Davies Jennifer M.,
Spencer Alice,
Macdonald Sian,
Dobson Lucy,
Haydock Emily,
Burton Holly,
Angelopoulos Georgios,
MartinHirsch Pierre,
Wood Nick J.,
Thangavelu Amudha,
Hutson Richard,
Munot Sarika,
Flynn Marina,
Smith Michael,
DeCruze Bridget,
Myriokefalitaki Eva,
Sap Katelijn,
WinterRoach Brett,
Macdonald Robert,
Edmondson Richard J.
Publication year - 2022
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.17098
Subject(s) - medicine , cervical cancer , cohort , pandemic , retrospective cohort study , population , cancer , cancer registry , cohort study , stage (stratigraphy) , covid-19 , disease , surgery , infectious disease (medical specialty) , environmental health , paleontology , biology
Objective To review the effect of the COVID‐19 pandemic on the diagnosis of cervical cancer and model the impact on workload over the next 3 years. Design A retrospective, control, cohort study. Setting Six cancer centres in the North of England representing a combined population of 11.5 million. Methods Data were collected retrospectively for all diagnoses of cervical cancer during May–October 2019 (Pre‐COVID cohort) and May–October 2020 (COVID cohort). Data were used to generate tools to forecast case numbers for the next 3 years. Main outcome measures Histology, stage, presentation, onset of symptoms, investigation and type of treatment. Patients with recurrent disease were excluded. Results 406 patients were registered across the study periods; 233 in 2019 and 173 in 2020, representing a 25.7% ( n = 60) reduction in absolute numbers of diagnoses. This was accounted for by a reduction in the number of low stage cases (104 in 2019 to 77 in 2020). Adding these data to the additional cases associated with a temporary cessation in screening during the pandemic allowed development of forecasts, suggesting that over the next 3 years there would be 586, 228 and 105 extra cases of local, regional and distant disease, respectively, throughout England. Projection tools suggest that increasing surgical capacity by two or three cases per month per centre would eradicate this excess by 12 months and 7 months, respectively. Conclusions There is likely to be a significant increase in cervical cancer cases presenting over the next 3 years. Increased surgical capacity could mitigate this with little increase in morbidity or mortality. Tweetable Abstract Covid will result in 919 extra cases of cervical cancer in England alone. Effects can be mitigated by increasing surgical capacity.