Impact of the COVID-19 Pandemic on Prostate Cancer Diagnosis, Staging, and Treatment: A Population-Based Study in Northern Italy

Simple Summary COVID-19 has had a dramatic impact on new cancer diagnoses and the treatment of cancer patients. This study examines how the COVID-19 pandemic affected prostate cancer diagnosis, staging, and treatment in Reggio Emilia, Northern Italy. Using data from the Cancer Registry from 2018 to 2021, we found a significant drop in new prostate cancer diagnoses during 2020, the height of the pandemic. The number of new cases decreased by 31% in 2020, with a slight recovery of 5% in 2021. We also observed a shift towards more advanced stages and aggressive forms of prostate cancer, with fewer early-stage diagnoses and more cases of metastatic cancer. Despite these changes, treatments such as surgery and radiation therapy have remained constant. The pandemic disrupted an increasing trend of prostate cancer diagnoses seen before 2019, highlighting the need for ongoing diagnostic services and healthcare delivery, even during global health emergencies. Our study highlights the significant impact of COVID-19 on prostate cancer management and the importance of healthcare system resilience.Abstract The COVID-19 pandemic has caused delays in cancer diagnoses and reductions in treatments. The aim of this work is to evaluate the impact of the pandemic on prostate cancer by evaluating whether there has been a shift towards more aggressive (Gleason) and more advanced tumors (stage IV) and a decline in treatments. The study was conducted on 1123 cases of prostate cancer incident in the Province of Reggio Emilia, Northern Italy, in the period of 2018-2021. In 2020, there was a decline in new diagnoses of prostate cancer (-31%), followed by a slight recovery in 2021 (+5%). While Gleason 7 and 8-10 values remained constant, a significant decrease was recorded in stage I (38.7%, 41.6%, 35.5%, and 27.7%) and an increase in stage IV (13.1%, 13%, 15.4%, and 20%) cases in the years 2018, 2019, 2020, and 2021, respectively. However, there was no impact on surgical treatment (which remained constant at around 35%) and radiotherapy (around 39%). Our findings underline the profound impact of COVID-19 on prostate cancer management, highlighting the importance of healthcare resilience in the face of unprecedented disruptions.