Trends in prostate cancer screening in the pre- and peri-COVID-19 Pandemic period

Document Type


Publication Date


Publication Title

Urol Pract


PURPOSE: This study sought to examine prostate-specific antigen testing rates before, early in, and later in the COVID-19 Pandemic.

MATERIALS AND METHODS: Our cohort included test results from men >45 years who received prostate-specific antigen testing at least once at our institution from November 2018-September 2021 and were alive at the end of that period. Monthly trends were evaluated for three periods: Pre-COVID (November 2018-February 2020), early-COVID (March-May 2020), and late-COVID (June 2020-September 2021). Univariable and multivariable analysis tested the impact of these periods on prostate-specific antigen testing rate, after accounting for available confounders. All analyses were stratified by prostate cancer diagnosis status.

RESULTS: A total of 141,777 prostate-specific antigen tests met inclusion criteria. The monthly number of tests in men without prostate cancer declined from 3,669 pre-COVID to 1,760 early-COVID (52% decrease; P=0.0086) before increasing to 4,171 (14% increase from pre-COVID; P<0.0001) late-COVID. The monthly average of first-time tests declined from 805 pre-COVID to 315 early-COVID (61% decrease; P=0.008) before rebounding to 795 (1% decrease from pre-COVID; P=0.7) late-COVID. The monthly number of tests in prostate cancer patients declined from 343 pre-COVID to 195 early-COVID (43% decrease; P=0.008) before partially rebounding to 313 (9% decrease; P=0.03) late-COVID. These differences remained within multivariable models.

CONCLUSIONS: A number of men have forgone first-time prostate-specific antigen testing opportunities following the COVID-19 outbreak; thus, early cancer diagnoses in some individuals might have been missed. Likewise, many prostate cancer patients have forgone follow-up in the late-COVID period, which might compromise their oncologic outcomes.

PubMed ID



ePub ahead of print

First Page


Last Page