Trends in prostate cancer screening in the pre- and peri-COVID-19 Pandemic period
Davis M, Stephens A, Butaney M, Morrison C, Corsi N, Sood A, Levin AM, Cole A, Trinh QD, Rogers C, and Abdollah F. Trends in prostate cancer screening in the pre- and peri-COVID-19 Pandemic period. Urol Pract 2023.
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.
ePub ahead of print