The impact of COVID-19 pandemic on bladder cancer incidence and stage at presentation: Results from a population-based cohort
Recommended Citation
Bertini A, Stephens A, Tylecki A, Finocchiaro A, Vigano S, Cusmano N, Dinesh A, Robinson B, Mssika A, Guivatchian E, Lughezzani G, Buffi N, Di Trapani E, Ficarra V, Salonia V, Briganti A, Montorsi F, Sood A, Rogers C, Abdollah F. The impact of COVID-19 pandemic on bladder cancer incidence and stage at presentation: Results from a population-based cohort. Eur Urol 2025; 87(S1):1495.
Document Type
Conference Proceeding
Publication Date
3-1-2025
Publication Title
Eur Urol
Abstract
Introduction & Objectives: The impact of the COVID-19 pandemic on bladder cancer (BCa) care has been scarcely evaluated. Assuming that the reduced diagnostic capacity induced by the COVID-19 pandemic may have led to a decreased BCa incidence alongside a shift towards higher tumor stage, we evaluated BCa age-adjusted incidence and the stage at presentation before and after the onset of the COVID-19 pandemic. Materials & Methods: First, we calculated age-adjusted incidence (per 1,000,000 people) in two time periods (01/2018-12/2019 and 01/2020-12/2021) for all BCa cases, Low-risk (LR) Non-Muscle Invasive Bladder Cancer (NMIBC) (Ta), High-Risk (HG) NMIBC (Tis-T1), Muscle Invasive Bladder Cancer (MIBC) (T2-4aN0M0), locally advanced BCa (T4b or pN1), and metastatic (M1) BCa. Second, the Surveillance, Epidemiology, and End Results (SEER) database was queried to identify patients with a histologically confirmed BCa (any T, any N and any M) between 01/2018 and 12/2021. Then, Logistic regression analysis tested the impact of COVID-19 pandemic on the diagnostic rates of HR-NMIBC, MIBC, locally advanced BCa and M1 BCa. Results: In 2020-2021, a lower age-adjusted incidence for BCa (171 vs 181, p<0.001) and for LR-NMIBC (73 vs 79, p<0.0001) was reported, compared to the two-year period of 2018-2019. Our final cohort consisted of 64613 patients with histologically confirmed BCa. Median age (IQR) and median follow-up time (IQR) were 73 (65-80) years and 17 (7-31) months, respectively. During the two-year period 2020-2021, patients were more likely to be diagnosed with pT2-4 BCa (22.6% vs 21.4%, p<0.0001), N+ BCa (5% vs 4.6%, p=0.004) and M+ BCa (3.6% vs 3.3%, p=0.029). At MVA, the two-year time period 2020-2021 was significantly associated with an increased probability to be diagnosed with HR-NMIBC (HR: 1.04, 95% CI: 1.00-1.07, p=0.04) locally advanced BCa (HR:1.12, 95% CI:1.03-1.22, p=0.009) and M1 BCa (HR: 1.10, 95% CI: 1.01-1.20, p=0.023). Conclusions: Our findings showed that during the COVID-19 pandemic, a reduced incidence of BCa and LR-NMIBC was reported, alongside an increased likelihood of diagnosis of HR-NMIBC, locally advanced BCa, and M1 BCa. Further studies are needed in the future to assess the impact of this phenomenon in terms of oncological outcomes.
Volume
87
Issue
S1
First Page
1495
