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Full length article| Volume 283, P95-99, April 2023

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Cervical cancer during the covid pandemic: Are patients presenting with more advanced or larger tumours?

  • Sally S. El-Tawab
    Correspondence
    Corresponding author at: Oxford Gynaecological Cancer Centre, Churchill Hospital, Oxford University Hospitals Foundation Trust, Headington, Oxford OX3 7DL, United Kingdom.
    Affiliations
    Oxford Gynaecological Cancer Centre, Churchill Hospital, Oxford University Hospitals Foundation Trust, Headington, Oxford OX3 7DL, United Kingdom

    Elshatby Maternity University Hospital, Gynaecology Oncology Center, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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  • Julia Fox
    Affiliations
    Consultant Biomedical Scientist, Cellular Pathology Department, John Radcliffe Hospital, Oxford University Hospitals Foundation Trust, Headington, Oxford OX3 9DU, United Kingdom
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  • Sally Trent
    Affiliations
    Clinical Oncology Department, Churchill Hospital, Oxford University Hospitals Foundation Trust, Headington, Oxford OX3 7DL, United Kingdom
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  • Sean Kehoe
    Affiliations
    Oxford Gynaecological Cancer Centre, Churchill Hospital, Oxford University Hospitals Foundation Trust, Headington, Oxford OX3 7DL, United Kingdom

    Nuffield Department of Women's & Reproductive Health, The Women’s Centre, John Radcliffe Hospital, Oxford OX3 9 DU, United Kingdom
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Published:February 11, 2023DOI:https://doi.org/10.1016/j.ejogrb.2023.02.006
Cervical cancer during the covid pandemic: Are patients presenting with more advanced or larger tumours?
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      Highlights

      • •
        No significant increase or decrease in cancer cervix cases was noted during the pandemic period.
      • •
        Referral routes were also unchanged.
      • •
        Statistically significant stage migration from FIGO stage 2 to stage 3 was noted in pandemic period cases.
      • •
        More research is required to see if the findings are noted on wider population base.

      Abstract

      Objectives

      Concerns were raised by clinicians at the Oxford Gynaecological Cancer MDT that there was an increasing number of women presenting with large cervical tumours requiring chemo-radiotherapy, possibly due to delays associated with the COVID pandemic. This audit was undertaken to assess whether this was a real event.

      Study design

      This retrospective cohort study collated the data from the central pathology service covering Oxfordshire, in the Oxford Gynaecological cancer centre. The control population consisted of patients treated during the 2 years pre-pandemic (1st Jan 2018–31 Dec 2019) and the study group the 2-year pandemic period (1st Jan 2020 until 31st December 2021). A total of 153 patients (74 control and 79 study) were diagnosed of cervical cancer during the study period. Variables included in the analysis were age, pathway of referral and diagnosis (cytology or clinical), FIGO stage, tumour histology, tumour size (using maximum diameter on MRI) and treatment. Student’s t-test was used for continuous and discrete variables, respectively. The X2 test was used for the statistical analysis of proportions.

      Results

      There was no statistically significant differences was noted in the referral pathways during both periods. Statistically significant stage migration from FIGO stage II to III was detected (p < 0.05), though no statistically significant change in tumour size. However, the pattern of tumour volume on case-to-case comparison elicited more cases with larger volumes during the pandemic periods.

      Conclusions

      Referral pathways of diagnosed cancer cervix was not affected during the pandemic in Oxfordshire. Therapeutic treatment numbers were unchanged – but some changes in tumour volume were likely the reason for the impression more such cases. Whether the stage shift noted here is representative of the wider population requires further studies.

      Keywords

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      Article info

      Publication history

      Published online: February 11, 2023
      Accepted: February 10, 2023
      Received in revised form: February 1, 2023
      Received: August 27, 2022

      Identification

      DOI: https://doi.org/10.1016/j.ejogrb.2023.02.006

      Copyright

      © 2023 Elsevier B.V. All rights reserved.

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