ABSTRACT
Background: During the Covid-19 (Cov19) pandemic hospitals were assigned to four levels according their resources to manage the increased demand of intensive care treatments. This study aims to contribute towards quantifying the impact of the Cov19 pandemic on cancer care of patients with cervical cancer in Germany by investigating the diagnoses and treatments in Hessian hospitals of different Cov19 levels. Method(s): Data of patients with cervical cancer (C53) diagnosed from 2016 to 2020, were extracted from the database of the Hessian cancer registry. With regard to a continuously stable registration activity eleven hospitals were included in the analysis. Seven hospitals met the criteria for Cov19 level 1 (highest requirements) and four hospitals for level 2. Result(s): In 2020, 31% fewer patients with cervical cancer were diagnosed in eleven Hessian hospitals compared to previous years (n=124 vs. n=179). Primary tumor resections were reduced by 24%, whereas no difference could be detected in their relative amount or timespan from diagnosis. The patient cohort was younger with a median age of 46 vs. 50 years and with early stage I-II in 70% vs. 62%. The reduction in treatment was mostly seen in the Cov19 level 1 hospitals, while level 2 hospitals could increase the amount of diagnosed (14%) and treated (27%) patients. Discussion(s): Despite a reduction of diagnoses and treatments, primary surgery was not delayed. The patient characteristics imply that predominantly elder women with advanced stages omitted hospital treatment. The increased burden of care of Cov19 patients for the level 1 hospitals clearly had an impact on the care of cancer patients, which could be partially absorbed by level 2 hospitals. Conclusion(s): Reorganisation of hospitals according to Cov19 levels was an important tool to enable treatment of Cov19 patients while maintaining cancer care by shifting treatment to other hospitals. However, there is an impact on missed diagnoses and treatments of patients, that will result in a higher morbidity and mortality.