PROSTATE CANCER IN THE FIRST WAVE OF PANDEMIC: HAS COVID-19 CHANGED THE PERSPECTIVE OF PROSTATE CANCER

ABSTRACT

Introduction: Prostate cancer is the most common cancer in men[1]. The incidence of prostate cancer in Croatia is in steady increase[2]. One of the possible reasons in the early screening via PSA screening, but also, global aging of the population. Pandemic has greatly affected all levels of healthcare, including, unfortunately, cancer patients. The 'lockdown' period during the first wave of pandemic limited patients' access to diagnostics and subsequently, timely treatment [3]. Several observational studies reported temporary suspensions of early detection programs, and, in the countries where such suspensions did not occur, a lesser number of patients underwent screening programs [4],[5]. The number of patients increased afterwards, to the pre-pandemic level[6]. Based on the current publishing practice, Croatian Cancer registry bulletin for Croatia in the period 2022-2022 are expected in 2024 at soonest. The goal of this collaboration was to test the impact of epidemiologic measures on the number of newly registered prostate cancer patients within three dalmatian general hospitals and the University hospital center in Split. Methods: Retrospective observational study was conducted at the Department of internal medicine at the General hospital of Šibenik- Knin County, Department of oncology at the General hospital Zadar, Department of oncology at the General hospital Dubrovnik, and the Department of oncology and radiotherapy at the University hospital in Split. Analysis involved newly diagnosed prostate cancer patients' medical charts in the period of January 1st, 2018, till December 31st, 2020. Results: Analysis encompassed a three-year period, and 1644 patients' medicals files were examined. The number of newly diagnosed prostate cancer patients in 2018 was 634, 524 in 2019 and 486 in 2020. Most patients were from the area surrounding University hospital Split (865), followed by the Zadar County (506). General hospitals in Šibenik and Dubrovnik had fewer patients (136 and 137, respectively). The most significant decrease in number of newly diagnosed patients in 2020 compared to the average of the two pre-pandemic years was in the area belonging to General hospital Dubrovnik (-36%), followed by General hospital Zadar (-31%), University Hospital of Split (-7%), while the number of newly diagnosed patients in General hospital Šibenik-Knin County was increased (+7%). Conclusion: The number of newly diagnosed prostate cancer patients in Dalmatia decreased during the first wave of pandemics compared to the average of the previous years. The decrease was 23% in absolute, contradicting the increase of incidence expected both in Croatia and worldwide. Public health measures, and previously reported patients' unwillingness to participate in the screening programs during the pandemics decreased the number of newly diagnosed prostate cancer patients. True consequences of these measures, described through patients' and tumors' characteristics, disease stage at diagnosis and the treatment initiation are to be analyzed.