Restricted access and advanced disease in post-pandemic testicular cancer

Authors

  • Mitchell Fagan Memorial University
  • W.C. Ian Janes Memorial University
  • Matthew Andrews Memorial University
  • David R. Harvey Memorial University
  • Geoff M. Warden Memorial University
  • Michael K. Organ Memorial University
  • Paul Johnston Memorial University

DOI:

https://doi.org/10.5489/cuaj.8648

Keywords:

Testicular cancer, COVID-19, Outcomes, Staging

Abstract

INTRODUCTION: Urologists observed reduced cancer consultations and surgeries during the SARS-CoV-2 pandemic, raising concern about treatment delays. Testicular cancer serves as a particularly sensitive marker of this phenomenon, as the clinical stage of testicular cancer at presentation is predictive of cancer-specific survival. We aimed to investigate whether COVID-related restrictions to primary care access resulted in increased incidence of metastatic germ cell testis cancer.

METHODS: A retrospective chart review was conducted on all cases of testicular cancer managed surgically at our center from March 1, 2018, to February 28, 2023. Patients were categorized into temporal cohorts, representing before, during, and following the implementation of COVID-19 public health restrictions in the province of Newfoundland and Labrador.

RESULTS: Forty-one cases of testicular germ cell tumors were identified during the study period. The mean age at diagnosis was 40.8 years (standard deviation ±13.7). Demographics did not vary across the cohorts. Clinical stage 3 disease remained stable before and during the pandemic at 10.5% and 9.1% of cases, respectively. In the post-pandemic period, there was an increase to 27.3% (p=0.617). Surgical wait times remained stable across the pandemic (p=0.151).

CONCLUSIONS: There was a 16.8% rise in clinical stage 3 disease from the pre-pandemic to post-pandemic period. Our study failed to identify a statistically significant increase in metastatic testis cancer incidence upon lifting of pandemic restrictions. Further study is necessary to confirm suspicions that pandemic restrictions contributed to increased incidence of metastatic testis cancer.

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Published

2024-04-02

How to Cite

Fagan, M. G., Janes, W. I., Andrews, J. M., Harvey, D. R., Warden, G. M., Organ, M. K., & Johnston, P. H. (2024). Restricted access and advanced disease in post-pandemic testicular cancer. Canadian Urological Association Journal, 18(8), 262–7. https://doi.org/10.5489/cuaj.8648

Issue

Vol. 18 No. 8 (2024): CUAJ August

Section

Original Research

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