20,000 men may have missed a prostate cancer diagnosis due to the coronavirus pandemic

A new study from the Universities of Surrey and Oxford has found that prostate cancer diagnoses in 20,000 men may have been missed due to the coronavirus pandemic. Longer wait times and changes in people's behavior when seeking medical care during the pandemic may contribute to missed diagnoses.

In this study, scientists sought to investigate the impact of the coronavirus disease (COVID-19) pandemic on prostate cancer diagnosis and mortality rates in the UK. Scientists used data from OpenSAFELY, which consists of 24 million electronic health records of people enrolled with primary care providers, to estimate the incidence of prostate cancer from January 2015 to July 2023. The incidence was analyzed.

Understandably, during the COVID-19 pandemic, health system resources and attention have been directed toward virus prevention and control. This has been to the detriment of other areas of health services, including cancer treatment.

Early diagnosis of cancer is key to improving cancer-related outcomes and long-term survival. It is important to learn lessons from the pandemic, but to do so we need to fully understand how services and diagnosis rates have been affected during this period. ”

Dr. Agnieszka Lemanska, Lead author, Senior Lecturer in Health Data Science, University of Surrey

To assess the impact of COVID-19, scientists used pre-pandemic data and statistical models to predict whether prostate cancer from March 2020 would have been as if the pandemic had never occurred. The expected incidence of this was predicted. Analyzing data from 285,160 participants, scientists found that there were 15,550 new diagnoses in the dataset in 2020, compared to a predicted 20,322, with a diagnosis rate of 4,772 (31 %) was found to have decreased. The number of prostate cancer cases recorded in 2021 was 17,950, a decrease of 3,148 (18%) compared to the estimated 21,098. By 2022, the incidence of diagnosis had returned to expected levels.
The scientists then modeled these findings from the OpenSAFELY dataset, which represents 40% of the UK population, and estimated that the drop in incidence represented around 20,000 missed cases in the UK.

Scientists have also identified two peaks in prostate cancer mortality in April 2020 and January 2021, each with a prostate cancer-related mortality rate of approximately 5.5 per 100,000 men. The number of deaths increased from 8.5 people to 7.5 people. Scientists note that these two peaks coincide with England's two national lockdowns. Because these changes in mortality rates are temporary, they are not investigated in statistical models.

Interestingly, scientists also identified changes in the characteristics of men diagnosed with prostate cancer during the pandemic. As 2020 data revealed, men diagnosed during the pandemic were more likely to be older, with an average age of 71.6 years at diagnosis, higher than the 2019 average age of 71.3 years. In 2021, the average age rose again to 71.8 years. By 2022, age at diagnosis fell to 71.4 years, and in 2023 it fell again to 71.0 years, returning to pre-pandemic values.

Dr Agnieszka Lemanska added:

”Although cancer incidence returned to pre-pandemic levels by the end of 2022, the number of diagnoses has not increased enough to compensate for missed cases. The prevalence of prostate cancer at the end of our study was still lower than it would have been without the pandemic. The effects of the pandemic are still being felt and more needs to be done to explore the impact this is having on patients and healthcare systems. ”

The study was published in the journal BJU International.