Kosin Med J.  2023 Sep;38(3):193-200. 10.7180/kmj.23.116.

The COVID-19 pandemic's impact on prostate cancer screening and diagnosis in Korea

• KMID: 2546154
• DOI: http://doi.org/10.7180/kmj.23.116

Abstract

Background
The global coronavirus disease 2019 (COVID-19) pandemic, which started in early 2020, has had multiple impacts on cancer care. This study assessed how the COVID-19 pandemic influenced prostate cancer (PCa) screening and diagnosis in South Korea.
Methods
Patients who visited the outpatient clinic at a single institution for PCa evaluation were included in this study and divided into a pre-COVID-19 group and a COVID-19 pandemic group, based on the start of the COVID-19 pandemic and social distancing policies on March 1, 2020. The number of prostate-specific antigen (PSA) tests, patients with elevated PSA levels, and prostate biopsy results were analyzed.
Results
In total, 8,926 PSA tests were administered during the COVID-19 pandemic, compared to 15,654 before the pandemic (p<0.05). Of 2,132 patients with high PSA levels, 1,055 (49.5%) received prostate biopsies before the pandemic and 1,077 (50.5%) did so during the COVID-19 pandemic. The COVID-19 pandemic group had a higher detection rate of PC, and increased rates of Gleason scores (GS) 7 and 9–10, while the rate of GS 6 decreased compared to the pre-COVID-19 group (p<0.05). The rate of clinically significant PCa (csPCa) was also higher during the pandemic (p<0.05). In both magnetic resonance imaging-guided and standard biopsies, the GS 6 rate decreased, and the csPCa rate increased during the COVID-19 pandemic (each, p<0.05).
Conclusions
During the COVID-19 pandemic, the detection rate of prostate biopsies and the rate of csPCa increased significantly. Thus, PCa was diagnosed at a more advanced state in Korea during the COVID-19 pandemic.

Figure

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  Fig. 1. Differences in the distribution of Gleason scores (GS) in prostate biopsies before and during the coronavirus disease 2019 (COVID-19) pandemic. Each GS is represented by a color, and the number inside the bar represents the number. The y-axis represents the proportion of each GS.

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  Fig. 2. Differences in the Gleason score (GS) distribution of magnetic resonance imaging (MRI)-guided and standard biopsies before and during the coronavirus disease 2019 (COVID-19) pandemic. Each GS is represented by a color, and the number inside the bar represents the number. The y-axis represents the proportion of each GS. (A) The MRI-guided biopsies comprised MRI-ultrasound fusion targeted target biopsies (two cores per target lesion) and standard biopsies. The group with these biopsies was compared before and during the COVID-19 pandemic. (B) The standard biopsy group was compared before and during the COVID-19 pandemic.

Reference

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