Treatment delay and treatment pattern modifications among epithelial ovarian cancer patients during the COVID-19 pandemic: A retrospective cohort study

J Surg Oncol. 2022 Dec;126(7):1155-1161. doi: 10.1002/jso.27048. Epub 2022 Aug 5.

Abstract

Background and objectives: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare access and medical treatment, including oncological care. Treatment delay in ovarian cancer could impact survival. We aimed to assess if there were delays and treatment changes in a cohort of epithelial ovarian cancer patients.

Methods: A retrospective cohort of epithelial ovarian cancer patients included cases diagnosed during the first 22 months of the COVID-19 pandemic in the state of Sao Paulo and those diagnosed in the 22 months preceding the outbreak. Time-to-treat was measured in days. In each group, surgery and chemotherapy proportions were assessed according to healthcare insurance status.

Results: A 56.2% reduction in epithelial ovarian cancer diagnosis was identified during the pandemic group compared to the prepandemic group; fewer patients were diagnosed in stage I (p < 0.01). Time-to-treat increased from 18.9 to 23 days (p < 0.01). Surgery in the public sector fell from 74.6% to 65.3% during the pandemic, compared to 87.1% to 68.8% in the private sector.

Conclusion: There were fewer overall diagnoses, reduced stage I diagnosis, increased time-to-treat, and a reduction in the proportion of patients submitted to surgery. Brazil's public healthcare system demonstrated a higher resiliency to treatment change than the private sector.

Keywords: COVID-19; ovarian cancer; surgery; treatment.

MeSH terms

  • Brazil / epidemiology
  • COVID-19* / epidemiology
  • Carcinoma, Ovarian Epithelial / therapy
  • Cohort Studies
  • Female
  • Humans
  • Ovarian Neoplasms* / drug therapy
  • Ovarian Neoplasms* / therapy
  • Pandemics
  • Retrospective Studies
  • Time-to-Treatment