Abstract PO-038: Strong decline of newly diagnosed gynecologic and breast cancers during the COVID-19 pandemic: A retrospective analysis from Innsbruck, Austria
Authors: Tsibulak Irina , Reiser Elisabeth , Ebner Christoph , Knoll Katharina , Leitner Katharina , Wieser Verena , Angerer Justina , Marth Christian 
Published: December 2020

Abstract
A nationwide lockdown was declared on March 16 in Austria due to coronavirus disease 2019 (COVID-19) outbreak, requiring citizens to remain in their homes except for necessary reasons. The lockdown resulted not only in social distancing and reduction of commercial activity, but also in severe restrictions in the health care system. Regular medical services and outpatient care were nearly shut down to prevent the spread of the virus and to increase the total hospital capacities. Thus, patients faced barriers to attend preventive checkups, such as mammography, screening for cervical cancer, or to consult the general practitioner. As a gynecologic department with a large oncologic subunit, we noticed significantly fewer tumor diagnoses presenting at our department since the lockdown. This phenomenon forced us to perform this retrospective study on newly diagnosed gynecologic and breast cancers before and during the COVID-19 pandemic. A retrospective analysis of newly diagnosed gynecologic and breast cancers presented at the University Hospital Innsbruck from January to May 2019 and from January to May 2020 was performed. Descriptive statistics and analysis of the clinical data stratified by the year of diagnosis were performed using SPSS software and Mann-Whitney U test. Our results showed a slight increase of newly diagnosed cancers in January and February 2020 as compared to 2019 (+13%) and a strong decline in newly diagnosed tumors since the lockdown: -45% in March 2020 vs. March 2019, -63% in April 2020 vs. April 2019, and -44% in May 2020 vs. May 2019. Around two third of patients diagnosed during the pandemic consulted the specialist due to tumor symptoms, while before the pandemic less than 50% of patients presented with symptoms. The ratio of breast and vulvar cancer was significantly higher during the pandemic (71 vs. 61% and 3 vs. 1.9%, respectively; p=0.043), but significantly fewer cervical cancers were diagnosed (4.4 vs. 8.9%; p=0.043). Patients with other malignant, rheumatic, or metabolic disease were rarely diagnosed with a new cancer in 2020 as compared to 2019 (7.5 vs. 12%; 0.7 vs. 3.7% and 6.7 vs. 12%, respectively; p=0.014). A better performance status was observed in patients presented in 2020 as compared to 2019 (p=0.011). In a country with maximum intensive care bed occupancy of 26% during the COVID-19 pandemic, the accessibility of the health care services was severely impaired and preventive care and early cancer detection was restricted, leading to an increase in undetected or postponed tumor diagnoses. The aim of our work is to raise awareness of this issue. It is not clear whether these undetected cases will lead to potential months of life lost; however, decreased accessibility of the medical services and postponed diagnosis of potentially curable cancers are clearly a step backwards in our health care system and will probably impair cancer treatment outcomes. Thus, new strategies to manage early cancer detection are needed to optimize cancer care in a time of pandemic in the future.
Citation Format: Irina Tsibulak, Elisabeth Reiser, Christoph Ebner, Katharina Knoll, Katharina Leitner, Verena Wieser, Justina Angerer, Christian Marth. Strong decline of newly diagnosed gynecologic and breast cancers during the COVID-19 pandemic: A retrospective analysis from Innsbruck, Austria [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-038.