The impact of the COVID-19 pandemic in 2020 on the diagnosis, treatment, and cancer-specific survival of major urological cancers: An observational study

The impact of the COVID-19 pandemic in 2020 on the diagnosis, treatment, and outcomes of major urological cancers remains poorly understood. Patients diagnosed with prostate cancer, bladder cancer, and kidney cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Ordered logistic regression was used to evaluate the effect of the COVID-19 pandemic in 2020 on cancer stage at diagnosis. Logistic regression was employed to determine the impact of the pandemic on the diagnosis of different patient subgroups. Kaplan-Meier curves were used to evaluate cancer-specific survival (CSS). In the SEER-17 and SEER-22 datasets, the number of newly diagnosed cases of prostate cancer, bladder cancer, and kidney cancer decreased in 2020. Patients diagnosed with prostate cancer (OR = 1.04, 95% CI, 1.01-1.07, P = .016), bladder cancer (OR = 1.07, 95% CI, 1.01-1.14, P = .019), and kidney cancer (OR = 1.08, 95% CI, 1.02-1.14, P < .001) in 2020 were at a higher risk of advanced stages. Among the 3 cancers, patients with a median household income > 75,000 USD were more likely to be diagnosed in 2020, while urban and female patients (bladder and kidney cancers) tended to be diagnosed in 2018/2019. For prostate cancer (HR = 1.06, 95% CI, 0.97-1.15, P = .207), bladder cancer (HR = 1.04, 95% CI, 0.98-1.11, P = .188), and kidney cancer (HR = 1.03, 95% CI, 0.94-1.12, P = .496), no significant differences in CSS were observed between patients diagnosed in 2020 and those diagnosed in 2018/2019. The COVID-19 pandemic in 2020 led to a decrease in the number of diagnoses for prostate cancer, bladder cancer, and kidney cancer, with varying impacts on different patient subgroups. Patients diagnosed during this period were more likely to have later-stage disease. Additionally, no significant differences in CSS were observed between patients diagnosed during the COVID-19 pandemic in 2020 and those diagnosed in 2018/2019; however, this finding should be interpreted cautiously given the relatively short follow-up period and the potential influence of competing risks during the COVID-19 pandemic.