Introduction/Background We set out to quantify the effect of the COVID-19 pandemic on waiting times experienced by patients referred to a tertiary gynae-oncology service at Queen Alexandra Hospital, Portsmouth by comparing waiting times, before and during, the pandemic.

Methodology All gynaecological cancer diagnoses over two five-month periods 1/2/2019 – 30/6/2019 (the pre-Covid period), and during the initial pandemic period 1/2/2020 – 30/6/2020, (during Covid), were tracked from referral date onwards throughout the patient pathway, and waiting times (average number of days) compared. Patients receiving private care, with a diagnosis prior to formal referral or having chemo or radiotherapy prior to surgery were excluded.

Results There were 131 gynaecological cancer diagnoses in the pre-Covid period, and 87 during Covid. Waiting time from referral to see a specialist was 13.1 days pre-Covid, and 10.9 during Covid (p=0.08). Time from referral to imaging (CT/MRI) was similar between the two groups (29.0 vs 25.6 during Covid, p=0.36). Time from referral to diagnosis was significantly shorter during Covid (34.9 vs 23.7 days during Covid, p = 0.0017). 74 patients (pre-Covid) and 51 (during Covid) underwent surgery as their primary treatment. Waiting time from decision to treat to operation date was similar between the two groups (29.5 vs 24.2 days during Covid, p=0.13). Waiting time from initial referral to surgery was significantly shorter during the pandemic (55.5 vs 42.5 during Covid, p=0.001).

Conclusion Cancer diagnoses at this centre were a third less than the same time the previous year. Unlike benign gynaecological services, resourcing for gynae-oncology services remained consistent throughout the pandemic. The reduced patient volumes meant those in the pathway had improved care in the form of quicker diagnoses and surgery. These findings suggest that Covid-related challenges in the gynae-oncology care pathway were pre-hospital, possibly related to reduced presentations, GP access and or referrals.