Introduction/Background Chemoradiotherapy (CCRT) is the gold standard treatment for locally advanced cervical cancer. The COVID-19 pandemic resulted in a UK-wide lockdown in March 2020, potentially limiting access to healthcare. We evaluated stage at presentation of women diagnosed with locally advanced cervical cancer who were referred for radical CCRT over the subsequent 12 months.
Methodology The central radiotherapy prescribing system at a single institution was interrogated to identify patients who commenced radical RT/CCRT from 1st April 2020 to 31st March 2021. Staging information (FIGO 2009 & 2018) was retrieved from corresponding electronic records and compared with a previous treatment period; 1st April 2018 to 31st March 2019.
Results Primary RT/CCRT was delivered to 80 patients in the 2020 – 2021 cohort and 88 patients in the 2018 – 2019 cohort (adjuvant/salvage therapies were excluded). Median age was 53 years (range 30 – 77) and 49 years (range 30 – 82), respectively. The proportion of squamous cell carcinoma was 75%, 2020 – 2021, and 85%, 2018 – 2019. Median tumour size was 51 mm (range 15 – 130 mm) in the 2020 – 2021 period and 44 mm (range 10 – 105 mm) in the 2018 – 2019 period. Stage distribution is illustrated in table 1. * Denotes pelvic/abdominal disease encompassed within radical field.
Conclusion There was no significant difference in median primary tumour size, but more patients had lymph node involvement and stage IVA disease in 2020 – 2021, suggesting a delay to presentation and/or diagnosis. Inclusion of patients with more advanced disease who were directed to systemic anti-cancer therapy or best supportive care would provide a more comprehensive analysis of the effect of the pandemic on cervical cancer stage at diagnosis.
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