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Abstract
Introduction/Background The COVID-19 pandemic has had significant effects on healthcare systems worldwide, including the disruption of routine screening programs for cervical cancer. This study aimed to compare the incidence rate patterns of grades 2 and 3 cervical intraepithelial neoplasia, adenocarcinoma, and squamous carcinoma of the cervix before and after the COVID-19 pandemic.
Methodology Retrospective analysis was performed using archive data from the Policlinico di Bari - Unit of Gynecology and Obstetrics. The study included patients belonging to the II level of cervical-carcinoma screening. The time period studied spanned from December 2017 to December 2022. Incidence rates of CIN2/CIN3 lesions were compared between the pre-pandemic period (2017–2019) and the post-pandemic period (2020–2022). The study obtained approval from the ethics committee of Policlinico di Bari, with the approval number 7675.
Results Our study comprised a cohort of 1,558 consecutive patients who underwent a second- level screening program. The comparison between the pre-pandemic and post-pandemic revealed a statistically significant increase in the incidence rate of patterns of grades 2 and 3 cervical intraepithelial neoplasia lesions, rising from 23.9 to 63.3 per 100,000 (IRR = 2.62, 95% CI: 1.64- 4.20). Furthermore, there was an increase in the total number of pre-neoplastic lesions identified during the cervical cancer screening program.
Conclusion Our study is the first to highlight the impact of the COVID 19 pandemic on the incidence of pre-neoplastic and neoplastic cervical lesions. In our experience, the temporary suspension of national screening programmes has resulted in a worrying increase in cases of moderate to severe cervical disease. These results further underline the importance of cervical screening as an effective tool for the prevention and early diagnosis of cervical oncological diseases.
Disclosures The authors declare no conflict of interest.
Flow chart to present the number of patients included
Patterns of grades 2 and 3 cervical intraepithelial neoplasia (CIN2+), squamous carcinoma and cervical adenocarcinoma incidence rates between the years 2017–2019 and 2020–2022