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Cervical Cancer and COVID: A collaborative assessment of the effect of the COVID pandemic on the presentation of Cervical cancer in the North of England
  • +17
  • Jennifer Davies,
  • Alice Spencer,
  • Sian Macdonald,
  • Lucy Dobson,
  • Emily Haydock,
  • Holly Burton,
  • Georgios Angelopoulos,
  • Pierre Martin-Hirsch,
  • Nicholas Wood,
  • Richard Edmondson,
  • Amudha Thangavelu,
  • Richard Hutson,
  • Sarika Munot,
  • Marina Flynn,
  • Katelijn Sap,
  • Michael Smith,
  • Eva Myriokefalitaki,
  • Brett Winter-Roach,
  • Bridget Decruze,
  • Robert MacDonald
Jennifer Davies
Liverpool Women's Crown Street Hospital
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Alice Spencer
Liverpool Women's Crown Street Hospital
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Sian Macdonald
Liverpool Women's Crown Street Hospital
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Lucy Dobson
Liverpool Women's Crown Street Hospital
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Emily Haydock
Lancashire Teaching Hospitals NHS Foundation Trust
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Holly Burton
Lancashire Teaching Hospitals NHS Foundation Trust
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Georgios Angelopoulos
Lancashire Teaching Hospitals NHS Foundation Trust
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Pierre Martin-Hirsch
Lancashire Teaching Hospitals NHS Foundation Trust
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Nicholas Wood
Lancashire Teaching Hospitals NHS Foundation Trust
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Richard Edmondson
The University of Manchester
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Amudha Thangavelu
Leeds Teaching Hospitals NHS Trust
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Richard Hutson
Leeds Teaching Hospitals NHS Trust
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Sarika Munot
Leeds Teaching Hospitals NHS Trust
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Marina Flynn
Hull University Teaching Hospitals NHS Trust
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Katelijn Sap
The Christie NHS Foundation Trust
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Michael Smith
The Christie NHS Foundation Trust
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Eva Myriokefalitaki
Christie Hospital
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Brett Winter-Roach
Christie Hospital
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Bridget Decruze
The Christie NHS Foundation Trust
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Robert MacDonald
Liverpool Women's Crown Street Hospital
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Abstract

Objective: To review the effect of the COVID-19 pandemic on the presentation of Cervical cancer. Design/ Setting: Retrospective study involving the Regional Cancer Centres in the M62 Group. Methods: Data was collected for two equal time periods. All cervical cancers were included and FIGO 2018 staging was used for the data collection. P values were calculated using binomial hypothesis test for the difference in staging. Time from symptoms to diagnosis was assessed using a normal distribution test. All other calculations were performed using chi-squared test. Statistical significance was considered if p values were <0.05. Main outcome measures: Histology, stage at diagnosis, date of onset of symptoms, investigation and type of treatment. Results: A total of 406 cases of cervical cancer were reviewed; 233 from May – October 2019 (pre-COVID) and 173 between May – October 2020 (post COVID); representing a significant reduction in new cervical cancer diagnoses of 25% post COVID (p<0.001) There was a 42% increase in the delay from start of symptoms to diagnosis Post COVID. Pre COVID, 27% of patients presented with Stage 3 or 4 disease, whilst during COVID this was 38%; statistically significant (p <0.001). When we evaluated the treatments received between the two time periods, this was also statistically significant (chi-squared, p=0.0005). Conclusions: This study has demonstrated a statistically significant increase in the stage of cervical cancer at diagnosis and a change in treatment for cervical cancer following the onset of COVID-19. The implications of this are discussed.

Peer review status:IN REVISION

14 Jun 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
09 Jul 2021Assigned to Editor
09 Jul 2021Submission Checks Completed
18 Jul 2021Reviewer(s) Assigned
28 Aug 2021Editorial Decision: Revise Major