ABSTRACT
INTRODUCTION:
Urologists observed reduced
cancer consultations and surgeries during the
SARS-CoV-2 pandemic, raising concern about
treatment delays.
Testicular cancer serves as a particularly sensitive marker of this phenomenon, as the clinical stage of
testicular cancer at presentation is predictive of
cancer-specific
survival. We aimed to investigate whether COVID-related restrictions to
primary care access resulted in increased
incidence of metastatic
germ cell testis cancer.
METHODS:
A retrospective chart
review was conducted on all cases of
testicular cancer managed surgically at our center from March 1, 2018, to February 28, 2023.
Patients were categorized into temporal cohorts, representing before, during, and following the implementation of COVID-19
public health restrictions in the province of
Newfoundland and Labrador.
RESULTS:
Forty-one cases of testicular
germ cell tumors were identified during the study period. The mean age at
diagnosis was 40.8 years (standard deviation ±13.7). Demographics did not vary across the cohorts. Clinical stage 3
disease remained stable before and during the
pandemic at 10.5% and 9.1% of cases, respectively. In the post-
pandemic period, there was an increase to 27.3% (p=0.617). Surgical wait times remained stable across the
pandemic (p=0.151).
CONCLUSIONS:
There was a 16.8% rise in clinical stage 3
disease from the pre-
pandemic to post-
pandemic period. Our study failed to identify a statistically significant increase in metastatic
testis cancer incidence upon
lifting of
pandemic restrictions. Further study is necessary to confirm suspicions that
pandemic restrictions contributed to increased
incidence of metastatic
testis cancer.
