Covid-19 Impact On Breast And Prostate Cancer Screening, Diagnosis, And Surgery: A Real-World Study From The Brazilian And Colombian Public Healthcare System Perspectives

The uncontrolled transmission of SARS-CoV-2 during 2020 has demanded health authorities and governments to establish physical distancing policies to slow down the COVID-19 pandemic. As a consequence, several procedures were avoided, especially in oncology. This real-world study aims to estimate the impact of the COVID-19 pandemic on main surgery, screening, and diagnostic procedures related to breast and prostate cancers in Brazilian and Colombian public healthcare systems. Public databases were reviewed in Brazil (DataSUS) and Colombia (SISPRO) to compare the frequency of screening tests (mammograms and PSA test), diagnostic exams (breast biopsy and prostate biopsy) and surgeries (mastectomy and prostatectomy) in 2019 and 2020, from April to September to capture the pandemic period in both countries. In Brazil, breast and prostate cancer screening tests were reduced by 31.0% and 39.7%, respectively. A monthly average of 3,441.5 (± 315.2) prostate biopsies were performed in 2019, while 2,478.8 (± 373.9) in 2020, representing a 28.0% decrease. Breast cancer diagnostic exams decreased by 26.6%. The number of mastectomies decreased by 14.4%. Meanwhile, prostatectomies decreased by 35.0%. In Colombia, breast and prostate cancer screening tests were reduced by 42.7% and 25.6% respectively. A monthly average of 981.0 (± 139.1) prostate biopsies were performed in 2019, while 466.8 (± 349.4) were performed in 2020, representing a 52.4% decrease. Breast biopsies decreased by 29.2%. The number of prostatectomies decreased by 18.3%, while mastectomies decreased by 9.3% in this period of 2020. The pandemic severely impacted screening and diagnostic tests, which delays cancer diagnosis and negatively impacts prognosis. Besides, the reduction of the frequency of surgeries suggests they might have been postponed, which could worsen clinical outcomes and even increase the risk of death.