A Comparison of Prostate Biopsies Performed Before and During the COVID-19 Pandemic

Abstract

Prostate cancer is the most common cancer in men in developed countries, and prostate biopsy is the gold standard for diagnosis. However, the COVID-19 pandemic disrupted medical examinations, potentially leading to delays in diagnostic investigations, particularly for vulnerable oncology patients. This study included a total of 2796 patients. Biopsies were performed from 2018 to 2021, with a division into pre-pandemic (2018-2019) and pandemic (2020-2021) periods. To compare the two period and yearly data, we used the Chi-square test and the Cochran-Armitage trend test, respectively. During the pandemic period, there was a 26.47% decrease in prostate biopsies compared with pre-pandemic years. The percentage of patients diagnosed with GS 3+3 adenocarcinomas decreased by 37.93% and by 17.66% for GS ≥3+4 (p=0.0164). The percentage of decrease for systematic biopsy was 37.85%, while the percentage of targeted+systematic biopsy increased by 57.89% (p<0.0001). Although the Department of Urology of the UHC Zagreb continued to perform prostate biopsies during the COVID-19 pandemic without interruption, there was a noticeable decrease in the number of biopsies. However, during the pandemic period, we observed an increased proportion of targeted biopsies and a subsequent increase in the proportion of higher-grade adenocarcinoma (GS ≥3+4). The long-term impact of the reduced number of biopsies and prostate cancer diagnoses is yet to be determined, but we believe that this study could be a good starting point for further investigations on this topic.

Keywords

• Prostate cancer
• Prostate biopsy
• COVID-19
• Pandemic