Dados do Resumo

Título

Impact of the pandemic on diagnosis of prostate cancer in different age groups of geriatric population in the city of São Paulo from 2018 to 2023.

Introdução

The COVID-19 pandemic has brought numerous brand new challenges to public health, such as the negative impact on the diagnosis process of chronic diseases. Prostate cancer, considered the second most lethal among men in Brazil, had its early diagnosis compromised due to the overload of health services, which jeopardized the identification as well as the adequate treatment of this illness at the appropriate time for a good patient prognosis. Therefore, the importance of studying the pathology in question is highlighted.

Objetivo

To analyze the impact of the COVID-19 pandemic on the detection of prostate cancer in different age groups of the geriatric population in the city of São Paulo, from 2018 to 2023.

Métodos

Ecological epidemiological study with quantitative analysis of the number of diagnoses for malignant prostate neoplasia in elderly people, from 2019 to 2023, in the city of São Paulo. Data collected from the Department of Information and Informatics of the Unified Health System (DATASUS), associated with a literature review by searching the Pubmed database for articles published in the last 5 years. The keywords used were "elderly," "prostate neoplasms," and "COVID-19."

Resultados

The analysis of the data by biennia showed a significant impact of the COVID-19 pandemic on the detection of neoplasia. From 2018 to 2019, 6.217 cases were recorded, with 68% of diagnoses in men aged 60 to 74 years (60-64: 1.861 cases; 65-69: 4.393; 70-74: 3.675). In 2020-2021, there was a reduction of 423 cases (-6,8%), totaling 5.794 diagnoses, with a greater reduction in the 50-59 age group (-21%). In 2022-2023, the number increased to 5.856 cases (+1,1%). The 60-64 age group continued to lead, with 1.078 diagnoses (34% of the total). Regarding the facilities that diagnosed the neoplasia most, from 2018-2019, the Hospital das Clínicas diagnosed 1.170 cases (19%) and the Instituto do Câncer Arnaldo Vieira de Carvalho, 771 (12%). In 2020-2021, the Hospital das Clínicas remained ahead with 1.108 cases (-5%) and the Institute recorded 542 (-30%). In 2022-2023, the Hospital das Clínicas partially recovered with 556 cases (+50%) and the Instituto do Câncer Arnaldo Vieira de Carvalho with 771 (+42%). In terms of staging, 30% of cases were diagnosed in stage 1 and 10% in stage 2 in 2018-2019. The rate of unstaged cases in the period 2020/2021 was 20% higher compared to the pre-pandemic period, and in 2022/2023, the same rate decreased by 24% compared to the previous biennium.

Conclusões

The study shows the negative impact of the COVID-19 pandemic on the early diagnosis of prostate cancer in the geriatric population of São Paulo. The decrease in diagnoses between 2020 and 2021 shows a compromise in the screening of chronic diseases. Even with partial recovery, deficits persist, suggesting a worsening in the staging and prognosis of patients. Variations between centers and an increase in cases of unstaged cancers demonstrate the vulnerability of the healthcare system in crises. The need for public policies that guarantee oncological care and strengthen care networks in emergencies is emphasized.