Department of Gynecology, The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan.
J Obstet Gynaecol Res. 2024 Dec;50(12):2280-2285. doi: 10.1111/jog.16119. Epub 2024 Oct 9.
This study investigated the impact of coronavirus disease 2019 (COVID-19) on the clinical characteristics and interregional movement of patients with uterine cervical cancer.
This study included 1189 patients who underwent treatment for cervical cancer, including cervical intraepithelial neoplasm and adenocarcinoma in situ, at our hospital in Tokyo, Japan, in 2017-2018 and in 2021, before and after the pandemic, respectively. The patients' clinical information was compared during both periods. The clinical stage was unified using the International Federation of Gynecology and Obstetrics (FIGO) 2008 staging.
The number of patients treated for cervical cancer was 355, 420, and 414 in 2017, 2018, and 2021, respectively. The percentage of invasive carcinomas significantly increased from 158 (44.5%) and 196 (46.7%) to 219 (52.9%) (p = 0.049). In all periods, no significant differences were observed in median age, histological type, and treatment. The proportions of FIGO Stage IA1 were significantly elevated from 3.9% and 3.8% to 11.4% (p < 0.001). The percentage of patients from prefectures other than Tokyo significantly increased from 34.9% to 40.8% (p = 0.049). Furthermore, the proportion of patients with invasive carcinoma in private clinics increased from 28.0% to 37.9% (p = 0.014).
The number of patients with invasive carcinoma and the percentage of patients with invasive carcinoma referred from private clinics increased, indicating that the COVID-19 pandemic influenced patients to delay consultations. Furthermore, the surge in patients from other prefectures indicates that medical resources were more limited in rural areas, another impact of COVID-19.
本研究旨在探讨 2019 年冠状病毒病(COVID-19)对宫颈癌患者临床特征和跨区域转移的影响。
本研究纳入了 2017 年至 2018 年和 COVID-19 大流行前后(分别为 2021 年)在日本东京我院接受治疗的 1189 例宫颈癌患者,包括宫颈上皮内瘤变和原位腺癌。比较了两个时期患者的临床信息。采用国际妇产科联盟(FIGO)2008 分期统一临床分期。
2017 年、2018 年和 2021 年接受宫颈癌治疗的患者人数分别为 355、420 和 414 例。浸润性癌的比例从 158 例(44.5%)和 196 例(46.7%)显著增加至 219 例(52.9%)(p=0.049)。在所有时期,中位年龄、组织学类型和治疗均无显著差异。FIGO 分期 IA1 的比例从 3.9%和 3.8%显著升高至 11.4%(p<0.001)。来自东京以外县的患者比例从 34.9%显著增加至 40.8%(p=0.049)。此外,私人诊所的浸润性癌患者比例从 28.0%增加至 37.9%(p=0.014)。
浸润性癌患者数量和私人诊所转介的浸润性癌患者比例增加,表明 COVID-19 大流行影响了患者的咨询时间。此外,来自其他县的患者数量增加表明 COVID-19 对农村地区的医疗资源造成了更大的限制。