Dados do Trabalho

Título

O EFEITO DA PANDEMIA DA COVID-19 NO ESTADIO DO CANCER DE MAMA

Título em Inglês

THE EFFECT OF THE COVID-19 PANDEMIC ON BREAST CANCER STAGE

Introdução

The COVID-19 pandemic brought us several behavioral changes, including social isolation, impacting breast cancer screening around the world, including Brazil. With decrease in exams performed, the risk of breast cancer detection in later stages increases, negatively impacting the prognosis of the disease.

Objetivos

To analyze and compare breast cancer stage in patients at a hospital in Mogi das Cruzes - SP before and during the pandemic.

Métodos

Retrospective, observational, and analytical study carried out through analysis of patient records admitted to the outpatient clinic between January 1, 2019 and December 31, 2020. This service is reference for 11 municipalities covering an estimated population of more than 3 million inhabitants. For statistical analysis, and to allow cases referred in the pre-pandemic period to be considered as such, the pandemic period was determined to be from April 1, 2020.

Resultados

A total of 331 breast cancer patients who started treatment between 2019 and 2020 were identified. A 23.6% fewer cases were admitted during pandemic, with 102 patients attended, an average of 11.3 patients/month, while before the pandemic the average was 15.3 patients/month. There was a statistically significant difference of 4 patients/month (p <0.001). The mean age of the patients also varied significantly, with the patients being younger during pandemic, with a difference of 3.5 years (57.8 vs 54.3; p = 0.03).
In order to analyze the effect of the pandemic in breast cancer stage, the number of cases each month was studied, and a significant drop was identified in the stage 0 and I (3.2 vs 0.7 cases/month; p <0.001), with no increase identified in the other stages. The multivariate analysis also identified a significant drop in diagnoses of early stage, even after considering confounding factors (age), with OR = 0.29 (95% CI 0.11 - 0.63; p = 0.004). No significant change was identified in cases of locally advanced or metastatic disease (stages III and IV), with an OR of 0.86 (95% CI: 0.51 - 1.41; p = 0.55).
It is important to remember that in these early-stage disease patients are often asymptomatic and diagnosed, mostly, through screening tests.

Conclusões

The deficit in patients diagnosed at early stages was not accompanied by an increase in advanced stages. It is possible that there are still many women with undiagnosed breast cancer, but with the possibility of early identification.

Palavras Chave

Breast neoplasms, coronavirus infections, neoplasms staging

Área

EPIDEMIOLOGY, RISK, AND PREVENTION - Epidemiology