Change of Cervical Cancer Stage at Diagnosis After the COVID-19 Pandemic

Background Cervical cancer stage determines prognosis. Screening programs aim to detect cancer early, but the COVID-19 pandemic reduced cervical screening in Mexico by 79%. Our objective was to evaluate changes in the clinical stage at diagnosis, histologic type, time from screening to treatment, and time from diagnosis to treatment of patients with cervical cancer diagnosed before (2019), and during the pandemic (2020-2023). Methods Retrospective secondary data analysis of all newly diagnosed cervical cancer cases at a reference center from 2019 to 2023. Stages at diagnosis before, during, and after the COVID-19 pandemic were compared using the Chi-squared test, time from diagnosis to treatment was tested by the Mann-Whitney U Test. Results Compared to the pre-pandemic period, there was a significant change in the number of patients with cervical cancer during the pandemic period: -19.48% in 2020, followed by a maximum increase of +36% in 2022. Early-stage cervical cancer cases changed by -16.3%, -44.3%, -11.8%, and +6.4% during 2020-2023; locally advanced stages changed by -7.4%, +6.5%, +10%, and -6.4%; and metastatic cases by +94.4%, +58.2%, +36.6%, and +48.4%. Epidermoid cases decreased by -15%, -17%, -11%, and -4%; and adenocarcinoma increased by +72%, +78%, +52%, and +20% in the studied period. Time from screening to treatment increased by 2021 but returned to pre-pandemic lapse in 2023. Conclusion Early-stage cervical cancer decreased during the COVID-19 pandemic, while metastatic stages increased significantly, along with a significant change in histological types, time from screening to diagnosis increased since the COVID-19 pandemic.