Endometrial cancer diagnoses in times of the covid-19 pandemic

Abstract

Introduction: Endometrial cancer (EC) is the sixth most frequent among women. During the COVID-19 pandemic, there was a severe compromise of the health system, contributing to later diagnoses of EC and directly interfering with the prognosis. Objectives: To evaluate the prevalence of EC in pandemic years among patients at the Gynecology Department of the University Hospital. Methods: Patients with histological diagnosis of EC from January 2020 to December 2022. Patients with abnormal uterine bleeding (AUB) and endometrial thickness (EE) greater than or equal to 12mm underwent Novak Curettage (NC); unsuccessful patients with NC or EE greater than 12mm or inconclusive results on NC underwent hysteroscopy. Results: 25 patients were diagnosed with EC. Among them, 22 (88%) had SUA as their main symptom and 20 (80%) were post-menopausal. CN was diagnosed in 12 patients (48%), and 8 (32%) were diagnosed by hysteroscopy. Ten patients had the diagnosis by incidental finding. The mean age, BMI, and EE were 59.6 years, 30.5, and 20.9 mm, respectively. The mean waiting time from first symptom and treatment was 12.4 months, the mean time to diagnosis with CN was eight months, and with hysteroscopy was 16.5 months. The most prevalent histological subtype was endometrioid adenocarcinoma (32%). Conclusion: SUA is a symptom that should be investigated. The pandemic context has hampered the diagnosis and treatment of EC cases. Optimizing the avenues of suspicion, diagnosis, and treatment of endometrial cancer as early as possible is crucial, aiming at its more significant therapeutic and possibly curative success.