Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Surgery

Supervisor

Melissa Huynh

2nd Supervisor

Nicholas E. Power

Co-Supervisor

Abstract

Introduction

The COVID-19 pandemic may have caused delays in care for patients with bladder cancer (BC). This study aims to investigate its impact on oncologic outcomes of BC in Ontario, Canada.

Methods

The Institute for Clinical Evaluative Sciences (ICES) databases were used as the data source. The patients were divided into 2 groups: pre-COVID era (January 1, 2016, to March 14, 2020) and the COVID era (March 15, 2020 to December 31, 2021). The study compared BC stage at diagnosis, surgical volumes, wait times, and overall survival (OS) between the groups.

Results

There were 17,760 patients included. No significant difference was found in the pathological stage and in the number of BC diagnoses between the two era groups. Patients in the COVID era underwent earlier transurethral resection of bladder tumor. Lastly, after a 2-year follow-up, there was no significant difference in OS rates.

Conclusions

Patients diagnosed with BC in Ontario during the pandemic did not have more advanced stages of cancer at the time of presentation or worse OS rates compared to those diagnosed before the pandemic. Furthermore, surgical volumes and wait times were not compromised during this period.

Summary for Lay Audience

COVID-19 is a type of coronavirus that primarily affects the respiratory system and causes a severe inflammatory response. It has a high mortality rate and has caused the worst pandemic of the last century, overwhelming healthcare systems worldwide. The changes in healthcare systems due to the pandemic affected patients with all types of diseases, including cancer patients. Among urologic cancers, bladder cancer (BC) is the second most common in the world and is the fifth most common cancer in Canada. Early and timely diagnosis of BC is crucial for optimal oncologic outcomes. Therefore, obtaining early treatment such as transurethral resections of bladder tumor (TURBT) or radical cystectomy (RC) is of utmost importance.

Our research aimed to investigate the impact of the COVID-19 pandemic on the care of patients with BC in Ontario, Canada. The study found no significant difference in the number of patients diagnosed with BC before and after the beginning of the pandemic. Furthermore, the number of surgeries for BC and their waiting times were not compromised during the pandemic.

After a follow-up of two years, the survival rates of patients diagnosed in the COVID era did not differ from those in the pre-COVID group. Therefore, being diagnosed with BC in Ontario during the pandemic did not lead to worse survival outcomes than pre-pandemic times.

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