Impact of the Covid-19 pandemic on cervical cancer diagnosis and mortality: a comparative analysis pre and post-pandemic (2013-2024)

Introduction: Cervical cancer is a common and well-recognized neoplasm in clinical practice. It has a strong genetic link and is associated with a sexually transmitted disease, Human Papillomavirus (HPV). The prognosis of this disease mainly depends on early diagnosis through specific cytopathological tests such as the Pap smear.

Objective: Due to the SARS-CoV-2 pandemic, many patients were underserved due to various factors, such as fear of contracting COVID-19 and social distancing. Consequently, there has been an increase in mortality and cases for several chronic diseases. This study aims to examine whether the pandemic significantly impacted the number of deaths and diagnoses of cervical cancer by comparing pre- and post-pandemic variables. Materials and Methods: We analyzed retrospective data from January 2013 to June 2024 on cervical cancer from the Cancer Information System (SISCAN), hospital morbidity of SUS, and outpatient production, available on the TabNet/DATASUS platform. Data collection utilized R software with the “microdatasus” package (R. F. SALDANHA, 2019), including variables like gender, age, place of residence, procedures, and specific diagnoses. Data analysis was performed using Excel for better organization.

Results: From the data collected via R, we observed a total of 65,801 diagnoses of cervical cancer and 10,774 deaths. This value increased from an average of 855.5 deaths annually in the pre-pandemic period (2013-2018) to an average of 1,029 deaths in the post-pandemic period (2019-2024). Additionally, a decrease in preventive exams was observed, especially the Pap smear (cervical cytology), with a reduction of over 90% between the compared periods, from an average of 5,741,338 to 420,692 exams. There was also an increase in the time from diagnosis to treatment, particularly for diagnoses with more than 60 days to treatment, rising from an average of 2,300 patients to 3,300.

Conclusion: From the findings, we can demonstrate a pattern of increasing deaths and diagnoses over the period from 2013 to 2024, which was likely exacerbated by the pandemic, given the reduction in the number of exams, the increase in the time till the treatment, and the significant increase in deaths between the two periods. This underscores the urgent need to reinstate incentives for screening and diagnosing cervical cancer.

Corresponding author: Cainã Gonçalves Rodrigues (e-mail: cainagrodrigues@gmail.com).