The rate of more advanced and more aggressive disease among patients undergoing procedures for bladder cancer was higher in the first year of the COVID-19 pandemic compared with a comparable period before the pandemic, according to a study published in Annals of Medicine and Surgery.

The researchers hypothesize that this finding is related to patients presenting later to their health care providers, but this cannot be confirmed because the time from symptom onset to presentation is unknown.

Steven Anderson, of the University Hospital Limerick in Ireland, and colleagues conducted this retrospective study of bladder cancer procedures prior to the pandemic (period 1: March 1, 2019 to March 15, 2020) and during the pandemic (period 2: March 16, 2020 to March 1, 2021).

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A total of 207 procedures for confirmed bladder cancer were performed during the study period: 126 in period 1 and 81 in period 2. New cases account for 66 (52.4%) of the 126 procedures in period 1 and 43 (53.1%) of the 81 procedures in period 2.

The rates of invasive disease and high-grade disease were higher during the pandemic than before the pandemic (43.2% and 26.2%, respectively, for invasive disease; 47.4% and 35.8%, respectively, for high-grade disease). 

“The higher rate of more advanced stage and grade of disease seen in period two suggests patients are presenting later,” the authors wrote. “This should be considered when allocating resources in the management of non-COVID-related diseases.”

Most patients had early-stage cancer, with 135 (65.2%) presenting with pTa and 50 (24.2%) with pT1 disease, the investigators reported.

The overall mean waiting times from the date of booking to the date of the procedure was similar during periods 1 and 2 (63 and 76 days, respectively).

The study is the first to report on bladder cancer outcomes in Ireland, according to the investigators.


Anderson S, Rigney K, Hayes L, et al. A retrospective cohort study of bladder cancer following COVID-19 pandemic: Are patients presenting with more aggressive disease. Ann Med Surg. Published online August 18, 2022. doi:10.1016/j.amsu.2022.104430

This article originally appeared on Renal and Urology News