The impact of the COVID-19 pandemic in 2020 on the diagnosis, treatment, and cancer-specific survival of major urological cancers - An observational study

Sep 22, 2026

The impact of the COVID-19 pandemic in 2020 on the diagnosis, treatment, and outcomes of major urological cancers remains poorly understood. Patients with prostate, bladder, and kidney cancer were identified from the SEER database, and ordered logistic regression assessed COVID-19 effects on cancer stage at diagnosis. Kaplan–Meier analyses evaluated cancer-specific survival. In SEER-17/SEER-22, newly diagnosed counts decreased in 2020, and those diagnosed then had higher advanced-stage risk. No significant CSS differences were found versus 2018/2019.

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CategoryResearch & Report

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Introduction

Background and healthcare disruption during COVID-19

Reported effects on urological cancer care

Study rationale and data sources

® Observational Study The impact of the COVID-19 pandemic in 2020 on the diagnosis, treatment, and cancer-specific survival of major urological cancers An observational study Mingsong Wang, MMeda ,* , Kang Jia, MMeda , Yu Wang, MMeda , Dan Yuan, MMeda , Long Huang, MMeda , Kang Li, MMeda , Xiao Zhong, MMeda | Abstract
The impact of the COVID-19 pandemic in 2020 on the diagnosis, treatment, and outcomes of major urological cancers remains poorly understood. Patients diagnosed with prostate cancer, bladder cancer, and kidney cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Ordered logistic regression was used to evaluate the effect of the COVID-19 pandemic in 2020 on cancer stage at diagnosis. Logistic regression was employed to determine the impact of the pandemic on the diagnosis of different patient subgroups. Kaplan–Meier curves were used to evaluate cancer-specific survival (CSS) . In the SEER-17 and SEER-22 datasets, the number of newly diagnosed cases of prostate cancer, bladder cancer, and kidney cancer decreased in 2020. Patients diagnosed with prostate cancer (OR = 1.04, 95% CI, 1.01–1.07, P = .016), bladder cancer (OR = 1.07, 95% CI, 1.01–1. 14, P = .019), and kidney cancer (OR = 1.08, 95% CI, 1.02–1. 14, P < .001) in 2020 were at a higher risk of advanced stages. Among the 3 cancers, patients with a median household income > 75,000 USD were more likely to be diagnosed in 2020, while urban and female patients (bladder and kidney cancers) tended to be diagnosed in 2018/2019 . For prostate cancer (HR = 1.06, 95% CI, 0.97–1. 15, P = .207), bladder cancer (HR = 1.04, 95% CI, 0.98–1. 11, P = . 188), and kidney cancer (HR = 1.03, 95% CI, 0.94–1. 12, P = .496), no significant differences in CSS were observed between patients diagnosed in 2020 and those diagnosed in 2018/2019 . The COVID-19 pandemic in 2020 led to a decrease in the number of diagnoses for prostate cancer, bladder cancer, and kidney cancer, with varying impacts on different patient subgroups. Patients diagnosed during this period were more likely to have later-stage disease. Additionally, no significant differences in CSS were observed between patients diagnosed during the COVID-19 pandemic in 2020 and those diagnosed in 2018/2019; however, this finding should be interpreted cautiously given the relatively short follow-up period and the potential influence of competing risks during the COVID-19 pandemic. | | --- | | Abbreviations: CSS = cancer-specific Survival , ICD-O-3 = International classification of diseases for oncology, 3rd edition, ISUP = International Society of Urological Pathology, Non-ccrcc = non-clear cell renal cell carcinoma, PSA = prostate-specific antigen, SARS-Cov-2 = severe acute respiratory syndrome Coronavirus 2, SEER = surveillance, epidemiology, and end results database, USD = United States Dollars. | | Keywords: Cancer-specific survival, COVID-19 , Diagnosis, Treatment, Urological cancers | 1. Introduction The global COVID-19 pandemic has had a significant negative impact on healthcare systems. [1] During the pandemic, all nonemergency medical procedures were postponed, raising concerns about the adverse oncological outcomes resulting from delays in cancer diagnosis and treatment. [2,3] Previous studies have extensively reported a decrease in the number of new diagnoses and an increase in the proportion of advanced-stage cancers during the COVID-19 pandemic. [4–6] In the field of urological cancers, several guidelines were issued during the pandemic to manage urological cancers in response to the shortage of MW and KJ contributed to this article equally. The authors have no funding and conflicts of interest to disclose. The datasets generated during and/or analyzed during the current study are publicly available. The data utilized in this research is publicly accessible and contains no identifiable patient information. Consequently, this study did not require an ethics

FAQs

Which dataset was used to identify patients and evaluate outcomes?

Patients with prostate, bladder, and kidney cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The analysis used SEER-17 and SEER-22 datasets for newly diagnosed case counts and stage outcomes.

How did the COVID-19 period in 2020 affect cancer stage at diagnosis?

Ordered logistic regression showed that patients diagnosed in 2020 had a higher risk of advanced stages for prostate cancer, bladder cancer, and kidney cancer compared with earlier periods.

Did cancer-specific survival differ between patients diagnosed during COVID-19 in 2020 and those diagnosed in 2018/2019?

For prostate, bladder, and kidney cancers, no significant differences in cancer-specific survival (CSS) were observed between those diagnosed in 2020 and those diagnosed in 2018/2019. The finding should be interpreted cautiously due to relatively short follow-up and competing risks.

Sep 22, 2026

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