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Cancer diagnostic rates during the 2020 ‘lockdown’, due to COVID-19 pandemic, compared with the 2018–2019: an audit study from cellular pathology
  1. Ludovica De Vincentiis1,
  2. Richard A Carr2,
  3. Maria Paola Mariani1,
  4. Gerardo Ferrara1
  1. 1 Anatomic Pathology, Hospital of Macerata, Macerata, Italy
  2. 2 Department of Histopathology, Warwick Hospital, Warwick, UK
  1. Correspondence to Dr Gerardo Ferrara, Anatomic Pathology, Hospital of Macerata, Macerata I62100, Italy; gerardo.ferrara{at}


Aims We performed an audit to evaluate the impact of the COVID-19 pandemic-related delay in the diagnosis of major cancers at a Pathology Unit of a Secondary Care Hospital Network in Italy.

Methods A comparison was made among the number of first cellular pathological diagnoses of malignancy made from the 11th to the 20th week of the years 2018–2020.

Results Cancer diagnoses fell in 2020 by 39% compared with the average number recorded in 2018 and 2019. Prostate cancer (75%) bladder cancer (66%) and colorectal cancer (CRC; 62%) had the greatest decrease. CRC was identified as carrying a potentially important diagnostic delay.

Conclusions For CRC corrective procedures (continuing mass screening tests; patient triage by family physicians; diagnostic procedures alternative to colonoscopy; predictive evaluation on biopsy samples) were advised. Our simple audit model is widely applicable to avoid pandemic-related delay in clinical diagnosis of cancer.

  • clinical audit
  • colorectal neoplasms
  • diagnosis
  • epidemiology
  • infections

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  • Handling editor Runjan Chetty.

  • Contributors All the authors contributed to the study design and the manuscript preparation to a relevant extent.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.