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. 2021;88(1):46-55.
doi: 10.1159/000509546. Epub 2020 Jul 7.

The Impact of the COVID-19 Pandemic and the Associated Belgian Governmental Measures on Cancer Screening, Surgical Pathology and Cytopathology

Marie-Caroline de Pelsemaeker  1 , Yves Guiot  1 , Jonathan Vanderveken  1 , Christine Galant  1   2 , Mieke Rosalie Van Bockstal  3   4
Affiliations

The Impact of the COVID-19 Pandemic and the Associated Belgian Governmental Measures on Cancer Screening, Surgical Pathology and Cytopathology

Marie-Caroline de Pelsemaeker et al. Pathobiology. 2021.

Abstract

Introduction: The severe acute respiratory syndrome coronavirus 2 caused a pandemic of coronavirus disease 2019 (COVID-19). Unprecedented public health actions were introduced, including social distancing, travel restrictions and quarantine. The Belgian government announced a national emergency plan, thereby postponing all non-urgent medical consultations and operations. This report analyses the impact of these measures on cancer screening, through assessment of the workload of a laboratory for histopathology and cytopathology.

Methods: Data on monthly numbers of histological and cytological samples, immunohistochemistry and molecular tests were extracted from the laboratory information management system.

Results: The global histopathological and cytological workload was substantially reduced. The impact on oncology-related surgical procedures was rather limited. The anti-COVID-19 measures significantly diminished all screening-related samples, such as colon biopsies, breast biopsies and cervical cytology, and strongly reduced the number of samples related to "functional" pathology, such as thyroidectomies and gastric biopsies.

Conclusions: Since many health care interventions are reflected in the workload of a pathology laboratory, this study enabled us to identify areas for "deconfinement" health care actions. Our findings indicate that various areas in medicine were affected, but the impact seemed largest for cancer screening. Health care professionals should assure that consultations related to cancer screening are postponed instead of cancelled.

Keywords: COVID-19; Cancer screening; Cervical cytology; Histopathology; SARS-CoV-2 infection.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
a Graph illustrating the reduced income in 2020 as compared to 2019 during the period of the Belgian Hospital Emergency Plan (HEP) in correlation with the reduced technical and administrative staff of the Department of Pathology. The HEP started in week 12 of 2020. b Graph illustrating the causes of absent technical staff as a function of time during the HEP (weeks 12–18 of 2020).
Fig. 2
Fig. 2
Graphs illustrating the decline of the number of samples per month, for colon biopsies (a), gastric biopsies (b), cervical cytology (c), prostate biopsies (d), skin biopsies (e) and EBUS biopsies (f).
Fig. 3
Fig. 3
Graphs illustrating the decline of the number of samples per month, for breast resections (a), thyroidectomies (b), resections of the lower gastrointestinal (GI) tract (c), appendectomy specimens (d), bone marrow biopsies (e) and external demands for any type of molecular test (f).
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