Is COVID-19 impacting prostate cancer screening? A survey of prostate-specific antigen test requests during a local outbreak

BACKGROUND: Although the ongoing pandemic of coronavirus disease 2019 (COVID-19) is directly contributing to negatively affect global health and fitness, the restrictive measures applied for containing the outbreaks are also impacting detection and management of many diseases, including cancers. This study aimed to establish if and how the COVID-19 outbreak may have impacted the practice of routine prostate cancer screening in Verona, Italy. METHODS: We searched the laboratory information system of the Service of Laboratory Medicine of the University Hospitals of Verona to identify all test requests for total prostate-specific antigen (PSA) and vitamin D (Vit D; i.e., the locally most requested immunochemical test) for outpatients during the last five years (December 10, 2016, to December 10, 2020). The weekly requests for these tests placed between February 25 and December 9, 2020, were compared to those placed during the same period of previous four years (i.e., 2016-2019). RESULTS: The volume of test requests for both Vit D and PSA did not differ in 2020 compared to previous four years. However, a dramatic decline was observed during the local lockdown period (between March 10 and May 17, 2020), with median decrease of 76% for Vit D and 62% for total PSA, respectively. This reduction was compensated by 13% increase for Vit D and 43% increase for total PSA in post-lockdown period. CONCLUSION: These results show that the lockdown period established during the first peak of the COVID-19 outbreak in Italy’s Verona province was associated with a dramatic decrease in routine prostate cancer screenings.