The impact of the COVID-19 pandemic on waiting times for endometrial cancer and precancer surgery: A single institutional experience at the epicenter of the COVID pandemic (517)

Objectives: The spread of COVID-19 led to a lockdown in New York in March of 2020. During this first wave, all non-emergent surgeries were postponed. By the summer of 2020, efforts were underway to address the accumulated backlog in endometrial cancer (EC) and endometrial hyperplasia (EH) surgery. Our goal was to examine the change in waiting times for EC and EH surgeries during the COVID pandemic at our institution with an emphasis on patients with comorbid conditions and obesity. Methods: Data on surgery incidence and waiting time were gathered for patients surgically treated with EH or EC from January 2019 through July 2021. Mean waiting time was calculated for patients with comorbid conditions defined by diabetes, prediabetes, cardiovascular disease, and obesity. Waiting time was defined as the time between tissue diagnosis with endometrial biopsy or dilation and curettage and surgery. Two-way analysis of variance and post hoc testing was used to analyze the difference in mean waiting times between the different groups. Results: After IRB approval,190 women with EC or EH were identified. The mean waiting time during the COVID pandemic was 112.6 days, whereas during the reference year was 64.29 days. This increase of 48.3 days was significant (95% CI: 27.5-70.85, p<.00001). Women with comorbid conditions experienced an average increase in waiting time of 15% during COVID compared to an average waiting time increase of 9.7% during the reference period. This effect was not seen for obese patients. As expected, when comparing EC and EH, women with EH experienced a significant increase in average waiting time during COVID of 47.5% compared to an average increased waiting time of 13.7% during the reference period (95% CI: 0.83-64.17, p=.044). Conclusions: Delay in treatment can have profound consequences on the mental well-being and oncologic outcome in women with EC and EH. We observed a 75% increase in waiting time during the COVID pandemic. This effect was further exacerbated in women with comorbid conditions and EC. It is premature to evaluate the effect of the delay in surgery on disease status (PFS and OS).