Background/objectives: The COVID-19 pandemic affected cancer care globally. Our objective was to analyze the demographic and clinical characteristics of kidney cancer (KC) patients between the pre-COVID-19 and COVID-19 periods. We also aimed to assess how KC was discovered—incidentally or symptomatically—and identify factors predicting the mode of discovery and advanced-stage disease.Methods: This retrospective study analyzed data from 400 patients aged 18 years or older diagnosed with kidney cancer (KC) at a large regional Hungarian clinical center during two time periods: the pre-COVID-19 period (1 January 2019 to 15 March 2020) and the COVID-19 period (16 March 2020 to 13 May 2021). Demographic and clinical information, including the mode of cancer discovery, was collected for all patients.Results: During the pandemic, monthly kidney cancer diagnoses declined by 10.3%. The proportion of female patients rose significantly from 31.9% to 42.9% (p= 0.023). Incidental tumor detection decreased from 82.4% to 72.4% (p= 0.018), while symptomatic presentation increased from 14.2% to 19.4%, although not significantly (p= 0.166). Non-incidental detection was associated with a 3.42-fold increase in odds of advanced cancer pre-pandemic and a 2.03-fold increase during the pandemic. Symptomatic presentation raised these odds by 4.51 and 2.76 times, respectively.Conclusions: Our study revealed changes in kidney cancer detection during the pandemic, including a rise in the proportion of female patients and a decline in case numbers, likely due to reduced incidental findings. Non-incidental discovery and symptom presence remained predictors of advanced-stage disease, although the odds were lower. Various factors—such as changes in healthcare access and gender-related differences in health-seeking behavior—may possibly explain these changes. Our findings support the critical role of incidental detection in high-risk populations.
背景/目的：COVID-19大流行对全球癌症诊疗产生了影响。本研究旨在分析新冠疫情前后肾癌患者的流行病学及临床特征，评估肿瘤的发现方式（偶然发现或症状性发现），并识别影响发现方式及晚期疾病的相关预测因素。 方法：本回顾性研究分析了匈牙利某大型区域临床中心在新冠疫情前（2019年1月1日至2020年3月15日）与疫情期间（2020年3月16日至2021年5月13日）两个时段内，400名18岁及以上肾癌确诊患者的临床资料。收集所有患者的人口统计学、临床信息及肿瘤发现方式。 结果：疫情期间肾癌月均诊断量下降10.3%。女性患者比例从31.9%显著上升至42.9%（p=0.023）。偶然性肿瘤检出率从82.4%降至72.4%（p=0.018），而有症状就诊比例从14.2%升至19.4%，但未达统计学显著性（p=0.166）。非偶然性发现与晚期癌症风险显著相关：疫情前风险增加3.42倍，疫情期间增加2.03倍；有症状表现则分别使风险增加4.51倍和2.76倍。 结论：研究发现疫情期间肾癌检出模式发生改变，包括女性患者比例上升及病例数量下降，后者可能与偶然发现减少有关。非偶然性发现和症状表现仍是晚期疾病的预测因素，但其风险比值有所降低。医疗可及性变化、健康寻求行为的性别差异等因素可能解释这些现象。本研究结果支持在高危人群中开展偶然性筛查具有重要临床价值。
Changes in the Characteristics of Kidney Cancer Detection During the COVID-19 Pandemic
肿瘤(癌症)患者之家