Prostate Cancer Research: Understanding How COVID-19 Impacted Utilization of Prostatectomy among Ethnicities


Daniel Lee, MD, MS, University of Pennsylvania

The following real-world data analysis of the American Urological Association AUA Quality Registry (AQUA) was featured in the October 2021 issue of AUANews. More real-world urologic research leveraging the AQUA network of more than 2,000 healthcare providers, nearly 8 million patients, and 8 years of longitudinal data can be found here. 

How the COVID-19 Pandemic Impacted Utilization of Prostatectomy among Different Racial/Ethnic Groups

By: Daniel Lee, MD, MS, University of Pennsylvania Health System, Philadelphia

The COVID-19 pandemic caused significant delays in cancer treatment. However, how these delays have affected different racial/ethnic groups has not been well understood. Prostate cancer has among the highest disparities in treatment outcomes by race of any cancer, so we sought to evaluate how rates of prostate cancer treatment varied by race during the COVID-19 pandemic.

Verana Health, the data partner of the AUA Quality (AQUA) Registry, evaluated how COVID-19 affected racial differences in prostate cancer care in a nationwide registry. AQUA Registry data were used to measure the rate of prostatectomies before and during the COVID-19 pandemic. An evaluation of 105 practices from January 2019 to April 2021 found large decreases in the number of prostatectomies performed per practice after the initial lockdown in March 2020 (see table and figure).1 The decreased utilization of prostatectomy has been relatively stable throughout 2020 after the lockdown and has not returned to pre-pandemic numbers.* Overall, the percent decreases were largest among Caucasian men, with a 35.3% decrease in prostatectomy, compared to a 23.5% decrease among Black men and 0% among Asian men. Interestingly, prostatectomies among Black men recovered slightly in August 2020 compared to March 2020 (9.2% increase), in contrast to a continued lower level among Caucasian (14% decrease) and Asian men (25% decrease).

February–April 2020March–August 2020
Black or African American–23.53%+9.21% (increase)

Table. Percent changes

Further investigation is needed to establish the impact of the COVID-19 pandemic on different racial/ethnic groups and utilization of any prostate cancer treatment over time, including surveillance, radiation and androgen deprivation therapy.

  1. Bernstein AN, Talwar R, Handorf E et al: Assessment of prostate cancer treatment among Black and White patients during the COVID-19 pandemic. JAMA Oncol 2021; doi: 10.1001/jamaoncol.2021.2755.

*As of October 5, 2021, the decreased utilization of prostatectomy has been relatively stable throughout 2020 after the lockdown and had not returned to pre-pandemic numbers.

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