Prostate cancer diagnosis, staging, and treatment in Sweden during the first phase of the COVID-19 pandemic

Figures & data

Figure 1. Number of cases of prostate cancer registered in the National Prostate Cancer Register (NPCR) of Sweden per week from 1 January to 30 June 2020, compared with the mean number in the same calender period in 2017–2019, as reported until January 31 of the year after each study period. ^#Data on number of COVID-19 cases and deaths from COVID-19 are taken from the Public Health Agency of Sweden (https//:www.folkhalsomyndigheten.se).

Table 1. Number of prostate cancer cases registered in The National Prostate Cancer Register (NPCR) of Sweden from March 18th to June 2nd in 2017–2020, reported until January 31st of the year after each study period.

	2017	2018	2019	Mean 2017–2019	2020	Difference 2020 vs 2017–2019
Prostate cancer cases, total no	2229	2372	2254	2285	1458	−827 (36%)
Risk category^a
Low/intermediate-risk	1362	1486	1397	1415	846	−569 (40%)
High-risk/metastatic	815	832	769	805	519	−286 (36%)
Missing	52	54	88	65	93	–
Age at diagnosis, years
<70	1097	1190	1087	1125	809	−316 (28%)
70–75	580	589	595	588	368	−220 (37%)
>75	552	593	572	572	281	−291 (51%)
Health care region^b
Stockholm-Gotland	333	424	486	414	321	−93 (23%)
Uppsala-Örebro	521	615	522	553	337	−216 (39%)
Southeast	293	311	235	280	187	−93 (33%)
South	369	322	382	358	237	−121 (34%)
West	466	456	440	454	236	−218 (48%)
North	247	244	189	227	140	−87 (38%)
Radical prostatectomy	1651	1626	1590	1622	1574	−48 (3%)
Radical radiotherapy	1163	1097	1267	1176	1547	+371 (32%)
Bone imaging^c	1985	2099	1852	1979	1570	−409 (21%)
Androgen deprivation therapy^d	993	988	856	946	709	−237 (25%)

^aPCa risk category: low/intermediate-risk = local clinical stage T1-2, Gleason score 6–7 and/or PSA ≤20 ng/ml; high-risk/metastatic = clinical T-stage ≥ T3 and/or Gleason score 8–10 and/or PSA >20 ng/ml and/or N1 and/or M1.

^bAggregated COVID-19 data for the entire population were only available at health care regional level. Part of region Halland belongs to health care region West and part belongs to health care region South, therefor data for Halland were included in both health care regions.

^cBone imaging includes all imaging used to search for metastasis, i.e. bone scan, CT scan and PET scan and plain X ray.

^dAndrogen deprivation therapy includes GnRH agonists and antagonists, bicalutamide and bilateral orchiectomy as registered in NPCR.

Figure 2. Number of cases of prostate cancer registered in the National Prostate Cancer Register (NPCR) of Sweden per week from 1 January to 30 June 2020, compared with the mean number in the same calender period in 2017–2019, as reported until January 31 of the year after each study period. ^#Data on number of COVID-19 cases and deaths from COVID-19 are taken from the Public Health Agency of Sweden (https//:www.folkhalsomyndigheten.se). Aggregated COVID-19 data for the entire population were only available at health care region level. Part of region Halland belongs to health care region West and part belongs to health care region South, therefore data for Halland was included in both regions.

Figure 3. Number of prostate cancer cases registered in the National Prostate Cancer Register per week according to prostate cancer risk category and age at diagnosis, from 1 January to 30 June 2020, compared with the mean number in 2017–2019, as reported until January 31 of the year after each study period. Prostate cancer risk categories: low/intermediate-risk: clinical local stage T1-2, Gleason score 2–7 and/or PSA 10 to ≤20 ng/ml; high-risk/metastatic: clinical T-stage ≥ pT3 and/or Gleason score 8–10 and/or PSA >20 ng/ml and/or N1 and/or M1

Figure 4. Number of radical prostatectomies, radical radiotherapy courses, bone imagining and start of androgen deprivation therapy as primary treatment per week registered in the National Prostate Cancer Register from 1 January to 30 June 2020, compared with the mean number in 2017–2019, as reported until January 31 of the year after each study period. Androgen deprivation therapy includes GnRH agonist or antagonist, bicalutamide and bilateral orchiectomy as reported in NPCR.

Figure 5. Percent of men below age 80 years with high-risk prostate cancer who underwent bone imaging per week registered in the National Prostate Cancer Register from 1 January to 30 June 2020, compared with the mean number in 2017–2019, as reported until January 31 of the year after each study period.

Data availability statement

Data on an aggregated level can be made available on a remote server upon request to the corresponding author