# Changes in the Characteristics of Kidney Cancer Detection During the COVID-19 Pandemic

## TL;DR

The study found that kidney cancer detection changed during the pandemic, with fewer cases found by chance and more later diagnoses.

## Contribution

The study reveals pandemic-related shifts in kidney cancer detection patterns and gender trends in healthcare access.

## Key findings

- Kidney cancer cases dropped by 10.3% monthly during the pandemic.
- Non-incidental detection increased and was linked to advanced-stage cancer.
- The proportion of female patients rose from 31.9% to 42.9% during the pandemic.

## Abstract

The COVID-19 pandemic disrupted healthcare systems globally. This study aimed to assess how these changes affected kidney cancer detection by comparing the data of patients before and during the pandemic at a large Hungarian clinical center. Medical records from 400 patients were analyzed to understand how the cancer was discovered—either incidentally (by chance during unrelated tests) or non-incidentally (for example, after symptoms appeared)—and what factors were linked to advanced-stage disease. During the pandemic, monthly kidney cancer cases dropped by 10.3%, and the proportion of female patients increased from 31.9% to 42.9%. Incidental detections fell from 82.4% to 72.4%, while non-incidental cases increased slightly. Non-incidental detection was associated with a two-to-threefold higher risk of advanced-stage cancer. Our findings suggest the pandemic uniquely impacted kidney cancer cases, with reduced incidental detection likely leading to later diagnoses. The rise in female cases may reflect gender differences in health-seeking behavior during the pandemic.

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.