Investigators in Ireland report that the rate of more advanced and more aggressive disease among patients undergoing procedures for bladder cancer was higher following the first year of the COVID-19 pandemic compared with a comparable period before the pandemic.

They hypothesize that this finding is related to patients presenting later to their health care providers, but this cannot be confirmed because the time from symptom onset to presentation is unknown, they noted.

Steven Anderson of the University Hospital Limerick, and colleagues concluded a retrospective study of bladder cancer procedures prior to the pandemic (period 1: March 1, 2019 to March 15, 2020) and following the pandemic (period 2: March 16, 2020 to March 1, 2021).

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A total of 207 procedures for confirmed bladder cancer were performed during the study period: 126 in period 1 and 81 in period 2, Anderson’s team reported in Annals of Medicine and Surgery. New cases account for 66 (52.4%) of the 126 procedures in period 1 and 43 (53.1%) of the 81 procedures in period 2. The rates of invasive disease and high-grade disease were higher following the pandemic compared with before the pandemic (43.2% vs 26.2% and 47.4% vs 35.8%, respectively). 

“The higher rate of more advanced stage and grade of disease seen in period two suggests patients are presenting later,” the authors wrote. “This should be considered when allocating resources in the management of non-COVID related diseases.”

Most patients had early-stage cancer, with 135 (65.2%) presenting with pTa and 50 (24.2%) with pT1 disease, the investigators reported.

The overall mean waiting times from the date of booking to the date of the procedure was similar during periods 1 and 2 (63 and 76 days, respectively).

The study is the first to report on bladder cancer outcomes in Ireland, according to the investigators.


Anderson S, Rigney K, Hayes L, et al. A retrospective cohort study of bladder cancer following COVID-19 pandemic: Are patients presenting with more aggressive disease. Ann Med Surg. Published online August 18, 2022. doi:10.1016/j.amsu.2022.104430