TY - JOUR T1 - Stage migration of testicular germ cell tumours in Alberta, Canada, during the COVID-19 pandemic: a retrospective cohort study JF - CMAJ Open JO - CMAJ SP - E633 LP - E642 DO - 10.9778/cmajo.20210285 VL - 10 IS - 3 AU - Richard Lee-Ying AU - Dylan E. O’Sullivan AU - Richard Gagnon AU - Nicholas Bosma AU - Rebecca N. Stewart AU - Cindy Railton AU - Derek Tilley AU - Nimira Alimohamed AU - Naveen Basappa AU - Tina Cheng AU - Michael Kolinsky AU - Safiya Karim AU - Dean Ruether AU - Scott North AU - Steven Yip AU - Brita Danielson AU - Daniel Heng AU - Darren Brenner Y1 - 2022/07/01 UR - http://www.cmajopen.ca/content/10/3/E633.abstract N2 - Background: An absence of screening recommendations and the rapid progression of testicular germ cell tumours (TGCTs) offer a perspective on the potential impact of the COVID-19 pandemic on cancer presentations. We evaluated the presenting cancer stages of TGCTs in a real-world population before and during the pandemic to assess stage migration.Methods: We performed a retrospective review of all new patients with TGCT diagnoses in Alberta, Canada, from Dec. 31, 2018, to Apr. 30, 2021, using the Alberta Cancer Registry. Because potential changes in staging should not occur instantaneously, we used a 6-month lag time from Apr. 1, 2020, for seminomas, and a 3-month lag time for nonseminomas, to compare initial cancer stages at presentation before and during the pandemic. We evaluated monthly rates of presentation by stage and histology. Exploratory outcomes included the largest tumour dimension, tumour markers and, for advanced disease, risk category and treatment setting.Results: Of 335 patients with TGCTs, 231 were diagnosed before the pandemic and 104 during the pandemic (using a lag time). In total, 18 (7.8%) patients diagnosed before the pandemic presented with stage III disease, compared to 16 (15.4%) diagnosed during the pandemic (relative risk 1.97, 95% confidence interval [CI] 1.05–3.72). We observed no significant differences for secondary outcomes. Without a lag time, the rate ratio for a stage II presentation decreased significantly during the pandemic (0.40, 95% CI 0.21–0.72).Interpretation: We observed signs of TGCT stage migration during the COVID-19 pandemic, driven by a decline in stage II disease and a potential rise in stage III disease. Management of TGCTs should remain a priority, even during a global pandemic. ER -