Posters 6: Oncology - Penis/Testis/Urethra & Prostate

Saturday June 25, 2022 from 16:00 to 17:30

Room: Aspen

MP-6.3 A quality assurance review of penile cancer diagnostic delays and advanced stage at presentation during the COVID-19 pandemic

William C. I. Janes

Medical Student
Faculty of Medicine
Memorial University


A quality assurance review of penile cancer diagnostic delays and advanced stage at presentation during the COVID-19 pandemic

William Janes1, Jessica Henley1, Matthew Andrews2, Paul H. Johnston2, Michael Organ2.

1Faculty of Medicine, Memorial University, St. John's, NL, Canada; 2Department of Urology, Memorial University, St. John's, NL, Canada

Introduction: Penile carcinomas are a rare, heterogenous subset of neoplasms that present with extraordinary potential for malignancy, with recent evidence supporting a global trend towards increased incidence over time. Penile cancer is a devastating occurrence causing significant psychosocial impacts that deter patients from seeking medical attention and further exacerbating consequences. The COVID-19 pandemic has necessitated a dramatic shift in healthcare delivery to virtual platforms, which has resulted in various reported diagnostic and treatment delays. It is suspected that prevalent psychosocial impacts of penile lesions have been further compounded by the pandemic, leading to several late-stage presentations engendering poorer outcomes.

Methods: A retrospective chart review was conducted for quality assurances purposes from December 2019 to December 2021 to identify cases of penile cancer subject to pandemic-induced delays in diagnosis and treatment. Diagnostic delays were defined on a timeframe of delay greater than three months. Charts were examined for delays in diagnostic measures and treatments. Outcomes of interest aimed to identify areas of improvement for care, including virtual care and timeliness/urgency of reported urogenital concerns.

Results: Secondary to virtual care appointments, three patients were unable to receive an initial physical exam, which delayed primary care referral and subsequent diagnosis. One patient had a physical exam delayed six months while receiving virtual care. A further 12 patients underwent partial or total penectomy for late-stage presentation at our institution, 10 of which occurred in 2020.

Conclusions: In cases of concern for penile malignancy, virtual care cannot replace the necessity of physical exams in preventing diagnostic and treatment delays. In response, urologists at our center have altered practices for urgent examination of referred males with genital abnormalities to prevent further exacerbation of delays.

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