OBJECTIVES: Uterine cancer (UCa) is the most common gynecological cancer and 4^th most common cancer in women. It has been well documented that the incidence rates of UCa are higher in older women, more socially deprived areas, and among women of Black ethnicity. The objective of our analysis was to describe changes in inequalities in UCa before and after COVID-19.

METHODS: Using an England-wide reimbursement secondary care dataset we identified all women diagnosed with UCa. We used a binary classification of pre- (01 April 2018 to 31 March 2020) and post-COVID-19 pandemic (01 April 2020 to 31 March 2022) to group timing of diagnosis. We compared the age, ethnicity, and socioeconomic profile of the women diagnosed before and after COVID-19 using χ² tests. Socioeconomic deprivation was derived from Indices of Multiple Deprivation (IMD) quintiles. Where there is no difference of effect, 20% of the given population should be observed in each quintile.

RESULTS: There were 11,231 women in England first diagnosed with UCa between April 2018 and March 2022; 6,177 were diagnosed pre-COVID-19 pandemic and 5,054 post-COVID-19. There was no difference in the age breakdown of those diagnosed with uterine cancer pre- and post-COVID-19 (50-59 years 20.8% in both time periods. Pre-COVID-19, fewer women from the most deprived IMD quintile were diagnosed with UCa compared with the least deprived group (p-value 0.034). In the post-COVID-19 period, UCa diagnoses fell significantly among the least deprived compared with pre-COVID-19 (14.6%, vs 16.3% pre-COVID-19; p-value 0.04).

CONCLUSIONS: Diagnosis of uterine cancer decreased after the onset of COVID-19, likely due to reduced non-COVID-19 healthcare interactions. Prior to COVID-19, there were fewer women from the most deprived areas of England with a Uca diagnosis, this reduced further after the onset of the pandemic. This finding warrants further investigation to ensure equal access to care.