Background/Objectives: The COVID-19 pandemic has impacted cancer diagnosis and treatment. This study assessed the effects of the pandemic on the stage and delays between diagnosis and treatment in endometrial cancer. Methods: The study included 543 cases diagnosed between 2017 and 2023 in a population-based cancer registry. Data on stage, diagnostic procedures, treatments, and time to surgery (TTS) were compared across the pre-COVID (2017-2019), COVID (2020-2022), and post-COVID (2023) periods. Multiple regression analysis was used to identify factors influencing TTS. Results: During the three periods, stages I and II showed no variation, whereas a significant increase was recorded in stage III (7.5%, 9.5%, and 17.8%, respectively; p < 0.05), as well as a slight increase in grade 3 (15.4%, 13.6%, and 19.2%, respectively). A significant decrease in laparotomies (30.3%, 11.6%, and 11.0%, respectively; p < 0.01) and an increase in laparoscopies (60.1%, 78.1%, and 80.8%, respectively; p < 0.05) were observed. TTS decreased for interventions performed within 30 days (10.1%, 3.7%, and 1.4%, respectively; p < 0.01) and within 60 days (38.6%, 19.4%, and 6.9%, respectively; p < 0.01), while a significant increase was observed for >60 days (22.8%, 29.8%, and 37.0%, respectively; p < 0.05) and >90 days (7.5%, 23.1%, and 20.5%, respectively; p < 0.01). Multivariable analysis confirmed a reduction in TTS in the pre-COVID period (β -19.63; CI 95% -31.31; -7.95) and an increase in the post-COVID period (β 31.60; CI 95% 13.68; 49.53); while an increase was confirmed only for stage IV (β 48.80; CI 95% 23.15; 74.45). Conclusions: The COVID-19 pandemic has led to an increase in more advanced cancers and delays in surgery.
Keywords: COVID-19; Italy; endometrial neoplasm; grading; stage; time to surgery; treatment.