The impact of war on cytopathological practice in Ukraine

Aim: To investigate the impact of Russian invasion on Ukrainian healthcare services related to cytopathology screening and diagnostics. Methods: The workload and output of the cytopathological laboratory located in Kyiv before and during 8 months of Russian invasion were analyzed. The laboratory performance was assessed by the total number of cytologic cases, the turn-around time (TAT) index, and the percentage of timely reported test results. The geographic distribution of cases was also analyzed. Results: There was a significant decline in the workload of the laboratory during the first two months of the war, and the numbers of cytopathology specimens fell to less than one third of prewar levels, and the TAT was prolonged. Since May 2022, the efficiency and quality of cytopathologic testing has been largely restored in most parts of Ukraine, only to be affected again by increased Russian bombardment toward the end of summer 2022. The number of cytology specimens was reduced and the source of cytology specimens changed from the prewar conditions reflecting the relocation of the CSD Lab to western Ukraine. Conclusion: Cytolopathological screening and diagnostics were seriously disrupted in Ukraine during the Russian invasion resulting in a decreased volume of cytology specimens received in the CSD Lab during the early months of the war. By adapting to the war conditions and reorganizing the cytology services, CSD Lab has continued providing cytology services at a level of efficiency similar to those of the prewar period. However, the volume of cytology specimens remains much smaller than before war, indicating that the cytology services have been adversely affected by the war