Impact of the COVID-19 pandemic on referral to and delivery of gynecologic oncology care

•The COVID-19 pandemic has significantly impacted gynecologic cancer care.•Referrals to gynecologic oncology decreased in the early months of the pandemic.•Referral time to gynecologic oncology evaluation was not impacted by the pandemic.•Time to cancer treatment initiation decreased significantly during the pandemic.•Disparities in time to cancer treatment initiation improving during the pandemic. To evaluate the impact of the COVID-19 pandemic on referral to and delivery of gynecologic oncology care at a National Cancer Institute-designated Comprehensive Cancer Center. We conducted a retrospective cohort study of patients referred for evaluation by a gynecologic oncologist at Washington University in St. Louis from October 2019 – February 2020 (pre-COVID-19), and April - August 2020 (COVID-19). The primary outcome, time from referral to evaluation by a gynecologic oncologist, was compared between the two time periods. Secondary outcomes included time from initial evaluation to treatment and delays/interruptions in care due to the pandemic. Sub-group analyses were performed on patients with a cancer diagnosis to evaluate the impact of COVID-19 on treatment decision making. 884 patients were referred during the study period. Total referrals fell by 32% (526 to 358 patients, p