BACKGROUND AND PURPOSE:

• Several studies have reported on the negative effects of the COVID-19 pandemic on cancer screening rates
  • No nationwide study on the extent of these effects has been conducted
• Burus et al. (JAMA Oncology, 2024) evaluated the observed and expected cancer rate trends for March through December 2020 using data from all 50 US states and DC

METHODS:

• Population-based cross-sectional analysis
  • US Cancer Statistics from January 1, 2018 through December 31, 2020
• Population
  • Invasive cancer diagnoses
• Exposures
  • Age | Race | Sex | Urbanicity | State-level response to COVID-19
• Study design
  • Time-series forecasting methods were used to calculate expected cancer incidence rates for March 1 through December 31, 2020 using prepandemic trends
• Primary outcomes
  • Relative difference between observed and expected cancer incidence rates
  • Number of potentially missed cancer cases

RESULTS:

• Cancer cases reported from March to December, 2020: 1,297,874
  • Age-adjusted incidence rate: 326.5 cases per 100,000 people
  • Male: 50.7% | Age ≥65: 58.3% | White: 82.2%
• Observed rates of all-sites cancer incidence were lower than expected during the entire 2020 study period
  • March to May 2020: 28.6% (95% prediction interval (PI), 25.4 to 31.7) lower
  • June to December 2020: 6.3% (95% PI, 3.8 to 8.8) lower
  • Overall: 13.0% (95% CI PI, 11.2 to 14.9) lower
• Potential undiagnosed cancer cases: 134,395 (95% PI, 112,544 to 156,680)
• The largest number of potentially missed cases were in
  • Prostate cancer: 22,950 cases
  • Female breast cancer: 16,870
  • Lung cancer: 16,333
• Total rate reduction in screenable cancers compared to expected: 13.9% (95% PI, 12.2 to 15.6)
• The rate of female breast cancer showed evidence of recovery to previous trends after the first 3 months of the pandemic
• However, levels remained low for colorectal, cervical and lung cancer
• From March to May of 2020, states with more restrictive COVID-19 responses experienced greater disruptions
  • By December 2020 these differences were nonsignificant for all sites except lung, kidney, and pancreatic cancer

CONCLUSION:

• During the first 10 months of the COVID-19 pandemic, US cancer incidence trends were significantly lower than expected based on prepandemic levels
• The authors state

These findings offer crucial information for current cancer prevention and control initiatives

Furthermore, these findings emphasize the need to consider how future disaster planning could affect cancer detection

Learn More – Primary Sources:

Undiagnosed Cancer Cases in the US During the First 10 Months of the COVID-19 Pandemic