“Immediate attention” is needed to address cancer diagnosis deficits stemming from the COVID-19 health crisis, researchers charged in a new analysis published Tuesday in JAMA Network Open [1].
In April 2020 following the pandemic declaration, overall cancer incidence dropped 23%, researchers estimated. This included a 46% decrease in breast cancer incidence and double-digit drops across other forms including cancers of the colon (35%), rectum (47%), head and neck (50%), and melanoma (65%). Lung cancer incidence, meanwhile, stayed stable until December 2020, when it fell by 11%, based on an analysis of data representing nearly 50,000 individuals diagnosed with cancer in Manitoba, Canada.
Most care sites saw a recovery following the initial downturn. However, the province still had an estimated deficit of 692 (5.3%) cancers as of December 2021.
“The cumulative deficit for some high-fatality cancers is concerning and needs attention from healthcare delivery organizations,” Kathleen M. Decker, PhD, with CancerCare Manitoba, and colleagues wrote Sept. 5. “Because of the heterogeneity in the association between the COVID-19 pandemic and cancer incidence, observational studies should be done to examine this association in other regions.”
Researchers performed their population-based, cross-sectional study using data from the Manitoba Cancer Registry. They targeted all individuals diagnosed with cancer from 2015 through 2021, producing a final sample of 48,378 individuals at a median age of 68.
The largest diagnosis deficits were observed for breast cancer (273 cases or a 14.1% deficit), followed by colon (133 cases/12.2%), and lung cancer (132/7.6%). Brain and central nervous system and urinary cancer diagnoses also decreased consistently between April 2020 to December 2021, at 26% and 12%, respectively. Cancer incidence increased by 12% for hematological diagnoses and 8% for cancers with an unknown primary site. Decker et al. also observed “no association” for gynecologic (1% increase), other digestive (1% drop) and pancreatic (7% increase) cancer incidence.
The authors believe drops in breast and colon cancer cases can be attributed to reductions in Manitoba’s screening programs between April and May of 2020. Mammography use among women 75 and older may have been impacted by reductions in available imaging systems, reluctance to seek medical care amid the pandemic, or the impact of COVID-related deaths among older adults. Drops in lung cancer incidence, the authors noted, may have been attributed to deaths among individuals with undiagnosed cases of the disease, along with likely reluctance to seek care.
Decker et al. believe their report provides important information as diagnostic radiologists prepare for future interruptions to cancer care screening programs.
“It is critical to evaluate the association between the COVID-19 pandemic and cancer incidence to address public and patient anxiety, inform recovery efforts, and identify strategies to reduce the system’s vulnerability to future disruptions,” they advised.
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Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.