Cancer diagnoses fell sharply during early days of pandemic, NCI report shows
New diagnoses for six of the most common cancer types sharply declined in the U.S. in early 2020 — along with the volume of pathology reports — largely due to the start of the COVID-19 pandemic, according to data released by NCI.
The Annual Report to the Nation on the Status of Cancer, part 2, published in Cancer, provides information about cancer occurrence and trends throughout the United States. Part 1, released in October 2022, focused on national cancer statistics, whereas part 2, released today, focuses on cancer diagnoses throughout the country during the first year of the pandemic.
Such declines in diagnoses, screenings and other cancer-related procedures are most likely due to interruptions in Americans’ ability to receive medical care in a timely manner during the onset of the COVID-19 pandemic, according to medical experts.
“These missed opportunities for early cancer detection are alarming, particularly for those vulnerable populations that continue to face significant barriers in accessing cancer care,” Monica M. Bertagnolli, MD, director of NCI, said in a press release. “This report highlights the urgency in helping all Americans get back on track with their cancer care so that we can avoid unnecessary deaths and complications.”
Researchers extracted data from selected U.S. population-based cancer registries for diagnosis years 2015 to 2020 using data from the North American Association of Central Cancer Registries. The analysis used monthly numbers of newly diagnosed cancer cases for colorectal, female breast, lung, pancreatic, prostate and thyroid cancer.
The investigation used observed-to-expected (O/E) ratios to compare the observed number of incident cancer cases in 2020 with the estimated number of cases.
Researchers observed an O/E ratio less than 1 for major screening-eligible cancer sites, highlighting fewer newly diagnosed cases than expected during 2020. O/E ratios appeared lowest in April 2020.
Asians/Pacific Islanders appeared to have the lowest O/E ratio of any race group for every cancer type, except pancreatic, analyzed in the study.
Overall, O/E ratios appeared lower for cases diagnosed at localized stages than for cases diagnosed at advanced stages.
Such declines in cancer diagnoses occurred from March to May 2020, before returning to prepandemic levels by July 2020 for all cancer types, except for prostate cancer.
“We are deeply concerned about the implications of delayed diagnosis, which is typically associated with more aggressive disease and worse outcomes,” Karen E. Knudsen, MBA, PhD, CEO of American Cancer Society, said in the release. “Is it imperative to ensure that we make up for lost ground on finding cancers early, and thereby maximize opportunities for effective treatment and survival.”
To get as many Americans back on track as possible following the delay in cancer screenings that took place during the COVID-19 pandemic, President Joe Biden and First Lady Jill Biden, through the reignited Cancer Moonshot initiative, previously announced a call to action on cancer screening. Their goal is to assist 10 million individuals across the U.S. in gain access to screenings they missed during the pandemic.
“We recommend everyone get back into routine health care, including cancer screening,” Lisa C. Richardson, MD, MPH, director of the CDC’s Division of Cancer Prevention and Control, said in the release. “It’s also important to make sure children, adolescents and adults are up to date on vaccines to prevent infections with viruses — like hepatitis B virus and human papillomavirus — that can lead to cancer.”
References:
- Annual Report to the Nation part 2: New cancer diagnoses fell abruptly early in the COVID-19 pandemic (press release). Available at: https://pressroom.cancer.org/ARNPart2. Published Sept. 27, 2023. Accessed Sept. 27, 2023.
- Negoita S, et al. Cancer. 2023;doi:10.1002/cncr.35026.