New research from the American College of Surgeons (ACS) outlines significant ways that the COVID-19 pandemic destabilized usual patterns of cancer care, as reported in the National Cancer Database (NCDB). The NCDB is one of the largest cancer registries in the world and is used by thousands of hospitals and centers around the United States to inform and improve the quality of cancer care.
The research, published in JAMA Surgery as a Special Communication article,1 describes specific ways that NCDB data models were impacted by the COVID-19 pandemic, offering guidance on how to interpret data from 2020 and onward. The report also paints a larger picture of pandemic disruptions beyond the immediate emergency of treating patients with COVID-19.
Key Study Findings
Researchers reviewed 4,045,097 cancer cases from adults (18 years or older) who were diagnosed with cancer and/or received their first-course treatment at a reporting facility from January 2018 to December 2020. The study offers a detailed look into the complexities and variations that occurred in cancer reporting because of the COVID-19 pandemic.
Among the key findings, the COVID-19 pandemic was associated with significant changes in diagnoses of all cancer types in 2020, with a 14.4% overall decline in the number of reported cancer cases in the NCDB compared with the prior year. This decline represents more than 200,000 cancer cases that were not diagnosed and/or treated at ACS Commission on Cancer facilities.These missing cancer cases are expected to appear in 2021 data and beyond, potentially at more advanced stages.
Overall, the proportion of patients diagnosed with early-stage disease decreased from March to June 2020, followed by a corresponding increase in the proportion of those diagnosed with late-stage disease, peaking in April 2020 and correcting to prior years’ percentages by July 2020. However, the 2020 stage distributions for specific types of cancer varied, and the study identified differences across sociodemographic data.
DISCLOSURE: For full disclosures of the study authors, visit jamanetwork.com.
REFERENCE
1. Lum SS, Browner AE, Palis B, et al: Disruption of National Cancer Database data models in the first year of the COVID-19 pandemic. JAMA Surg. April 12, 2023 (early release online).
