Findings from the Annual Report to theNation on the Status of Cancer, Part 2: Early Assessment of the COVID-19 Pandemic’s Impact on Cancer Diagnosis show new diagnoses of six major cancer types in the United States fell sharply between March and May 2020, coinciding with the beginning of the COVID-19 pandemic.1 The six cancer types include colorectal, female breast, lung, pancreas, prostate, and thyroid cancers. The volume of pathology reports also declined during this period, suggesting fewer cancer screenings and other cancer-related procedures were performed in 2020.
The Annual Report to the Nation on the Status of Cancer is a collaborative effort among the National Cancer Institute, Centers for Disease Control and Prevention, American Cancer Society, and North American Association of Central Cancer Registries, which track information on cancer occurrence and trends in the United States. Part 1 of the latest report, which focused on national cancer statistics, was published in October 2022.2
Study Methodology
Data were collected from selected U.S. population–based cancer registries for diagnosis for the years 2015 to 2020 using first-submission data from the North American Association of Central Cancer Registries. After a quality assessment, the researchers extracted the monthly numbers of newly diagnosed cancer cases for six cancer types: colorectal, female breast, lung, pancreas, prostate, and thyroid cancers.
The observed numbers of incident cancer cases in 2020 were then compared with the estimated numbers by calculating observed-to-expected (O/E) ratios. The expected numbers of incident cases were extrapolated using.
Key Results
The authors found an O/E ratio < 1.0 for major screening-eligible cancer sites, indicating fewer newly diagnosed cases than expected in 2020. The O/E ratios were lowest in April 2020. For every cancer site except the pancreas, Asians/Pacific Islanders had the lowest O/E ratio of any racial group. Observed-to-expected ratios were lower for cases diagnosed at localized stages than for cases diagnosed at advanced stages.
“This report highlights the urgency in helping all Americans get back on track with their cancer care, so we can avoid unnecessary deaths and complications from cancer.”— Monica M. Bertagnolli, MD
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“The current analysis provides strong evidence for declines in cancer diagnoses, relative to the expected numbers, between March and May 2020. The declines correlate with reductions in pathology reports and are greater for cases diagnosed at in situ and localized stage, triggering concerns about potential poor cancer outcomes in the coming years, especially in Asians/Pacific Islanders,” concluded the study authors. Serban Negoita, MD, DrPH, Chief, Data Quality, Analysis & Interpretation Branch of the National Cancer Institute, is the corresponding author of this study.
Clinical Significance
“These missed opportunities for early cancer detection are alarming, particularly for those vulnerable populations that continue to face significant barriers in accessing cancer care,” said Monica M. Bertagnolli, MD, Director of the National Cancer Institute, in a statement. “This report highlights the urgency in helping all Americans get back on track with their cancer care, so we can avoid unnecessary deaths and complications from cancer. That’s exactly why expanding cancer screening access and awareness is a key priority of the Biden-Harris Administration’s Cancer Moonshot.”
DISCLOSURE: Funding for this study was provided by the American Cancer Society, National Cancer Institute, National Center for Chronic Disease Prevention and Health Promotion, and North American Association of Central Cancer Registries.
REFERENCES
1. Negoita S, Chen HS, Sanchez PV, et al: Annual report to the nation on the status of cancer, part 2: Early assessment of the COVID-19 pandemic’s impact on cancer diagnosis. Cancer. September 27, 2023 (early release online).
2. Cronin KA, Scott S, Firth AU, et al: Annual report to the nation on the status of cancer, part 1: National cancer statistics. Cancer 128:4251-4284, 2022.
