In a research letter published in JAMA Oncology, Xuesong Han, PhD, and colleagues identified the number of deaths attributable to both cancer and COVID-19, with either as an underlying or contributing cause, in the United States from March 1 to December 31, 2020, and analyzed risk factors for these deaths.
Study Details
The study used data from the Multiple Cause of Death database provided through the Centers for Disease Control and Prevention WONDER database. COVID-related cancer deaths were classified as those with cancer being the underlying cause and COVID-19 being the contributing cause. Cancer-related COVID deaths were classified as those with COVID-19 being the underlying cause and cancer being the contributing cause. Data were also obtained on deaths from cancer without COVID-19 as a contributor and those from COVID-19 without cancer as a contributor.
Xuesong Han, PhD
Key Findings
From March to December 2020, there were 3,142 COVID-related cancer deaths, 13,419 cancer-related COVID deaths, 497,965 non–COVID-related cancer deaths, and 337,393 non–cancer-related COVID deaths. Compared with non–COVID-related cancer deaths, deaths caused by both cancer and COVID-19 were more likely to occur in large central metropolitan areas; in November and December; among individuals aged ≥ 85 years; among patients belonging to American Indian/Alaska Native, Black, or Hispanic racial and ethnic groups; and in inpatient, nursing home, or long-term care settings.
Higher proportions of COVID-related cancer deaths (13.7%) and cancer-related COVID deaths (25.5%) occurred among individuals with hematologic malignancies compared with non–COVID-related cancer deaths (9.5%). Lung cancer was the most common cancer among non–COVID-related cancer deaths. Prostate cancer was more frequently an underlying or contributing cause in deaths caused by both cancer and COVID-19 than a cause of non–COVID-related cancer deaths. Gynecologic cancers in females and gastrointestinal cancers in both sexes were less commonly underlying or contributing causes of deaths attributed to both cancer and COVID-19 compared with causes of non–COVID-related cancer deaths.
The investigators stated, “In the first 10 months of the [COVID-19] pandemic, 16,561 deaths occurred among patients with cancer with complications of COVID-19 in the United States. Risk factors for COVID-19 deaths among the general population, including older age, minority race and ethnicity groups, and large central metropolitan residence, were more prevalent in deaths caused by both cancer and COVID-19 than in non–COVID-related cancer deaths. The high proportion of deaths caused by both cancer and COVID-19 in medical facilities suggests a high economic burden to be evaluated in future studies. The finding of hematologic neoplasms is consistent with previous studies from medical institutions, although the finding of prostate cancer is novel and merits further examination…. Ongoing monitoring of the mortality burden from COVID-19 variants among patients with cancer is warranted, especially after vaccines became available.”
Dr. Han, of the American Cancer Society, is the corresponding author for the JAMA Oncology article.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
