The Annual Report to the Nation on the Status of Cancer, Part 2—published by Negoita et al in the journal Cancer—showed that new diagnoses of six major cancer types in the United States fell sharply between March and May of 2020, coinciding with the beginning of the COVID-19 pandemic. The six cancer types include colorectal, female breast, lung, pancreatic, prostate, and thyroid cancers. The volume of pathology reports also declined in this time period, suggesting that 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 by Cronin et al in Cancer.

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, including colorectal, female breast, lung, pancreatic, 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 ratios. The expected numbers of incident cases were extrapolated using Joinpoint trend models.

Results

The authors found an observed-to-expected ratio of < 1.0 for major screening-eligible cancer sites, indicating fewer newly diagnosed cases then expected in 2020. The observed-to-expected ratios were lowest in April 2020. For every cancer site except pancreatic, Asian/Pacific Islander individuals had the lowest observed-to-expected ratio of any racial group. Observed-to-expected ratios were lower for cancers diagnosed at localized stages than for those diagnosed at advanced stages.

“The current analysis provides strong evidence for declines in cancer diagnoses, relative to the expected numbers, between March and May of 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.

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, FACS, FASCO, 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 that 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.”

Serban Negoita, MD, DrPH, of the Surveillance Research Program and Chief of the Data Quality, Analysis, and Interpretation Branch, National Cancer Institute, is the corresponding author of this study.

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. For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.