New diagnoses of six major cancer types in the United States fell abruptly in early 2020, coinciding with the start of the COVID-19 pandemic, according to findings from part 2 of the latest Annual Report to the Nation on the Status of Cancer.1 The volume of pathology reports also declined sharply in early 2020, suggesting that fewer cancer screenings and other cancer-related procedures were performed during that time. Taken together, the findings suggest that many cancers were not being diagnosed in a timely manner during the early part of the COVID-19 pandemic, likely because of interruptions in medical care.
Collaborative Effort
The Annual Report to the Nation on the Status of Cancer is a collaborative effort among National Cancer Institute (NCI), the Centers for Disease Control and Prevention (CDC), the American Cancer Society, and the North American Association of Central Cancer Registries to provide information about cancer occurrence and trends in the United States. Part 1 of the latest report, which focused on national cancer statistics, was released in October 2022.
The authors analyzed cancer incidence data for 2015 to 2020 using data from select population-based national cancer registries. They compared the number of newly diagnosed cases of cancer in 2020 with what was expected based on previous years. They looked at female breast, lung, and colorectal cancers, which are often diagnosed through screening tests or other forms of early detection; thyroid and prostate cancers, which are often diagnosed incidentally; and pancreatic cancer, which is usually diagnosed when the patient presents with symptoms. The authors also compared the volume of electronic pathology reports sent to central cancer registries in 2020 with the volume sent in 2019.
From March to May 2020, new cases of all six cancer types fell sharply. By July 2020, however, diagnoses of all cancer types except prostate cancer had returned to levels before the COVID-19 pandemic.
Over the same period in early 2020, the volume of electronic pathology reports also declined steeply before returning to pre–COVID-19 pandemic levels. Missed screenings only partly explain the observed declines in new cancer cases. Fewer in-person medical visits likely also contributed to the underdiagnoses, particularly for diseases such as thyroid cancer.
DISCLOSURE: Some of the authors are employed by the American Cancer Society, and the other authors reported no conflicts of interest.
REFERENCE
1. Negoita S, Chen HS, Sanchez PV, et al: Annual report to the nation on the status of cancer, part 2. Cancer 130:117-127, 2024.
