Association of the COVID-19 Pandemic With Patterns of Statewide Cancer Services

Abstract

The coronavirus disease 2019 (COVID-19) pandemic led to delayed medical care in the United States. We examined changes in patterns of cancer diagnosis and surgical treatment between January 1 and December 31 in 2020 and 2019 with real-time electronic pathology report data from population-based Surveillance, Epidemiology, and End Results cancer registries from Georgia and Louisiana. During 2020, there were 29 905 fewer pathology reports than in 2019, representing a 10.2% decline. Declines were observed in all age groups, including children and adolescents younger than 18 years. The nadir was early April 2020, with 42.8% fewer reports than in April 2019. Numbers of reports through December 2020 never consistently exceeded those in 2019 after first declines. Patterns were similar by age group and cancer site. Findings suggest substantial delays in diagnosis and treatment services for cancers during the pandemic. Ongoing evaluation can inform public health efforts to minimize any lasting adverse effects of the pandemic on cancer diagnosis, stage, treatment, and survival.

Figure 1.

Cancer Pathology Reports: 2019 and 2020. This figure shows the number of cancer pathology reports in Georgia and Louisiana in biweekly intervals to allow comparison of the same period in 2019 as in 2020. Numbers of pathology reports (blue bars) are shown with the primary y-axis, the coronavirus disease 2019 (COVID-19) mortality rate per 100 000 population in Georgia and Louisiana (light orange area) is shown with the secondary y-axis, and the percentage change in the number of pathology reports between 2019 and 2020 (red solid line) is shown with the tertiary y-axis. Shutdown policies announced in March 2021 are indicated by the vertical bar.