Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct:9:100188.
doi: 10.1016/j.lanepe.2021.100188. Epub 2021 Aug 18.

Impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020: Evidence from the German Childhood Cancer Registry and a qualitative survey

Friederike Erdmann  1   2 , Maike Wellbrock  1 , Claudia Trübenbach  1 , Claudia Spix  1 , Martin Schrappe  3 , Joachim Schüz  2 , Desiree Grabow  1 , Michael Eichinger  4   5   6
Affiliations

Impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020: Evidence from the German Childhood Cancer Registry and a qualitative survey

Friederike Erdmann et al. Lancet Reg Health Eur. 2021 Oct.

Abstract

Background: The indirect impact of the COVID-19 pandemic on cancer care and timely diagnosis is of increasing concern. We investigated the impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020.

Methods: We analysed incident paediatric cancer cases diagnosed in 0- to 17-year olds in Germany in 2020 using data of the German Childhood Cancer Registry. Absolute numbers and age-standardised incidence rates (ASR) in 2020 were compared to the previous five years (2015-2019). Moreover, we conducted a survey with open-ended questions, gathering perceptions of the diagnostic process and healthcare delivery for paediatric oncology patients during the COVID-19 pandemic.

Findings: More or similar numbers of paediatric cancer patients were newly diagnosed each month throughout 2020 in comparison to the previous five years. The estimated ASRs showed markedly higher incidence rates, overall and across diagnostic groups, in 2020 compared to 2015-2019. Results from the qualitative survey indicated that diagnostic processes, timeliness of diagnosis, and delivery of treatment were hardly affected during the COVID-19 pandemic. However, psychosocial supportive care and non-urgent appointments were considerably reduced during the lockdown periods.

Interpretation: We found no indications of severe adverse effects of the COVID-19 pandemic on diagnosis and delivery of healthcare among children with cancer in Germany. The underlying reasons of the increase in incidence rates remain speculative. Continued close monitoring of incidence patterns may shed light on the underlying reasons of the present increase and contribute to understanding disease aetiology.

Funding: None.

Keywords: COVID-19 pandemic; Childhood cancer; Diagnosis; German Childhood Cancer Registry; Germany; Healthcare delivery; Incidence.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial, personal or financial relationships with other people or organisations that could be construed as a potential conflict of interest.

Figures

Fig 1
Fig. 1
a-f: Absolute numbers of newly diagnosed childhood cancer cases (in 0 – 17 year olds) in 2020 by calendar months versus the average numbers of childhood cancer cases during 2015–2019. The whiskers display the respective minimum and maximum number of cancer cases by calendar month during 2015-2019. The comparison is given for all cancers combined (a), and separately for leukaemias (b), lymphoid leukaemias (c), lymphomas (d), tumours of the central nervous system (e) and solid tumours other than in the central nervous system (non-CNS solid tumours) (f). Diagnostic groups and cancer types were defined according to the International Classification of Childhood Cancer – 3rd version (ICCC-3). The group of non-CNS solid tumours includes ICCC-3 diagnostic groups IV to XII (IV. Neuroblastoma and other peripheral nervous cell tumours, V. Retinoblastomas, VI. Renal tumours, VII. Hepatic tumours, VIII. Malignant bone tumours, IX. Soft tissue and other extraosseous sarcomas, X. Germ cell tumours, trophoblastic tumours, and neoplasm of gonads, XI. Other malignant epithelial neoplasms and melanomas, and XII. Other and unspecified malignant neoplasms).
Fig 2
Fig. 2
a-d: Absolute numbers of newly diagnosed childhood cancer cases (in 0 – 17 year olds) in 2020 by calendar months and age at diagnosis (<1 year (a), 1-4 years (b), 5-9 years (c), 10-17 years (d)) versus the average numbers of childhood cancer cases during 2015–2019. The whiskers display the respective minimum and maximum number of cancer cases by calendar month during 2015-2019.
See this image and copyright information in PMC

References

    1. Pritchard-Jones K, Pieters R, Reaman GH. Sustaining innovation and improvement in the treatment of childhood cancer: lessons from high-income countries. Lancet Oncol. 2013;14(3):e95–e103. - PubMed
    1. Gatta G, Botta L, Rossi S. Childhood cancer survival in Europe 1999–2007: results of EUROCARE-5—a population-based study. Lancet Oncol. 2014;15(1):35–47. - PubMed
    1. Allemani C, Matsuda T, Di Carlo V. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023–1075. - PMC - PubMed
    1. Erdmann F, Kaatsch P, Grabow D, Spix C. Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) at the University Medical Center of the Johannes Gutenberg University; Mainz: 2020. German Childhood Cancer Registry - Annual Report 2019 (1980-2018)
    1. Erdmann F, Frederiksen LE, Bonaventure A. Childhood cancer: Survival, treatment modalities, late effects and improvements over time. Cancer Epidemiol. 2020 - PubMed