COVID-19 and Other Underlying Causes of Cancer Deaths - United States, January 2018-July 2022

Abstract

Cancer survivors (persons who have received a diagnosis of cancer, from the time of diagnosis throughout their lifespan)* have increased risk for severe COVID-19 illness and mortality (1). This report describes characteristics of deaths reported to CDC's National Vital Statistics System (NVSS), for which cancer was listed as the underlying or a contributing cause (cancer deaths) during January 1, 2018-July 2, 2022. The underlying causes of death, including cancer and COVID-19, were examined by week, age, sex, race and ethnicity, and cancer type. Among an average of approximately 13,000 weekly cancer deaths, the percentage with cancer as the underlying cause was 90% in 2018 and 2019, 88% in 2020, and 87% in 2021. The percentage of cancer deaths with COVID-19 as the underlying cause differed by time (2.0% overall in 2020 and 2.4% in 2021, ranging from 0.2% to 7.2% by week), with higher percentages during peaks in the COVID-19 pandemic. The percentage of cancer deaths with COVID-19 as the underlying cause also differed by the characteristics examined, with higher percentages observed in 2021 among persons aged ≥65 years (2.4% among persons aged 65-74 years, 2.6% among persons aged 75-84 years, and 2.4% among persons aged ≥85 years); males (2.6%); persons categorized as non-Hispanic American Indian or Alaska Native (AI/AN) (3.4%), Hispanic or Latino (Hispanic) (3.2%), or non-Hispanic Black or African American (Black) (2.5%); and persons with hematologic cancers, including leukemia (7.4%), lymphoma (7.3%), and myeloma (5.8%). This report found differences by age, sex, race and ethnicity, and cancer type in the percentage of cancer deaths with COVID-19 as the underlying cause. These results might guide multicomponent COVID-19 prevention interventions and ongoing, cross-cutting efforts to reduce health disparities and address structural and social determinants of health among cancer survivors, which might help protect those at disproportionate and increased risk for death from COVID-19.

FIGURE 1

Number of cancer deaths with cancer or COVID-19 as underlying or contributing cause of death, by MMWR week of death — United States, January 7, 2018–July 2, 2022 Abbreviation: ICD-10 = International Classification of Diseases, Tenth Revision. * National Vital Statistics System data for 2018–2020 are final. Provisional data for 2021 and 2022 are incomplete. These data exclude deaths that occurred in the United States among residents of U.S. territories and foreign countries. Based on records received and processed as of September 4, 2022. ^† Deaths with malignant neoplasm (cancer), coded to ICD-10 codes C00–C97, as an underlying or contributing cause of death. ^§ Deaths with confirmed or presumed COVID-19, coded to ICD-10 code U07.1.

FIGURE 2

Number of deaths with cancer as a contributing cause of death, by noncancer underlying cause of death and MMWR week of death — United States, January 7, 2018–July 2, 2022 Abbreviation: ICD-10 = International Classification of Diseases, Tenth Revision. * National Vital Statistics System data for 2018–2020 are final. Provisional data for 2021 and 2022 are incomplete. These data exclude deaths that occurred in the United States among residents of U.S. territories and foreign countries. Based on records received and processed as of September 4, 2022. ^† Deaths with malignant neoplasm (cancer), coded to ICD-10 codes C00–C97, as a contributing cause of death. ^§ Deaths with cancer as a contributing cause of death and the underlying cause of death attributed to other diseases or conditions, including diseases of the circulatory system (ICD-10 codes I00–I99), including heart disease and stroke; mental and behavioral disorders and diseases of the nervous system (F00–G99), including Alzheimer disease; endocrine, nutritional, metabolic, and digestive system diseases (E00–E99, K00–K99), including diabetes and cirrhosis; diseases of the respiratory system (J00–J99), including chronic obstructive pulmonary disease, influenza, and pneumonia; confirmed or presumed COVID-19 (U07.1); and all other causes. Together, these deaths accounted for <20% of all cancer deaths (weekly range = 9%–19%).