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
Meta-Analysis
. 2023 Jan;38(1):31-38.
doi: 10.1007/s10654-022-00946-6. Epub 2023 Jan 3.

Decrease of cancer diagnosis during COVID-19 pandemic: a systematic review and meta-analysis

Marco Angelini  1 , Federica Teglia  1 , Laura Astolfi  1 , Giulia Casolari  1 , Paolo Boffetta  2   3
Affiliations
Meta-Analysis

Decrease of cancer diagnosis during COVID-19 pandemic: a systematic review and meta-analysis

Marco Angelini et al. Eur J Epidemiol. 2023 Jan.

Abstract

Many health services, including cancer care, have been affected by the COVID-19 epidemic. This study aimed at providing a systematic review of the impact of the epidemic on cancer diagnostic tests and diagnosis worldwide. In our systematic review and meta-analysis, databases such as Pubmed, Proquest and Scopus were searched comprehensively for articles published between January 1st, 2020 and December 12th, 2021. Observational studies and articles that reported data from single clinics and population registries comparing the number of cancer diagnostic tests and/or diagnosis performed before and during the pandemic, were included. Two pairs of independent reviewers extracted data from the selected studies. The weighted average of the percentage variation was calculated and compared between pandemic and pre-pandemic periods. Stratified analysis was performed by geographic area, time interval and study setting. The review was registered on PROSPERO (ID: CRD42022314314). The review comprised 61 articles, whose results referred to the period January-October 2020. We found an overall decrease of - 37.3% for diagnostic tests and - 27.0% for cancer diagnosis during the pandemic. For both outcomes we identified a U-shaped temporal trend, with an almost complete recovery for the number of cancer diagnosis after May 2020. We also analyzed differences by geographic area and screening setting. We provided a summary estimate of the decrease in cancer diagnosis and diagnostic tests, during the first phase of the COVID-19 pandemic. The delay in cancer diagnosis could lead to an increase in the number of avoidable cancer deaths. Further research is needed to assess the impact of the pandemic measures on cancer treatment and mortality.

Keywords: COVID-19; Cancer; Cancer diagnosis; Diagnostic test; Meta-analysis; Pandemic; Review.

PubMed Disclaimer

Conflict of interest statement

All authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA (Preferred reporting items for systematic reviews and meta-analyses) flow diagram
Fig. 2
Fig. 2
Weighted average variation of cancer diagnostic tests from January to October 2020 compared to pre pandemic period, divided by time period.
Fig. 3
Fig. 3
Weighted average variation of cancer diagnosis from January to October 2020 compared to pre-pandemic period, divided by time period.
See this image and copyright information in PMC

References

    1. Ferraro CF, Findlater L, Morbey R, et al. Describing the indirect impact of COVID-19 on healthcare utilisation using syndromic surveillance systems. BMC Public Health. 2021;21(1):2019. Published 2021 Nov 5. - PMC - PubMed
    1. Tam CF, Cheung KS, Lam S, et al. Impact of Coronavirus disease 2019 (COVID-19) outbreak on ST-segment-elevation myocardial infarction care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020;13(4):e006631. doi: 10.1161/CIRCOUTCOMES.120.006631. - DOI - PMC - PubMed
    1. Morris EJA, Goldacre R, Spata E, et al. Impact of the COVID-19 pandemic on the detection and management of colorectal cancer in England: a population-based study. Lancet Gastroenterol Hepatol. 2021;6(3):199–208. doi: 10.1016/S2468-1253(21)00005-4. - DOI - PMC - PubMed
    1. Stover J, Kelly SL, Mudimu E, et al. The risks and benefits of providing HIV services during the COVID-19 pandemic. PLoS One. 2021;16(12):e0260820. - PMC - PubMed
    1. Patt D, Gordan L, Diaz M, et al. Impact of COVID-19 on cancer care: how the pandemic is delaying cancer diagnosis and treatment for American seniors. JCO Clin Cancer Inform. 2020;4:1059–1071. doi: 10.1200/CCI.20.00134. - DOI - PMC - PubMed