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. 2024 Feb 8;116(2):208-215.
doi: 10.1093/jnci/djad205.

Cancer and COVID-19: US cancer incidence rates during the first year of the pandemic

Nadia Howlader  1 , Manami Bhattacharya  1 , Steve Scoppa  2 , Daniel Miller  2 , Anne-Michelle Noone  1 , Serban Negoita  1 , Kathy Cronin  1 , Angela Mariotto  1
Affiliations

Cancer and COVID-19: US cancer incidence rates during the first year of the pandemic

Nadia Howlader et al. J Natl Cancer Inst. .

Abstract

Background: The COVID-19 pandemic has had a profound global impact on health-care systems and patient outcomes. However, the specific effects of the pandemic on cancer incidence rates in the United States during its initial year remain unknown.

Methods: In this study, we analyzed data from the Surveillance, Epidemiology, and End Results-22 registries, which encompass approximately 50% of the US population. We investigated changes in monthly incidence rates stratified by various factors, including cancer type, stage, age group, sex, race and ethnicity, socioeconomic status, rural-urban status, and registry locations. We compared the incidence rates observed during the pandemic with those from the previous year.

Results: Our findings revealed a decline in incidence rates for all cancer sites combined starting in March 2020, coinciding with the implementation of stay-at-home orders. This decline reached its lowest point in April 2020 and persisted at a lower level until May 2020. Notably, compared with April 2019, the incidence rates in April 2020 dropped by 48.1% and did not consistently return to prepandemic levels. The reduction in cancer rates was more pronounced in urban and affluent counties. Across all cancer types, there was a statistically significant decrease in incidence rates during the pandemic, with the largest declines observed in thyroid (71.2%), prostate (57.9%), breast (54.9%), and colon and rectum cancers (54.1%). Furthermore, these decreases were primarily observed in early stage rather than late-stage disease.

Conclusions: The COVID-19 pandemic had a statistically significant impact on cancer outcomes. Monitoring long-term consequences of the pandemic on cancer incidence, stage at diagnosis, and mortality trends will be crucial.

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Conflict of interest statement

The authors declare no potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Monthly incidence rates for all cancer sites combined and by gender, age, race, poverty, and rural-urban continuum. 2019-2020. Surveillance, Epidemiology, and End Results–22.
Figure 2.
Figure 2.
Monthly incidence rates by Surveillance, Epidemiology, and End Results (SEER) registry site. 2019-2020. SEER-22. LA = Los Angeles; SF = San Francisco; SJM = San Jose Monterey.
Figure 3.
Figure 3.
Monthly incidence rates by cancer site. 2019-2020. Surveillance, Epidemiology, and End Results–22.
See this image and copyright information in PMC

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