Affiliation:
1. Department of Radiology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
2. Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
3. Department of Pathology and Laboratory Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
4. Division of Oncology, Department of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
Abstract
AbstractImportanceThe COVID‐19 pandemic led to reductions in primary care and cancer screening visits, which may delay detection of some cancers. The impact on incidence has not been fully quantified. We examined change in cancer incidence to determine how the COVID‐19 pandemic may have altered the characteristics of cancers diagnosed among women.MethodsThis study included female patients aged ≥18 years and diagnosed with breast (n = 9489), colon (n = 958), pancreatic (n = 669), or uterine (n = 1991) cancer at three hospitals in North Carolina. Using interrupted time series, we compared incidence of cancers diagnosed between March 2020 and November 2020 (during pandemic) with cancers diagnosed between January 2016 and February 2020 (pre‐pandemic).ResultsDuring the pandemic, incidence of breast and uterine cancers was significantly lower than expected compared to pre‐pandemic (breast—18%, p = 0.03; uterine −20%, p = 0.05). Proportions of advanced pathologic stage and hormone receptor‐negative breast cancers, and advanced clinical stage and large size uterine cancers were more prevalent during the pandemic. No significant changes in incidence were detected for pancreatic (−20%, p = 0.08) or colon (+14%, p = 0.30) cancers.Conclusion and RelevanceIn women, the COVID‐19 pandemic resulted in a significant reduction in the incidence of breast and uterine cancers, but not colon or pancreatic cancers. A change in the proportion of poor prognosis breast and uterine cancers suggests that some cancers that otherwise would have been diagnosed at an earlier stage will be detected in later years. Continued analysis of long‐term trends is needed to understand the full impact of the pandemic on cancer incidence and outcomes.
Funder
National Cancer Institute
National Center for Advancing Translational Sciences