Pandemic disruptions to health care worsened cancer survival, study suggests

NEW YORK (AP) — In the early years of the COVID-19 pandemic, experts worried that disruptions in cancer diagnosis and treatment would cost lives. A new study suggests they were right.

The federally funded study published Thursday by the medical journal JAMA Oncology is believed to be the first to evaluate the effects of pandemic-related disruptions on the short-term survival of cancer patients.

Researchers found that people diagnosed with cancer in 2020 and 2021 had worse short-term survival than those diagnosed between 2015 and 2019. This was true for a wide range of cancers, and whether they were diagnosed at a late or early stage.

Of course, COVID-19 itself was particularly dangerous for patients already weakened by cancer, but researchers worked to filter out deaths primarily attributed to the coronavirus, to see if other factors played a role.

Researchers weren’t able to show with certainty what led to worse survival, said Todd Burus of the University of Kentucky, the study’s lead author.

“But disruptions to the health care system were probably a key factor,” said Burus, who specializes in medical data analysis.

COVID-19 forced many people to postpone cancer screenings – colonoscopies, mammograms and lung scans – as the coronavirus overwhelmed doctors and hospitals, especially in 2020.

Previous research had shown that overall cancer death rates in the United States had continued to decline throughout the pandemic and that there had not been considerable changes in late diagnoses.

Recinda Sherman, a researcher on that earlier paper, applauded the new work.

“As this study is the first to document cause-specific survival in a pandemic, I think it is important,” said Sherman, of the North American Association of Central Cancer Registries. “The more we understand the impact of COVID-19, the better we will be able to prepare for the next one. »

How might overall cancer mortality rates decline in 2020 and 2021, while short-term survival deteriorates for newly diagnosed patients?

Cancer prevention, diagnosis and treatment measures that for years had been driving down cancer death rates did not suddenly disappear during the pandemic, Burus noted.

“We haven’t forgotten how to do these things,” he said. “But disruptions could have changed access and how quickly people were treated.”

Further research will show whether the impact was lasting, said Hyuna Sung, senior principal scientist and cancer epidemiologist at the American Cancer Society.

“Transient declines in survival that recover quickly may have little impact on long-term mortality trends,” she said.

The new study leveraged data from the National Cancer Registry to focus more specifically on patients who received a first diagnosis of malignant cancer in 2020 and 2021. More than 1 million people were diagnosed with cancer in those two years, and about 144,000 died within a year, according to the researchers’ data.

The researchers looked at the one-year survival rates of these patients, checking at what stage they were at the time of diagnosis.

They calculated that one-year survival was lower for early- and late-stage diagnoses across all cancer sites. Most worrying were the large differences seen in colorectal, prostate and pancreatic cancers, they said.

Overall, researchers found that more than 96% of people diagnosed with early-stage cancer in 2020 and 2021 – and more than 74% of those diagnosed with late-stage cancer – survived more than a year. These rates were slightly lower than would have been expected based on trends from 2015 to 2019, resulting in approximately 17,400 more deaths than expected.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.