Antoine Eskander1,2,3, Qing Li1, Jiayue Yu4, Julie Hallet1,2,5, Natalie G Coburn1,2,5, Anna Dare1,2,5, Kelvin K W Chan1,2,6, Simron Singh1,2,6, Ambica Parmar1,6, Craig C Earle1,6, Lauren Lapointe-Shaw1,2,7, Monika K Krzyzanowska1,2,7, Timothy P Hanna1,8, Antonio Finelli1,2,5, Alexander V Louie9, Nicole Look Hong1,2,5, Jonathan C Irish3,10, Ian J Witterick3,10, Alyson Mahar11, Christopher W Noel2,3, David R Urbach1,12, Daniel I McIsaac1,13, Danny Enepekides3, Rinku Sutradhar1,2,4. 1. ICES, Toronto, Ontario. 2. Institute of Health Policy, Management, and Evaluation. 3. Department of Otolaryngology - Head and Neck Surgery. 4. Division of Biostatistics, Dalla Lana School of Public Health. 5. Department of Surgery. 6. Division of Medical Oncology, Department of Medicine, and. 7. Department of Medicine, University of Toronto, Toronto, Ontario. 8. Division of Radiation Oncology, Queen's University, Kingston, Ontario. 9. Department of Radiation Oncology, University of Toronto, Ontario. 10. Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre and Ontario Health - Cancer Care Ontario, Toronto, Ontario. 11. Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba. 12. Department of Surgery, Women's College Hospital, Toronto, Ontario; and. 13. Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
Abstract
BACKGROUND: Resource restrictions were established in many jurisdictions to maintain health system capacity during the COVID-19 pandemic. Disrupted healthcare access likely impacted early cancer detection. The objective of this study was to assess the impact of the pandemic on weekly reported cancer incidence. PATIENTS AND METHODS: This was a population-based study involving individuals diagnosed with cancer from September 25, 2016, to September 26, 2020, in Ontario, Canada. Weekly cancer incidence counts were examined using segmented negative binomial regression models. The weekly estimated backlog during the pandemic was calculated by subtracting the observed volume from the projected/expected volume in that week. RESULTS: The cohort consisted of 358,487 adult patients with cancer. At the start of the pandemic, there was an immediate 34.3% decline in the estimated mean cancer incidence volume (relative rate, 0.66; 95% CI, 0.57-0.75), followed by a 1% increase in cancer incidence volume in each subsequent week (relative rate, 1.009; 95% CI, 1.001-1.017). Similar trends were found for both screening and nonscreening cancers. The largest immediate declines were seen for melanoma and cervical, endocrinologic, and prostate cancers. For hepatobiliary and lung cancers, there continued to be a weekly decline in incidence during the COVID-19 period. Between March 15 and September 26, 2020, 12,601 fewer individuals were diagnosed with cancer, with an estimated weekly backlog of 450. CONCLUSIONS: We estimate that there is a large volume of undetected cancer cases related to the COVID-19 pandemic. Incidence rates have not yet returned to prepandemic levels.
BACKGROUND: Resource restrictions were established in many jurisdictions to maintain health system capacity during the COVID-19 pandemic. Disrupted healthcare access likely impacted early cancer detection. The objective of this study was to assess the impact of the pandemic on weekly reported cancer incidence. PATIENTS AND METHODS: This was a population-based study involving individuals diagnosed with cancer from September 25, 2016, to September 26, 2020, in Ontario, Canada. Weekly cancer incidence counts were examined using segmented negative binomial regression models. The weekly estimated backlog during the pandemic was calculated by subtracting the observed volume from the projected/expected volume in that week. RESULTS: The cohort consisted of 358,487 adult patients with cancer. At the start of the pandemic, there was an immediate 34.3% decline in the estimated mean cancer incidence volume (relative rate, 0.66; 95% CI, 0.57-0.75), followed by a 1% increase in cancer incidence volume in each subsequent week (relative rate, 1.009; 95% CI, 1.001-1.017). Similar trends were found for both screening and nonscreening cancers. The largest immediate declines were seen for melanoma and cervical, endocrinologic, and prostate cancers. For hepatobiliary and lung cancers, there continued to be a weekly decline in incidence during the COVID-19 period. Between March 15 and September 26, 2020, 12,601 fewer individuals were diagnosed with cancer, with an estimated weekly backlog of 450. CONCLUSIONS: We estimate that there is a large volume of undetected cancer cases related to the COVID-19 pandemic. Incidence rates have not yet returned to prepandemic levels.
Authors: J Ribes; L Pareja; X Sanz; S Mosteiro; J M Escribà; L Esteban; J Gálvez; G Osca; P Rodenas; P Pérez-Sust; J M Borràs Journal: ESMO Open Date: 2022-04-14