COVID-19 associated with delayed cancer diagnoses and increased cancer mortality in Alberta

1. This study found that healthcare disruption during the COVID-19 pandemic led to significant reductions in diagnoses and increased mortality of various cancers compared to the period before the pandemic. 

Evidence Rating Level: 2 (Good)

The COVID-19 pandemic that started in Canada in January 2020, involved minimizing in-person care for healthcare services not related to COVID-19 in efforts to reduce the strain on the healthcare system. In doing so, there were delays and disruptions in cancer care services including nonemergency surgeries and screening programs. This study aimed to evaluate the impact of COVID-19 on the number of cancer diagnoses, the cancer stage at diagnosis, and cancer survival rates in Alberta. The Alberta Cancer Registry was used to identify 42 862 cancer diagnoses between January 2018 and December 2022. Breast, colorectal, and prostate cancers, and melanoma experienced significant reductions in diagnoses during the state of emergency (SOE) period (Mar 16 to June 15, 2020). New diagnoses of breast, colorectal, prostate, and melanoma cancers were  33%, 36%, 36%, and 43% lower during the SOE than before it, respectively, and monthly diagnoses recovered at a rate of 10%, 8%, 8%, and 9% per month, respectively. In terms of cancer stage, the SOE led to statistically significant decreases in the detection of stage I and III breast cancers, stage I and unstaged colorectal cancers and melanoma, and stage I to III prostate cancers. After accounting for confounding variables, there was an increased risk of mortality for patients diagnosed with colorectal cancer (hazard ratio [HR] 1.21, 95% CI 1.05–1.40), non-Hodgkin lymphoma (HR 1.43, 95% CI 1.14–1.79), and uterine cancer (HR 1.57, 95% CI 1.06–2.33) from March to December 2020 compared those who received the diagnosis in 2018. Overall, these findings suggest that the pandemic-related state of emergency in Alberta corresponded with decreased diagnoses of earlier stage breast, colorectal, and prostate cancers, and melanoma, and increased mortality for colorectal cancer, non-Hodgkin lymphoma, and uterine cancer. 

Click to read the study in CMAJ

Image: PD

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