In this cross-sectional, population-based study, researchers utilized the Surveillance, Epidemiology, and End Results 22 (SEER-22) registries database and sought to investigate observed versus expected cancer rate trends from January 2020 to December 2021.
The authors aimed to ascertain to what degree disruptions to cancer diagnosis in 2020 were resolved during the second year of the COVID-19 pandemic in the U.S.
Primary outcomes and measures included expected cancer incidence rates for the COVID-19 pandemic years of 2020 and 2021 based on prepandemic trends using ensemble forecasting methods. The relative difference between observed and expected cancer incidence rates and the number of potentially missed cases were computed.
The results revealed that the SEER-22 registries reported 1,578,697 cancer cases in 2020 and 2021, including 798,765 among male individuals (50.6%) and 909,654 among persons aged 65 years or older (57.6%). The overall cancer incidence rates were 9.4% lower than projected in 2020 (95% prediction interval [PI], 8.5%-10.5%), 2.7% lower than projected in 2021 (95% PI, 1.4%-3.9%), and 6.0% lower than expected across both years combined (95% PI, 5.1%-7.1%) which resulted in an estimated 149,577 potentially undiagnosed cancer cases.
Among the four cancers detected through screening, only female breast cancer exhibited a noteworthy recovery in 2021, with rates surpassing expectations by 2.5%, and significant decreases persisted for lung cancer (9.1% lower than expected and cervical cancer—4.5% lower than expected), particularly for early-stage diagnoses. Additionally, rates of all-site cancer incidence reverted to prepandemic trends in 2021 among female individuals, individuals aged younger than 65 years, and individuals who were of non-Hispanic Asian and Pacific Islander ancestry.
The authors wrote, “Overall, our findings suggest that pandemic-related disruptions to cancer diagnoses in the US lasted well beyond the first few months of 2020. Cancer cases in the U.S. continued to be underdiagnosed during the second year of the COVID-19 pandemic,” and added, “Particular attention should be directed at strategies to immediately increase cancer screenings to make up lost ground and prevent a future surplus of late-stage diagnoses.”
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