COVID Pandemic Worsened Cancer Survival Rates for Newly Diagnosed Patients

Disrupted Care Led to Deadly Consequences

A groundbreaking study published in JAMA Oncology has confirmed what medical experts feared most during the pandemic: disruptions to cancer diagnosis and treatment during the early years of COVID-19 cost lives . The federally funded study is being called the first to assess 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. That was true across a range of cancers, and whether they were diagnosed at a late or early stage . The study analyzed national cancer registry data for patients who had 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 one year .

Overall, more than 96% of people who got an early-stage cancer diagnosis in 2020 and 2021 — and more than 74% of those with a late-stage diagnosis — survived more than a year. Those rates were slightly lower than would have been expected based on 2015-2019 trends, resulting in about 17,400 more deaths than expected .

Healthcare System Overwhelmed

COVID-19 forced many people to postpone cancer screenings—colonoscopies, mammograms, lung scans, and the like—as the coronavirus overwhelmed doctors and hospitals, especially in 2020 . The pandemic created a perfect storm of delayed care that had ripple effects throughout the entire cancer treatment pipeline.

COVID-19 itself was especially dangerous to patients already weakened by cancer, but the researchers worked to filter out deaths mainly attributed to the coronavirus, so they could see if other factors played a role . The researchers were not able to definitively show what drove 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 contributor," said Burus, who specializes in medical data analysis .

Global data from 245 articles in 46 countries showed declines in cancer screening participation (39.0%), diagnoses (23.0%), diagnostic procedures (24.0%) and treatment (28.0%), ranging from a 15.0% decline for radiotherapy to a 35.0% decline for systemic treatment during the pandemic compared to during the prepandemic period .

The Hidden Cost of Delays

The consequences of treatment delays proved more severe than many anticipated. The risk of death from colon cancer increases 6% every 4 weeks that surgery is delayed, and similar delays in adjuvant chemotherapy for colorectal cancer elevate the risk of mortality by 13% . In Australia alone, researchers estimate that a 1-year interruption to health-care services and a 26-week delay in treatment would lead to 1719 additional deaths between 2020–44 among colorectal cancer patients .

The disruption wasn't limited to patient care. Among surveyed cancer researchers, approximately a third had a clinical trial delayed or stopped, with two-thirds stating their laboratory was shut down . This created a domino effect that slowed research progress and delayed potential breakthroughs in treatment.

Looking Forward

"We didn't forget how to do those things," Burus noted about cancer prevention and treatment measures. "But disruptions could have changed access, could have changed how quickly people were getting treated" . Hyuna Sung, senior principal scientist and cancer epidemiologist at the American Cancer Society, noted that "transient declines in survival that quickly recover may have little impact on long-term mortality trends" .

"As this study is the first to document pandemic-related, cause-specific survival, I think it is important," said Recinda Sherman, of the North American Association of Central Cancer Registries. "The more we understand about the impact of COVID-19, the better we will be able to prepare for the next one" . The study serves as a stark reminder that public health emergencies have far-reaching consequences beyond their immediate effects, and healthcare systems must develop more resilient approaches to maintain critical care during future crises.