Site-specific patterns of early-stage cancer diagnosis during the COVID-19 pandemic

JNCI Cancer Spectr. 2024 Apr 30;8(3):pkae022. doi: 10.1093/jncics/pkae022.

Abstract

The COVID-19 pandemic caused widespread disruptions in cancer care. We hypothesized that the greatest disruptions in diagnosis occurred in screen-detected cancers. We identified patients (≥18 years of age) with newly diagnosed cancer from 2019 to 2020 in the US National Cancer Database and calculated the change in proportion of early-stage to late-stage cancers using a weighted linear regression. Disruptions in early-stage diagnosis were greater than in late-stage diagnosis (17% vs 12.5%). Melanoma demonstrated the greatest relative decrease in early-stage vs late-stage diagnosis (22.9% vs 9.2%), whereas the decrease was similar for pancreatic cancer. Compared with breast cancer, cervical, melanoma, prostate, colorectal, and lung cancers showed the greatest disruptions in early-stage diagnosis. Uninsured patients experienced greater disruptions than privately insured patients. Disruptions in cancer diagnosis in 2020 had a larger impact on early-stage disease, particularly screen-detected cancers. Our study supports emerging evidence that primary care visits may play a critical role in early melanoma detection.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / epidemiology
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / epidemiology
  • Databases, Factual
  • Delayed Diagnosis / statistics & numerical data
  • Early Detection of Cancer* / statistics & numerical data
  • Female
  • Humans
  • Insurance, Health / statistics & numerical data
  • Linear Models
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / epidemiology
  • Male
  • Medically Uninsured / statistics & numerical data
  • Melanoma* / diagnosis
  • Melanoma* / epidemiology
  • Middle Aged
  • Neoplasm Staging*
  • Neoplasms* / diagnosis
  • Neoplasms* / epidemiology
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / epidemiology
  • Pandemics*
  • Primary Health Care / statistics & numerical data
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / epidemiology
  • SARS-CoV-2 / isolation & purification
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / epidemiology
  • United States / epidemiology
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / virology