Clinical Epidemiology (Jun 2024)

The Impact of the COVID-19 Pandemic on Incidence and Short-Term Survival for Common Solid Tumours in the United Kingdom: A Cohort Analysis

  • Barclay NL,
  • Burkard T,
  • Burn E,
  • Delmestri A,
  • Miquel Dominguez A,
  • Golozar A,
  • Guarner-Argente C,
  • Avilés-Jurado FX,
  • Man WY,
  • Roselló Serrano À,
  • Rosen AW,
  • Tan EH,
  • Tietzova I,
  • Prieto Alhambra D,
  • Newby D

Journal volume & issue
Vol. Volume 16
pp. 417 – 429

Abstract

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Nicola L Barclay,1 Theresa Burkard,1 Edward Burn,1 Antonella Delmestri,1 Andrea Miquel Dominguez,2 Asieh Golozar,3 Carlos Guarner-Argente,4 Francesc Xavier Avilés-Jurado,5 Wai Yi Man,1 Àlvar Roselló Serrano,6 Andreas Weinberger Rosen,7 Eng Hooi Tan,1 Ilona Tietzova,8 Daniel Prieto Alhambra,1,9 Danielle Newby1 On behalf of the OPTIMA Consortium1Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; 2Otorrinolaringology department, Hospital Joan XXIII de Tarragona, Tarragona, Spain; 3Odysseus Data Services, Cambridge, MA, USA; 4Gastroenterology Department, Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí, Barcelona, Spain; 5Head Neck Tumors Unit, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain; 6Institut Català d’Oncologia, Hospital Universitari Dr Josep Trueta, Girona, Spain; 7Centre for Surgical Science, Department of Surgery, Zealand University Hospital, Koege, Denmark; 8First Department of Tuberculosis and Respiratory Diseases, First Faculty of Medicine, Charles University, Prague, Czech Republic; 9Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, the NetherlandsCorrespondence: Daniel Prieto Alhambra, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, United Kingdom, Email [email protected]: The COVID-19 pandemic profoundly affected healthcare systems and patients. There is a need to comprehend the collateral effects of the pandemic on non-communicable diseases. We examined the impact of the pandemic on short-term survival for common solid tumours, including breast, colorectal, head and neck, liver, lung, oesophageal, pancreatic, prostate, and stomach cancer in the UK.Methods: This was a population-based cohort study of electronic health records from the UK primary care Clinical Practice Research Datalink GOLD database. In sum, 12,259,744 eligible patients aged ≥ 18 years with ≥ 1 year’s history identified from January 2000 to December 2022 were included. We estimated age-standardised incidence and short-term (one- and two-year) survival for several common cancers from 2000 to 2019 (in five-year strata) and compared these to 2020– 2022 using the Kaplan–Meier method.Results: Incidence decreased for most cancers in 2020 and recovered to different extents in 2021– 2022. Short-term survival improved for most cancers between 2000 and 2019, but then declined, albeit minimally, for those diagnosed in 2020– 2022. This was most pronounced for colorectal cancer, with one-year survival falling from 78.8% (95% CI 78%– 79.6%) in 2015– 2019 to 77% (95% CI 75.6– 78.3%) for those diagnosed in 2020– 2022.Conclusion: Short-term survival for many cancers was impacted, albeit minimally, by the pandemic in the UK, with reductions in survivorship from colorectal cancer equivalent to returning to the mortality seen in the first decade of the 2000s. While data on longer-term survival are needed to fully comprehend the impact of COVID-19 on cancer care, our findings illustrate the need for an urgent and substantial commitment from the UK National Health Service to address the existing backlog in cancer screening and diagnostic procedures to improve cancer care and mortality.Keywords: cancer, COVID-19, colorectal cancer, incidence, pandemic, survival

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