Impact of the SARS-CoV-2 pandemic on female breast, colorectal and non-small cell lung cancer incidence, stage and healthcare pathway to diagnosis during 2020 in Wales, UK, using a national cancer clinical record system

Giles Greene, Rowena Griffiths, Jun Han, Ashley Akbari, Monica Jones, Jane Lyons, Ronan A Lyons, Martin Rolles, Fatemeh Torabi, Janet Warlow, Eva R A Morris, Mark Lawler, Dyfed Wyn Huws

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

Background
COVID-19 pandemic responses impacted behaviour and health services. We estimated the impact on incidence, stage and healthcare pathway to diagnosis for female breast, colorectal and non-small cell lung cancers at population level in Wales.

Methods
Cancer e-record and hospital admission data linkage identified adult cases, stage and healthcare pathway to diagnosis (population ~2.5 million). Using multivariate Poisson regressions, we compared 2019 and 2020 counts and estimated incidence rate ratios (IRR).

Results
Cases decreased 15.2% (n = −1011) overall. Female breast annual IRR was 0.81 (95% CI: 0.76–0.86, p < 0.001), colorectal 0.80 (95% CI: 0.79–0.81, p < 0.001) and non-small cell lung 0.91 (95% CI: 0.90–0.92, p < 0.001). Decreases were largest in 50–69 year olds for female breast and 80+ year olds for all cancers. Stage I female breast cancer declined 41.6%, but unknown stage increased 55.8%. Colorectal stages I–IV declined (range 26.6–29.9%), while unknown stage increased 803.6%. Colorectal Q2-2020 GP-urgent suspected cancer diagnoses decreased 50.0%, and 53.9% for non-small cell lung cancer. Annual screen-detected female breast and colorectal cancers fell 47.8% and 13.3%, respectively. Non-smal -cell lung cancer emergency presentation diagnoses increased 9.5% (Q2-2020) and 16.3% (Q3-2020).

Conclusion
Significantly fewer cases of three common cancers were diagnosed in 2020. Detrimental impacts on outcomes varied between cancers. Ongoing surveillance with health service optimisation will be needed to mitigate impacts.
Original languageEnglish
Pages (from-to)558-568
Number of pages11
JournalBritish Journal of Cancer
Volume127
Early online date02 May 2022
DOIs
Publication statusPublished - 2022

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