New cancer cases at the time of SARS-Cov2 pandemic and related public health policies: A persistent and concerning decrease long after the end of the national lockdown

Abstract

Introduction The dissemination of SARS-Cov2 may have delayed the diagnosis of new cancers. This study aimed at assessing the number of new cancers during and after the lockdown. Methods We collected prospectively the clinical data of the 11.4 million of patients referred to the Assistance Publique Hôpitaux de Paris Teaching Hospital. We identified new cancer cases between January 1 st 2018 and September 31 st 2020, and compared indicators for 2018 and 2019 to 2020 with a focus on the French lockdown (March 17 th to May 11 th , 2020), across cancer types and patient age classes. Results Between January and September, 21,681, 20,778 and 16,764 new cancer cases were identified in 2018, 2019 and 2020, respectively. The monthly median number of new cases reached 2,520 (interquartile range, IQR, 2,328; 2,586), 2,322 (IQR 2,307; 2,399) and 1,949 (IQR 1,586; 2,045) in 2018, 2019 and 2020, respectively. From March 1 st to May 31 st , new cancer decreased by 33% in 2020 compared to the 2018-19 average; then by 19% from June 1 st to September 31 st . This evolution was consistent across all tumor types: -33% and -19% for colon, -30% and -8% for lung, -29% and -13% for breast, -30% and -18% for prostate cancers, respectively. For patients aged < 70 years, the decrease of colorectal and breast new cancers in April between 2018-2019 average and 2020 reached 46% and 44%, respectively. Conclusion The SARS-Cov2 pandemic led to a substantial decrease of new cancer cases. Delays in cancer diagnoses may affect clinical outcomes in the coming years.

Effect of lockdown on digestive system cancer care amongst older patients during the first wave of COVID-19: The CADIGCOVAGE multicentre cohort study

“…This type of decrease had also been observed (for patients of all ages) in a study of eastern France (-39%) [1] and in studies worldwide [ 12 , 13 ]. Our results are also in line with reports on the number of patients newly treated for cancer in our institution [ 14 , 15 ]. Furthermore, we observed a sustained, low number of newly treated older patients with digestive system cancer in the post-lockdown period (-17.0%), relative to 2018-2019.…”

Differences in the Impact of COVID-19 on Pathology Laboratories and Cancer Diagnosis in Girona

“…A reduction in prostate and thyroid diagnoses was also observed for 2020 compared to 2019. These results make sense and are consistent with others that have been published [ 37 ], such as those related to melanoma, given that these types of neoplasms do not require urgent surgical intervention and generally have a good prognosis. In the case of prostate cancer, the reduction in diagnoses may be in part due to the decline in prostate-specific antigen (PSA) testing observed in recent years [ 38 ].…”

Delays in Cancer Diagnostic Testing at a Quick Referral Unit in Spain during COVID-19

“…Additionally, using a national database where all cases of cancer were reported, a French article reported a 33% reduction in the average number of new cancers during lockdown (March-May) in 2020, which was consistent through all cancer sites including breast, colorectal, lung, pancreatic, and prostatic cancers. Despite a recovery trend after lockdown (June-September 2020), the number remained 19% lower than the average of 2018 and 2019 [34].…”