Ahead of print
Research paper
Published online: 2024-02-16
The impact of the COVID-19 pandemic on incidence gap in screen-detectable cancers: a cohort study in Greater Poland, Poland
DOI: 10.5603/rpor.99354
Abstract
Background: The global COVID-19 pandemic has had a significant impact on healthcare systems. This study aimed to assess the incidence gap in screening-detectable cancers in the Greater Poland (Poland) in 2020.
Materials and methods: Data on breast, cervix uteri, and colorectal cancer cases diagnosed from 2010 to 2020 were obtained from the regional cancer registry. Standardized incidence ratios (SIR) and incidence rate differences (IRD) were calculated to estimate the change in incident cancer cases during the pandemic. The number of observed cases was extracted from the registry database. Simple linear regression analysis was used to predict the expected number of incident cancer cases in 2020 and the age-standardized incidence rate based on registry data from the preceding ten years (2010–2019).
Results: In 2020, the registered number of incident female breast cancer cases decreased by 12% [SIR 0.88, 95% confidence interval (CI): 0.88–0.92, observed: 1,848, expected: 2,101], resulting in an IRD of –6.3 per 100 K. The number of registered cervical cancers decreased by 15% (SIR 0.85, 95% CI: 0.73–0.98, observed: 181, expected: 213), with an IRD of –0.8 per 100 K. For colorectal cancer, there was a 16% decrease in new cases among females (SIR 0.84, 95% CI: 0.78–0.90) and a 15% decrease among males (SIR 0.85, 95% CI: 0.80–0.91), resulting in IRDs of –3.04 and –5.29 per 100K, respectively.
Conclusions: The COVID-19 pandemic led to a significant, 15% decrease in newly diagnosed screening-detectable cancer cases in 2020. Further studies are needed to investigate the impact of delayed cancer diagnoses on stage at diagnosis and survival rates.
Keywords: cancercancer diagnosisCOVID-19incidencepopulation-based cancer registrycancer screening
References
- OECD, European Union. Health at a Glance: Europe 2020: State of Health in the EU Cycle. OECD (2020). doi: 10.1787/82129230-en 2020.
- Angelini M, Teglia F, Astolfi L, et al. Decrease of cancer diagnosis during COVID-19 pandemic: a systematic review and meta-analysis. Eur J Epidemiol. 2023; 38(1): 31–38.
- Mayo M, Potugari B, Bzeih R, et al. Cancer Screening During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. Mayo Clin Proc Innov Qual Outcomes. 2021; 5(6): 1109–1117.
- Figueroa JD, Gray E, Pashayan N, et al. Breast Screening Working Group (WG2) of the Covid-19 and Cancer Global Modelling Consortium. The impact of the Covid-19 pandemic on breast cancer early detection and screening. Prev Med. 2021; 151: 106585.
- Stefura T, Rymarowicz J, Wysocki M, et al. Surgical care in Poland after COVID-19 outbreak: a national survey. Folia Med Cracov. 2020; 60(3): 33–51.
- Mularczyk-Tomczewska P, Zarnowski A, Gujski M, et al. Barriers to accessing health services during the COVID-19 pandemic in Poland: A nationwide cross-sectional survey among 109,928 adults in Poland. Front Public Health. 2022; 10: 986996.
- Skovlund CW, Friis S, Christensen J, et al. Drop in cancer diagnosis during the COVID-19 pandemic in Denmark: assessment of impact during 2020. Acta Oncol. 2022; 61(5): 658–661.
- Johansson ALV, Larønningen S, Skovlund CW, et al. The impact of the COVID-19 pandemic on cancer diagnosis based on pathology notifications: A comparison across the Nordic countries during 2020. Int J Cancer. 2022; 151(3): 381–395.
- Zagar T, Tomsic S, Zadnik V, et al. Impact of the COVID-19 epidemic on cancer burden and cancer care in Slovenia: a follow-up study. Radiol Oncol. 2022; 56(4): 488–500.
- Pinkas J, Jankowski M, Szumowski Ł, et al. Public Health Interventions to Mitigate Early Spread of SARS-CoV-2 in Poland. Med Sci Monit. 2020; 26: e924730.
- Perry N, Broeders M, de Wolf C, et al. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition--summary document. Ann Oncol. 2008; 19(4): 614–622.
- Arbyn M, Anttila A, Jordan J, et al. European Guidelines for Quality Assurance in Cervical Cancer Screening. Second edition--summary document. Ann Oncol. 2010; 21(3): 448–458.
- Segnan N, Patnick J, Karsa Lv. Screening for Colorectal Cancer: European Guidelines. Ann Oncol. 2012; 23: ix53.
- Koczkodaj P, Kamiński MF, Ciuba A, et al. Cancer screening coverage in Poland - from bad to better to the worst during the SARS-CoV-2 pandemic. Arch Med Sci. 2021; 17(4): 1132–1133.
- Koczkodaj P, Sulkowska U, Kamiński M, et al. SARS-CoV-2 as a new possible long-lasting determining factor impacting cancer death numbers. Based on the example of breast, colorectal and cervical cancer in Poland. Nowotw. J Oncol. 2021; 71(1): 42–46.
- Dinmohamed AG, Cellamare M, Visser O, et al. The impact of the temporary suspension of national cancer screening programmes due to the COVID-19 epidemic on the diagnosis of breast and colorectal cancer in the Netherlands. J Hematol Oncol. 2020; 13(1): 147.
- Główny Urząd Statystyczny / Obszary tematyczne / Ludność. https://stat.gov.pl/obszary-tematyczne/ludnosc/ (March 2, 2023).
- Didkowska J, Wojciechowska U, Michalek IM, et al. Cancer incidence and mortality in Poland in 2019. Sci Rep. 2022; 12(1): 10875.
- Bray F, Ferlay J. Chapter 7: Age standardization. IARC Sci Publ. 2014; 164 Pt 1: 112–115.
- von Elm E, Altman DG, Egger M, et al. STROBE Initiative, Iniciativa STROBE, Iniciativa STROBE, STROBE Initiative, STROBE Initiative, STROBE Initiative, STROBE Initiative, STROBE Initiative, STROBE Initiative, STROBE Initiative, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007; 147(8): 573–577.
- Programy profilaktyczne / Dla Pacjenta / Narodowy Fundusz Zdrowia (NFZ) — finansujemy zdrowie Polaków. Nar Fundusz Zdrowia NFZ — Finans Zdr Polaków. https://www.nfz.gov.pl/dla-pacjenta/programy-profilaktyczne/ (July 4, 2023).
- Wojciechowska U. Cancer in Poland in 2020. Warsaw 2022. https://onkologia.org.pl/sites/default/files/publications/2023-01/nowotwory_2020.pdf (March 12, 2023).
- Peacock HM, Tambuyzer T, Verdoodt F, et al. Decline and incomplete recovery in cancer diagnoses during the COVID-19 pandemic in Belgium: a year-long, population-level analysis. ESMO Open. 2021; 6(4): 100197.
- Eijkelboom AH, de Munck L, Vrancken Peeters MJT, et al. NABON COVID-19 Consortium and the COVID and Cancer-NL Consortium. Impact of the COVID-19 pandemic on diagnosis, stage, and initial treatment of breast cancer in the Netherlands: a population-based study. J Hematol Oncol. 2021; 14(1): 64.
- Eijkelboom AH, de Munck L, Lobbes MBI, et al. NABON COVID-19 Consortium and the COVID and Cancer-NL Consortium. Impact of the suspension and restart of the Dutch breast cancer screening program on breast cancer incidence and stage during the COVID-19 pandemic. Prev Med. 2021; 151: 106602.
- Mazidimoradi A, Hadavandsiri F, Momenimovahed Z, et al. Impact of the COVID-19 Pandemic on Colorectal Cancer Diagnosis and Treatment: a Systematic Review. J Gastrointest Cancer. 2023; 54(1): 171–187.
- Morris EJA, Goldacre R, Spata E, et al. Impact of the COVID-19 pandemic on the detection and management of colorectal cancer in England: a population-based study. Lancet Gastroenterol Hepatol. 2021; 6(3): 199–208.
- Elek P, Csanádi M, Fadgyas-Freyler P, et al. Heterogeneous impact of the COVID-19 pandemic on lung, colorectal and breast cancer incidence in Hungary: results from time series and panel data models. BMJ Open. 2022; 12(8): e061941.
- Hijos-Mallada G, Alfaro E, Navarro M, et al. Impact of the COVID-19 pandemic in colorectal cancer diagnosis and presentation. Gastroenterol Hepatol. 2023; 46(9): 702–709.
- Luo Q, O'Connell DL, Yu XQ, et al. Cancer incidence and mortality in Australia from 2020 to 2044 and an exploratory analysis of the potential effect of treatment delays during the COVID-19 pandemic: a statistical modelling study. Lancet Public Health. 2022; 7(6): e537–e548.
- Dyzmann-Sroka A. Cancer in the region of Greater Poland, 2020. https://wco.pl/wrn/u/publications/nr-19-2020-wyd-2022-64900619167a7136651589.pdf?v5 (July 5, 2023).
- Tonneson JE, Hoskin TL, Day CN, et al. Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis, Presentation, and Patient Management. Ann Surg Oncol. 2022; 29(4): 2231–2239.
- Trojanowski M, Radomyski P, Matuszewski K, et al. Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis in a Regional Cancer Center in Poland between 2019 and 2021. J Pers Med. 2022; 12(9).
- Knoll K, Reiser E, Leitner K, et al. The impact of COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers: a tertiary center perspective. Arch Gynecol Obstet. 2022; 305(4): 945–953.
- Davies JM, Spencer A, Macdonald S, et al. Cervical cancer and COVID-an assessment of the initial effect of the pandemic and subsequent projection of impact for women in England: A cohort study. BJOG. 2022; 129(7): 1133–1139.
- Popescu A, Craina M, Pantea S, et al. COVID-19 Pandemic Effects on Cervical Cancer Diagnosis and Management: A Population-Based Study in Romania. Diagnostics (Basel). 2022; 12(4).
- Smolić Š, Fabijančić M, Blaževski N. How did fear of COVID-19 affect access to healthcare in Central and Eastern Europe? Findings from populations aged 50 or older after the outbreak. East Eur Econ. 2022; 61(5): 571–590.
- Ribes J, Pareja L, Sanz X, et al. Cancer diagnosis in Catalonia (Spain) after two years of COVID-19 pandemic: an incomplete recovery. ESMO Open. 2022; 7(3): 100486.
- Malicki J, Martenka P, Dyzmann-Sroka A, et al. Impact of COVID-19 on the performance of a radiation oncology department at a major comprehensive cancer centre in Poland during the first ten weeks of the epidemic. Rep Pract Oncol Radiother. 2020; 25(5): 820–827.
- Appel S, Lawrence YR, Symon Z, et al. COVID-RO study: the radiation oncology practice at times of COVID-19 outbreak - international survey. Rep Pract Oncol Radiother. 2021; 26(1): 20–28.