Study: Cancer database cases drop 14% in first year of pandemic, showing 200,000 ‘missing cases’

Newly reported cases of cancer diagnosis in 2020 fell by 14.4% compared to the previous year, according to researchers. This correlates with the timing of stay-at-home orders in the early months of the COVID-19 pandemic.

a study, based on cases of new cancer diagnoses reported to the National Cancer Database (NCDB), approximately 200,000 cancer cases were diagnosed or treated at a Cancer Board-accredited facility at the start of the 2020 pandemic. I’m assuming it wasn’t. The amount of time triage guidelines recommend deferring cancer-related care.

According to the study’s lead author, analyzes show an overall trend of cancer cases declining in March 2020 and reaching extreme lows in April before partially recovering in the middle of the year. However, there was no recovery of backlog cases or a return to the case levels seen in previous years.

Figure 1: This comparison shows the observed number of cases entered into the NCDB in 2020 and the projected number of cases based on earlier data.

“Our findings reveal what we were all concerned about: many cancer cases did not occur early in the pandemic and did not catch up during the first year. So, these “missing cases” are out there somewhere. Sharon Lam, MD, MBA, Chair of Health Surgery, Loma Linda University, and Principal Investigator of the study. “Our concern is that these patients may present later and may be in a more advanced stage of the disease.”

The study was published today in the Journal of the American Medical Association Surgery. The authors hope their findings will be helpful to those who use NCBD data to conduct research, quality reports, and process improvement projects.

Lam said the researchers wanted to warn people using the 2020 NCBD data that all reports would change in some way from the confusion of reported cases.

A joint project of the Cancer Board of the American College of Surgeons and the American Cancer Society, NCDB is one of the world’s largest cancer registries, accounting for more than 70% of all cancer cases in the United States. About 1,500 programs accredited by the Cancer Board, including Loma Linda University Health, are leveraging NCBD data to improve the quality of cancer care in the United States, he said. She previously served as Vice Chair of the Cancer Board’s Quality Integration Committee.

Since 1989, NCDB data has historically proven to be reliably stable, says Lum. However, “the COVID-19 pandemic has destabilized the normal pattern of cancer care,” the study authors wrote.

Lam and researchers from academic and medical institutions across the country examined all cancer cases added to the NCDB in the years leading up to the pandemic and reported in 2020 compared to 2018 and 2019 We analyzed the differences between the cases identified. In 2020, he found that cancer cases recorded in the NCDB correlated with the timing of stay-at-home orders and triage guidelines recommending deliberate delays in cancer-related care.

Figure 2: These comparisons show the observed number of cases entered into the NCDB in 2020 and the expected number of cases based on the previous year’s data for stage I and stage IV disease, respectively.

In addition, Lam said researchers observed fewer early-stage disease early in the pandemic than expected, while at the same time observing more late-stage disease cases than expected.

The researchers didn’t identify overall patterns in patient demographics to explain various differences between observed and expected rates of reported cancer cases, Lum says.

“The differences between expected and observed cases did not occur in the same way across all cancer sites,” says Lum. There was a high level of variability between them.”

The study’s findings provide a month-by-month breakdown of NCDB’s 2020 trends in reported cases, Lum says. Monthly analysis is not available out-of-the-box for NCDB users and provides valuable insight into the progress details for the year. The findings suggest that her NCDB users engaged in cancer care quality reporting, process improvement, or research should cautiously interpret disease- and program-specific results in 2020 and beyond to avoid a disrupted pandemic. I am asking you to explain the data for the year . The study authors recommend that users conduct their own validation studies before incorporating her 2020 data and use disclaimer language in publications that use her 2020 NCDB data. increase.

“We are warning the cancer community to look closely at their institutional data to see how what happened in 2020 may have affected the appearance of their report. “Users of the database should consider what activities occurred in their local and organizational settings during the first year of the pandemic.”

Lum said the downstream impact of the 2020 data set, such as its impact on long-term survival reports, is not yet understood. The Cancer Board will follow his NCDB cohort in 2020 and conduct similar efficacy studies using subsequent data cohorts in 2021 and his 2022. Future studies can also assess COVID-19 infection-related associations, treatment adherence and outcomes, and long-term follow-up. He was 14.4% of his 14.4% of cancer diagnoses that were not treated as expected in Cancer Diagnostic Board-accredited cancer programs.

For more information on research at LLU, please visit: researchaffairs.llu.edu or call 909-558-8544. visit lluh.org/cancer-center To learn more about the treatments offered at Loma Linda University Cancer Center, or call us. 1-800-782-2623 Make a plan.