The COVID-19 pandemic in England could result in at least 20% more deaths over the next 12 months in people newly diagnosed with cancer, according to a University College London study with DATA-CAN: The Health Data Research Hub for Cancer in the UK.
The new analysis, published as a preprint, is the first to focus on the impact of the pandemic on mortality rates in people with cancer.
The researchers reported multi-centre, weekly cancer diagnostic referrals and chemotherapy treatments until April 2020 in England and Northern Ireland and analysed population-based health records from 3,862,012 adults in England to estimate one-year mortality in 24 cancer sites and 15 non-cancer comorbidity clusters (40 conditions) recognised to be at high risk.
They estimated overall (direct and indirect) effects of the COVID-19 pandemic on mortality under different Relative Impact of the Emergency (RIE) and different Proportions of the population Affected by the Emergency (PAE).
Weekly data until April 2020 demonstrated significant falls in admissions for chemotherapy (45%-66% reduction) and urgent referrals for early cancer diagnosis (70%-89% reduction), compared to pre-COVID-19 levels.
The study estimates that during pre-COVID-19, about 31,354 newly diagnosed cancer patients would die within a year in England. Under conservative assumptions of the pandemic affecting only people with newly diagnosed cancer (incident cases) at COVID-19 PAE of 40 per cent, and an RIE of 1.5, the model estimated 6270 excess deaths at one year in England. This number could rise to an estimated 17,915 additional deaths if all people currently living with cancer are considered.
In England, the proportion of patients with incident cancer with ≥1 comorbidity was 65.2 per cent. The number of comorbidities was strongly associated with cancer mortality risk. Across a range of model assumptions, and across incident and prevalent cancer cases, 78 per cent of excess deaths occur in cancer patients with ≥1 comorbidity.
