The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study
IntroductionThe COVID-19 pandemic had collateral effects on many health systems. Cancer screening and diagnostic tests were postponed, resulting in delays in diagnosis and treatment. This study assessed the impact of the pandemic on screening, diagnostics and incidence of breast, colorectal, lung, a...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-03-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1370862/full |
| _version_ | 1827307854283931648 |
|---|---|
| author | Nicola L. Barclay Marta Pineda Moncusí Annika M. Jödicke Daniel Prieto-Alhambra Daniel Prieto-Alhambra Berta Raventós Danielle Newby Antonella Delmestri Wai Yi Man Xihang Chen Marti Català |
| author_facet | Nicola L. Barclay Marta Pineda Moncusí Annika M. Jödicke Daniel Prieto-Alhambra Daniel Prieto-Alhambra Berta Raventós Danielle Newby Antonella Delmestri Wai Yi Man Xihang Chen Marti Català |
| author_sort | Nicola L. Barclay |
| collection | DOAJ |
| description | IntroductionThe COVID-19 pandemic had collateral effects on many health systems. Cancer screening and diagnostic tests were postponed, resulting in delays in diagnosis and treatment. This study assessed the impact of the pandemic on screening, diagnostics and incidence of breast, colorectal, lung, and prostate cancer; and whether rates returned to pre-pandemic levels by December, 2021.MethodsThis is a cohort study of electronic health records from the United Kingdom (UK) primary care Clinical Practice Research Datalink (CPRD) GOLD database. The study included individuals registered with CPRD GOLD between January, 2017 and December, 2021, with at least 365 days of clinical history. The study focused on screening, diagnostic tests, referrals and diagnoses of first-ever breast, colorectal, lung, and prostate cancer. Incidence rates (IR) were stratified by age, sex, and region, and incidence rate ratios (IRR) were calculated to compare rates during and after lockdown with rates before lockdown. Forecasted rates were estimated using negative binomial regression models.ResultsAmong 5,191,650 eligible participants, the first lockdown resulted in reduced screening and diagnostic tests for all cancers, which remained dramatically reduced across the whole observation period for almost all tests investigated. There were significant IRR reductions in breast (0.69 [95% CI: 0.63-0.74]), colorectal (0.74 [95% CI: 0.67-0.81]), and prostate (0.71 [95% CI: 0.66-0.78]) cancer diagnoses. IRR reductions for lung cancer were non-significant (0.92 [95% CI: 0.84-1.01]). Extrapolating to the entire UK population, an estimated 18,000 breast, 13,000 colorectal, 10,000 lung, and 21,000 prostate cancer diagnoses were missed from March, 2020 to December, 2021.DiscussionThe UK COVID-19 lockdown had a substantial impact on cancer screening, diagnostic tests, referrals, and diagnoses. Incidence rates remained significantly lower than pre-pandemic levels for breast and prostate cancers and associated tests by December, 2021. Delays in diagnosis are likely to have adverse consequences on cancer stage, treatment initiation, mortality rates, and years of life lost. Urgent strategies are needed to identify undiagnosed cases and address the long-term implications of delayed diagnoses. |
| first_indexed | 2024-04-24T18:46:30Z |
| format | Article |
| id | doaj.art-9a8ec2f8dd9049b2af82ecf5c71fee58 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-24T18:46:30Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-9a8ec2f8dd9049b2af82ecf5c71fee582024-03-27T05:11:28ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-03-011410.3389/fonc.2024.13708621370862The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort studyNicola L. Barclay0Marta Pineda Moncusí1Annika M. Jödicke2Daniel Prieto-Alhambra3Daniel Prieto-Alhambra4Berta Raventós5Danielle Newby6Antonella Delmestri7Wai Yi Man8Xihang Chen9Marti Català10Pharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomPharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomPharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomPharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomDepartment of Medical Informatics, Erasmus Medical Center University, Rotterdam, NetherlandsFundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, SpainPharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomPharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomPharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomPharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomPharmaco− and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United KingdomIntroductionThe COVID-19 pandemic had collateral effects on many health systems. Cancer screening and diagnostic tests were postponed, resulting in delays in diagnosis and treatment. This study assessed the impact of the pandemic on screening, diagnostics and incidence of breast, colorectal, lung, and prostate cancer; and whether rates returned to pre-pandemic levels by December, 2021.MethodsThis is a cohort study of electronic health records from the United Kingdom (UK) primary care Clinical Practice Research Datalink (CPRD) GOLD database. The study included individuals registered with CPRD GOLD between January, 2017 and December, 2021, with at least 365 days of clinical history. The study focused on screening, diagnostic tests, referrals and diagnoses of first-ever breast, colorectal, lung, and prostate cancer. Incidence rates (IR) were stratified by age, sex, and region, and incidence rate ratios (IRR) were calculated to compare rates during and after lockdown with rates before lockdown. Forecasted rates were estimated using negative binomial regression models.ResultsAmong 5,191,650 eligible participants, the first lockdown resulted in reduced screening and diagnostic tests for all cancers, which remained dramatically reduced across the whole observation period for almost all tests investigated. There were significant IRR reductions in breast (0.69 [95% CI: 0.63-0.74]), colorectal (0.74 [95% CI: 0.67-0.81]), and prostate (0.71 [95% CI: 0.66-0.78]) cancer diagnoses. IRR reductions for lung cancer were non-significant (0.92 [95% CI: 0.84-1.01]). Extrapolating to the entire UK population, an estimated 18,000 breast, 13,000 colorectal, 10,000 lung, and 21,000 prostate cancer diagnoses were missed from March, 2020 to December, 2021.DiscussionThe UK COVID-19 lockdown had a substantial impact on cancer screening, diagnostic tests, referrals, and diagnoses. Incidence rates remained significantly lower than pre-pandemic levels for breast and prostate cancers and associated tests by December, 2021. Delays in diagnosis are likely to have adverse consequences on cancer stage, treatment initiation, mortality rates, and years of life lost. Urgent strategies are needed to identify undiagnosed cases and address the long-term implications of delayed diagnoses.https://www.frontiersin.org/articles/10.3389/fonc.2024.1370862/fullbreast cancercolorectal cancerlung cancerprostate cancerCOVID-19pandemic |
| spellingShingle | Nicola L. Barclay Marta Pineda Moncusí Annika M. Jödicke Daniel Prieto-Alhambra Daniel Prieto-Alhambra Berta Raventós Danielle Newby Antonella Delmestri Wai Yi Man Xihang Chen Marti Català The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study Frontiers in Oncology breast cancer colorectal cancer lung cancer prostate cancer COVID-19 pandemic |
| title | The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study |
| title_full | The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study |
| title_fullStr | The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study |
| title_full_unstemmed | The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study |
| title_short | The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study |
| title_sort | impact of the uk covid 19 lockdown on the screening diagnostics and incidence of breast colorectal lung and prostate cancer in the uk a population based cohort study |
| topic | breast cancer colorectal cancer lung cancer prostate cancer COVID-19 pandemic |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1370862/full |
| work_keys_str_mv | AT nicolalbarclay theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT martapinedamoncusi theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT annikamjodicke theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT danielprietoalhambra theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT danielprietoalhambra theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT bertaraventos theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT daniellenewby theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT antonelladelmestri theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT waiyiman theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT xihangchen theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT marticatala theimpactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT nicolalbarclay impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT martapinedamoncusi impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT annikamjodicke impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT danielprietoalhambra impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT danielprietoalhambra impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT bertaraventos impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT daniellenewby impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT antonelladelmestri impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT waiyiman impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT xihangchen impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy AT marticatala impactoftheukcovid19lockdownonthescreeningdiagnosticsandincidenceofbreastcolorectallungandprostatecancerintheukapopulationbasedcohortstudy |