NEW YORK — During the early years of the COVID-19 pandemic, experts worried that disruptions to cancer diagnosis and treatment would cost lives. A new study suggests they were right.
The federally funded study published Thursday by the medical journal JAMA Oncology is called the first to assess the effects of pandemic-related disruptions on the short-term survival of cancer patients.
Researchers found that people diagnosed with cancer in 2020 and 2021 had worse short-term survival than those diagnosed between 2015 and 2019. That was true across a range of cancers, and whether they were diagnosed at a late stage or early stage.
Of course, COVID-19 itself was especially dangerous to patients already weakened by cancer. The researchers worked to filter out deaths mainly attributed to COVID-19, so they could see if other factors played a role.
The researchers were not able to definitively show what drove worse survival, said Todd Burus of the University of Kentucky, the study's lead author.
"But disruptions to the health care system were probably a key contributor," said Burus, who specializes in medical data analysis.
A radiologist uses a magnifying glass to check mammograms for breast cancer in Los Angeles.
COVID-19 forced many people to postpone cancer screenings — colonoscopies, mammograms and lung scans — as the coronavirus overwhelmed doctors and hospitals, especially in 2020.
Earlier research showed that overall cancer death rates in the U.S. continued to decline throughout the pandemic, and there weren't huge shifts in late diagnoses.
Recinda Sherman, a researcher on that earlier paper, applauded the new work.
"As this study is the first to document pandemic-related, cause-specific survival, I think it is important," said Sherman, of the North American Association of Central Cancer Registries. "The more we understand about the impact of COVID-19, the better we will be able to prepare for the next one."
How could overall cancer death rates decline in 2020 and 2021, while short-term survival worsened for newly diagnosed patients?
Cancer prevention, diagnosis and treatment measures that for years pushed cancer death rates down did not suddenly disappear during the pandemic, Burus noted.
"We didn't forget how to do those things," he said. "But disruptions could have changed access, could have changed how quickly people were getting treated."
As France 24 marks World Cancer Day, François Picard welcomes Lars Henning Milman Engelholm, Associate Professor and Group Leader at the Finsen Laboratory at the University of Copenhagen. From his lab in Copenhagen, Professor Engelholm describes a seismic shift underway in pancreatic cancer research, the result of a decade-long commitment to the steady evolution of translational science. At the heart of this shift are antibody-drug conjugates (ADCs): highly targeted therapies designed to reach what conventional treatments cannot.
Further research will show if effects were lasting, said Hyuna Sung, senior principal scientist and cancer epidemiologist at the American Cancer Society. "Transient declines in survival that quickly recover may have little impact on long-term mortality trends," she said.
The new study tapped national cancer registry data to focus more specifically on patients who had a first diagnosis of a malignant cancer in 2020 and 2021. More than 1 million people were diagnosed with cancer in those two years, and about 144,000 died within one year, according to the researchers' data.
The researchers looked at one-year survival rates for those patients, checking for what stage they were at the time of diagnosis.
They calculated that one-year survival was lower for both early and late-stage diagnoses for all cancer sites combined. Most worrisome were large differences seen in colorectal, prostate and pancreatic cancers, they said.
Overall, the researchers found that more than 96% of people who got an early stage cancer diagnosis in 2020 and 2021 — and more than 74% of those with a late-stage diagnosis — survived more than a year. Those rates were slightly lower than would have been expected based on 2015-2019 trends, resulting in about 17,400 more deaths than expected.
6 changes that will help you stay healthy as you age
1. Embrace avocados.
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Avocados are nutrient powerhouses chock-full of monounsaturated fatty -acids that support heart health and benefit cholesterol levels. Avocados are also high in fiber and provide a suite of vitamins and minerals, including potassium and magnesium. Add avocado to salads and sandwiches or puree with a little vinegar, garlic and herbs to make a creamy dressing. You can even include avocados in dessert such as chocolate pudding.
2. Opt for plant protein several times a week.
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Plant-based eating patterns are associated with a host of health benefits, including a lower risk of heart disease, hypertension, Type 2 diabetes and obesity. That's precisely why pulses (the umbrella term for beans, lentils, peas and chickpeas) are an excellent replacement for meat: they're a good source of protein, high in fiber and incredibly nutrient-rich. You can replace 3 to 4 ounces of meat with 1/2 to 1 cup of pulses in dishes like chili, stir-fries, burgers and meatballs.
3. Make nuts a go-to snack.
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Nuts are a near-perfect snack, rich in unsaturated fats, protein, fiber, vitamins, minerals and a variety of compounds that have anti-oxidant and anti-inflammatory effects. Eating a variety of nuts can support healthy cholesterol and blood pressure levels and help people maintain a healthy weight. And don't forget peanuts: although technically a legume, they are also packed with nutrients. Raw or roasted unsalted nuts are best. Aim for 1/4 cup out of the shell (about the size of a golf ball) or 2 tablespoons of nut butter per snack.
4. Incorporate veggies into every meal.
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Eating more vegetables may be the single most important dietary change you can make, as eating 7 to 10 servings per day of fruits and vegetables is tied to a significantly lower risk of heart disease and stroke and a slightly lower risk of cancer. A simple way to hit the mark is to include veggies in every meal and snack—even breakfast. And don't discount frozen vegetables!
5. Enjoy berries as a daily staple.
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Berries are full of antioxidants known to combat inflammation and protect against cell damage that leads to a number of diseases, including cancer, heart disease and neuro-degenerative disorders. They are also high in fiber and are great sources of vitamin C and potassium. Of particular interest is their role in brain health: a 20-year-long study of more than 16,000 older adults found that those who ate the most blueberries and strawberries experienced the slowest rates of cognitive decline. Aim for 1 cup of berries a day, and consider frozen too!
6. Go ahead, enjoy some dark chocolate!
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There are plenty of reasons to have a bit of dark chocolate as a daily ritual. Magnesium, which is found in dark chocolate, is tied to better sleep quality in women and a reduced risk of depression. Raw cocoa powder (aka non-Dutched, nonalkalized or natural) is another way to take advantage of chocolate's powerful benefits.
(EatingWell is a magazine and website devoted to healthy eating as a way of life. Online at www.eatingwell.com.)
