PURPOSE: The COVID-19 pandemic profoundly affected healthcare systems and patients. There is a need to comprehend the collateral effects of the pandemic on non-communicable diseases. We examined the impact of the pandemic on short-term survival for common solid tumours, including breast, colorectal, head and neck, liver, lung, oesophageal, pancreatic, prostate, and stomach cancer in the UK. METHODS: This was a population-based cohort study of electronic health records from the UK primary care Clinical Practice Research Datalink GOLD database. In sum, 12,259,744 eligible patients aged ≥18 years with ≥1 year's history identified from January 2000 to December 2022 were included. We estimated age-standardised incidence and short-term (one- and two-year) survival for several common cancers from 2000 to 2019 (in five-year strata) and compared these to 2020-2022 using the Kaplan-Meier method. RESULTS: Incidence decreased for most cancers in 2020 and recovered to different extents in 2021-2022. Short-term survival improved for most cancers between 2000 and 2019, but then declined, albeit minimally, for those diagnosed in 2020-2022. This was most pronounced for colorectal cancer, with one-year survival falling from 78.8% (95% CI 78%-79.6%) in 2015-2019 to 77% (95% CI 75.6-78.3%) for those diagnosed in 2020-2022. CONCLUSION: Short-term survival for many cancers was impacted, albeit minimally, by the pandemic in the UK, with reductions in survivorship from colorectal cancer equivalent to returning to the mortality seen in the first decade of the 2000s. While data on longer-term survival are needed to fully comprehend the impact of COVID-19 on cancer care, our findings illustrate the need for an urgent and substantial commitment from the UK National Health Service to address the existing backlog in cancer screening and diagnostic procedures to improve cancer care and mortality.

1st Department of Tuberculosis and Respiratory Diseases 1st Faculty of Medicine Charles University Prague Czech Republic

Centre for Statistics in Medicine Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford Oxford United Kingdom

Centre for Surgical Science Department of Surgery Zealand University Hospital Koege Denmark

Department of Medical Informatics Erasmus University Medical Centre Rotterdam the Netherlands

Gastroenterology Department Hospital de la Santa Creu 1 Sant Pau Universitat Autònoma de Barcelona Sant Quintí Barcelona Spain

Head Neck Tumors Unit Hospital Clínic de Barcelona Universitat de Barcelona Barcelona Spain

Institut Català d'Oncologia Hospital Universitari Dr Josep Trueta Girona Spain

Odysseus Data Services Cambridge MA USA

Otorrinolaringology department Hospital Joan XXIII de Tarragona Tarragona Spain

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Machii R, Takahashi H. Japanese cancer screening programs during the COVID-19 pandemic: changes in participation between 2017-2020. Cancer Epidemiol. 2023;82:102313. doi:10.1016/j.canep.2022.102313 PubMed DOI PMC

Alkatout I, Biebl M, Momenimovahed Z, et al. Has COVID-19 affected cancer screening programs? A systematic review. Front Oncol. 2021;11:675038. doi:10.3389/fonc.2021.675038 PubMed DOI PMC

Barclay NL, Pineda-Moncusí M, Jödicke AM, et al. 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. MedRxiv. 2023. doi:10.1101/2023.07.21.23292937 PubMed DOI PMC

Cancer Research UK. Cancer mortality statistics. Available from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/mortality#heading-Zero. Accessed September 28, 2023.

Rashid T, Bennett JE, Muller DC, et al. Mortality from leading cancers in districts of England from 2002 to 2019: a population-based, spatiotemporal study. Lancet Oncol. 2023;25:86–98. doi:10.1016/S1470-2045(23)00530-2 PubMed DOI PMC

Arnold M, Rutherford MJ, Bardot A, et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995-2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol. 2019;20(11):1493–1505. doi:10.1016/S1470-2045(19)30456-5 PubMed DOI PMC

Alderwick H. Is the NHS overwhelmed? BMJ. 2022;376:051. doi:10.1136/bmj.o51 PubMed DOI

Carr A, Smith JA, Camaradou J, Prieto-Alhambra D. Growing backlog of planned surgery due to covid-19. BMJ. 2021;2021:372. PubMed

McLellan A, Abbasi K. The NHS is not living with covid, it’s dying from it. BMJ. 2022;2022:378. PubMed

Maringe C, Spicer J, Morris M, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023–1034. doi:10.1016/S1470-2045(20)30388-0 PubMed DOI PMC

Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin. 2021;71(3):209–249. doi:10.3322/caac.21660 PubMed DOI

Herrett E, Gallagher AM, Bhaskaran K, et al. Data resource profile: clinical practice research Datalink (CPRD). Int J Epidemiol. 2015;44(3):827–836. doi:10.1093/ije/dyv098 PubMed DOI PMC

Voss EA, Makadia R, Matcho A, et al. Feasibility and utility of applications of the common data model to multiple, disparate observational health databases. J Am Med Inform Assoc. 2015;22(3):553–564. doi:10.1093/jamia/ocu023 PubMed DOI PMC

Gilbert J, Rao G, Schuemie M, Ryan P, Weaver J. CohortDiagnostics: diagnostics for OHDSI Cohorts. Available from: https://ohdsi.github.io/CohortDiagnostics. Accessed 2, August 2023.

Gallagher AM, Dedman D, Padmanabhan S, Leufkens HG, de Vries F. The accuracy of date of death recording in the clinical practice research Datalink GOLD database in England compared with the office for national statistics death registrations. Pharmacoepidemiol Drug Saf. 2019;28(5):563–569. doi:10.1002/pds.4747 PubMed DOI PMC

Eurostat Taskforce. Revision of the European Standard Population - Report of Eurostat’s task force. Available from: https://ec.europa.eu/eurostat/web/products-manuals-and-guidelines/-/ks-ra-13-028. Accessed August 2, 2023.

Mazidimoradi A, Hadavandsiri F, Momenimovahed Z, Salehiniya H. Impact of the COVID-19 pandemic on colorectal cancer diagnosis and treatment: a systematic review. J Gastrointest Can. 2021;2021:1–17. PubMed PMC

Cancer Research UK. Cancer incidence for all cancers combined. Available from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence/all-cancers-combined. Accessed August 9, 2023.

Strongman H, Williams R, Bhaskaran K. What are the implications of using individual and combined sources of routinely collected data to identify and characterise incident site-specific cancers? A concordance and validation study using linked English electronic health records data. BMJ open. 2020;10(8):e037719. doi:10.1136/bmjopen-2020-037719 PubMed DOI PMC

Maddams J, Utley M, Moller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer. 2012;107(7):1195–1202. doi:10.1038/bjc.2012.366 PubMed DOI PMC

Bennett R, Blanks R, Moss S. Evaluation of extension of breast screening to women aged 65–70 in England using screening performance measures. Br J Cancer. 2009;100(7):1043–1047. doi:10.1038/sj.bjc.6604981 PubMed DOI PMC

Mora N, Guiriguet C, Cantenys R, et al. Cancer diagnosis in primary care after second pandemic year in Catalonia: a time-series analysis of primary care electronic health records covering about 5 million people. Family Practice. 2023;40(1):183–187. doi:10.1093/fampra/cmac083 PubMed DOI PMC

Skovlund CW, Friis S, Dehlendorff C, Nilbert MC, Mørch LS. Hidden morbidities: drop in cancer diagnoses during the COVID-19 pandemic in Denmark. Acta oncologica. 2021;60(1):20–23. doi:10.1080/0284186X.2020.1858235 PubMed DOI

Nindenshuti PM, Caire-Juvera G. Changes in diet, physical activity, alcohol consumption, and tobacco use in adults during the COVID-19 pandemic: a systematic review. Inquiry. 2023;60:00469580231175780. doi:10.1177/00469580231175780 PubMed DOI PMC

Pandey V, Mohan R, Kumar A, Gangadevi P, Kurien N. The impact of the COVID-19 outbreak on lifestyle-related behavior among the general population. Cureus. 2023;15(9):e45756. doi:10.7759/cureus.45756 PubMed DOI PMC

Concepcion J, Yeager M, Alfaro S, et al. Trends of cancer screenings, diagnoses, and mortalities during the COVID-19 pandemic: implications and future recommendations. Am Surg. 2022;14:31348221091948. doi:10.1177/00031348221091948 PubMed DOI PMC

Trends in incidence, prevalence, and survival of breast cancer in the United Kingdom from 2000 to 2021