Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
Cancer Epidemiol Biomarkers Prev. 2024 Aug 1;33(8):1023-1027. doi: 10.1158/1055-9965.EPI-24-0121.
It is important to understand the impact of the COVID-19 pandemic on cancer death rates in 2020 in the US. We estimated whether there were larger-than-expected changes in cancer mortality rates from March to December 2020 after accounting for temporal and seasonal patterns using data from January 2011 to February 2020 by cancer type and age.
We obtained death counts and underlying causes of death by cancer type, month/year (2011-2020), and age group from the National Center for Health Statistics and population estimates from the US Census Bureau. Poisson regression was used to test for significant changes in cancer death rates from March to December 2020 compared with prior years.
After accounting for temporal trends and seasonal patterns, total cancer death rates were significantly lower than expected during March to December 2020 among 55- to 64-year-olds and ≥75-year-olds, but not in other age groups. Cancer death rates were 2% lower than expected from March to June among 55- to 64-year-olds and 2% to 3% lower from March to July and December among ≥75-year-olds. Among ≥75-year-olds, colorectal cancer death rates were lower from March to June [rate ratios (RR) = 0.94-0.96; P < 0.05]; however, lung cancer death rates were 5% lower across each month (all RRs = 0.95; P < 0.05).
In the US, cancer death rates based on the underlying cause of death were broadly similar to expected rates from March to December 2020. However, cancer death rates were lower than expected among 55- to 64-year-olds and ≥75-year-olds, likely due to COVID-19 as a competing cause of death.
Cancer mortality rates from 2020 should be interpreted with caution.
了解 2020 年美国 COVID-19 大流行对癌症死亡率的影响很重要。我们根据癌症类型和年龄,利用 2011 年 1 月至 2020 年 2 月的数据,在考虑时间和季节性模式的情况下,估计了 2020 年 3 月至 12 月癌症死亡率是否发生了超出预期的变化。
我们从国家卫生统计中心获取了按癌症类型、月份/年份(2011-2020 年)和年龄组划分的死亡人数和癌症死亡的根本原因,并从美国人口普查局获取了人口估计数据。我们使用泊松回归来检验 2020 年 3 月至 12 月与前几年相比癌症死亡率是否有显著变化。
在考虑时间趋势和季节性模式后,55-64 岁和≥75 岁人群 2020 年 3 月至 12 月的总癌症死亡率显著低于预期,但其他年龄组则不然。55-64 岁人群从 3 月至 6 月的癌症死亡率比预期低 2%,≥75 岁人群从 3 月至 7 月和 12 月的癌症死亡率比预期低 2%至 3%。≥75 岁人群中,3 月至 6 月结直肠癌死亡率较低(率比[RR]为 0.94-0.96;P<0.05);然而,肺癌死亡率在每个月都下降了 5%(所有 RR=0.95;P<0.05)。
在美国,基于根本死因的癌症死亡率与 2020 年 3 月至 12 月的预期死亡率大致相符。然而,55-64 岁和≥75 岁人群的癌症死亡率低于预期,这可能是由于 COVID-19 成为了另一个死亡原因。
2020 年的癌症死亡率数据应该谨慎解读。