Minimal Impact of COVID-19 on One-Year Mortality on US Patients with Cancer Diagnosed Early during the Pandemic

Patients with cancer diagnosed early in the COVID-19 pandemic may have been particularly vulnerable due to immunosuppression caused by their cancer. The objective was to assess cause of death due to COVID-19, cancer, and other causes among patients with cancer during the pandemic. We thus examined causes of death (cancer, COVID-19, other causes) among patients with cancer diagnosed in 2020 (N = 503,128) compared with 2018 (N = 537,006) in the Surveillance, Epidemiology, and End Results-22. We focused on 1-year cause-specific mortality by cancer type, stage, and age at diagnosis. In a counterfactual analysis, we estimated the number and proportions of patients with cancer dying of cancer or other competing causes if COVID-19 were eliminated as a possible cause of death. Among 2020 patients with cancer, 15.8% died of cancer, 3.3% from other causes, and 0.7% from COVID-19. Among those who died, COVID-19 mortality was 9%, 7.6%, 2.8%, 2.8%, and 1.2% of all deaths for prostate, breast, colorectal, lung, and pancreatic cancers, respectively. In a counterfactual analysis assuming that COVID-19 had not occurred, similar percentages would have died of cancer or other causes, except for lung and pancreatic cancers. In summary, cancer was the leading cause of death in 2020, but COVID-19 did not have a large influence on competing-cause mortality. These findings inform healthcare strategies to mitigate excess mortality among patients with cancer during future healthcare disruptions.

These findings show that, among patients with cancer, cancer remains a leading cause of death during the COVID-19 pandemic. These results underscore the importance of cancer care even amid other public health emergencies.