Pediatric and Young Adult Cancer Incidence in the United States During the COVID-19 Pandemic

Cancer incidence decreased during the COVID-19 pandemic; this study describes cancer incidence changes for children, adolescents, and young adults during this period. We used US Cancer Statistics (USCS) to describe potential impacts of the pandemic on cancer incidence for persons 0-39 years.

We used data from USCS, covering 98% of the US population, to evaluate cancer case counts, incidence rates, and monthly counts; incidence rate ratios were calculated comparing year 2019 (baseline) to 2020 and 2021. We calculated trends using joinpoint regression for the period 2003-2021.

Comparing 2019 with 2020, cancer incidence decreased 5% (95% confidence interval [CI], 3%-7%) for ages 0-19 years and 7% (95% CI, 6%-8%) for ages 20-39. For ages 0-19, decreases were seen for thyroid cancer, melanoma, and nonmalignant central nervous system (CNS) neoplasms. For ages 20-39, decreases were seen for leukemias, lymphomas, CNS neoplasms, sarcomas, melanoma, and some carcinoma types. Decreases in 2020 were least pronounced for the distant stage at diagnosis. For ages 0-39, new diagnoses were lowest during March or April 2020 but returned to prepandemic levels during the second half of 2020. Decreases in 2021 were consistent with previously decreasing trends for many cancer types.

Cancer rate decreases were largest for young adults (vs. children) and were significant for some cancer types. These findings might help assess the impacts of the COVID-19 pandemic, inform investigations into potential causes of these decreases, and guide responses to future public health crises.