COVID-19 pandemic shifted epidemiology for cancer screening sites: breast, cervix, colon, and rectum.

Abstract

Background: This study aimed to assess the epidemiological changes in breast, cervical, colon, and rectal cancers in Kazakhstan before and during COVID-19, including early-onset cancer (EOC) diagnosed between the ages of 20 and 49, using data from the oncological service of the Republic of Kazakhstan for the 2017-2022 period.

Methods: The cohort comprised patients aged 20 to 49 years (EOC) and 50 years and older [late-onset cancer (LOC)] from the total number of patients diagnosed each year during the study period of 2017 to 2022 for breast, cervical, colon, or rectal cancer. In order to indicate a difference in one-time intervals and characterize the global trend over the entire study period, annual percentage change (APC) and average APC (AAPC) were calculated, respectively.

Results: Breast cancer detection rates increased by 22.8% for EOC and 15.9% for LOC from 2017 to 2022, and AAPC increased by 4.3% for EOC and 3.6% for LOC. During the COVID-19 restriction period, breast cancer detection rates decreased by 6.1% for EOC and 15.6% for LOC. Cervical cancer detection rates increased by 2.3% for EOC and 7.5% for LOC from 2017 to 2022, and AAPC increased by 0.9% for EOC and 1.6% for LOC. During the COVID-19 restriction period, cervical cancer detection rates decreased by 11.3% for EOC and 3.1% for LOC. Colon cancer detection rates increased by 18.4% for EOC and 14.3% for LOC from 2017 to 2022, and AAPC increased by 3.7% for EOC and 2.9% for LOC. During the COVID-19 restriction period, colon cancer detection rates decreased by 14.4% for EOC and 5.8% for LOC. Rectal cancer detection rates increased by 13.6% for EOC and 19.2% for LOC from 2017 to 2022, and AAPC increased by 3.0% for EOC and by 3.9% for LOC. During the COVID-19 restriction period, rectal cancer detection rates increased by 18.6% for EOC and decreased by 12.0% for LOC.

Conclusion: The epidemiological indicators of population cancer screening worsened during the COVID pandemic; the detection rate decreased by 6.1% for breast EOC and 11.3% for cervical EOC, while there was an increase by 38.0% in EOC for colon cancer in men and by 8.0% in EOC for rectal cancer in men and 31.1% in women.