Using newly released cancer surveillance data, researchers at the American Cancer Society (ACS) found decreases in cancer diagnoses and proportion of early-stage diagnoses continued in 2021 in the United States during the second year of the COVID-19 pandemic. The proportion of late-stage diagnoses was lower in 2021 than in 2020, but has not returned to pre-pandemic levels.

The findings [were] presented at the annual American Society of Clinical Oncology (ASCO) Quality Care Symposium in San Francisco, September 27–28, 2024.

In the study, led by Nova Yang, associate scientist, health services research at the American Cancer Society, scientists reviewed the latest data from the National Cancer Database of adults aged 18 years and older who were newly diagnosed with first primary malignant cancers between 2019 and 2021 from 50 states and the District of Colombia. They calculated monthly cases, stage distribution, and adjusted odds ratios of stage I versus stage II-IV cancer and Stage IV versus Stage I–III cancer diagnoses in 2021 compared with 2019, controlling for sociodemographic and clinical factors and stratified by cancer type.

Researchers identified 864,430 individuals diagnosed in 2019, 780,478 diagnosed in 2020, and 819,791 diagnosed in 2021. The proportion of diagnoses at Stage I decreased from 39.6% in 2019 to 31.1% in April 2020 and was 39.2% overall in 2021. The decrease in Stage I diagnoses was mirrored by an increase in Stage IV diagnoses. The pattern was most prominent for female breast, lung, colorectal, and prostate cancers, and melanoma.

Overall, compared to 2019, researchers found a 5.98% decrease in Stage I diagnoses and a 4.55% decrease in Stage IV diagnoses in 2021. Lower odds of diagnosis at Stage I were most prominent among individuals who were male, aged 18 to 44, Hispanic, from the Mid-Atlantic region, and for the cancers of melanoma, non-Hodgkin lymphoma, prostate, esophagus, and cervical cancer. Higher odds of diagnosis at Stage IV in 2021 vs. 2019 were most prominent among individuals who were Hispanic and diagnosed with cancers of the prostate, thyroid, liver, esophagus, and cervix.

Researchers emphasize that the COVID-19 pandemic exacerbated existing disparities in health outcomes throughout the U.S. and stress continuous efforts to improve timely diagnosis and early detection of cancer are needed.

This news release was published by the American Cancer Society on September 23, 2024.