• Emily Heer, Yibing Ruan, Devon J Boyne, Tamer N Jarada, Daniel Heng, Jan-Willem Henning, Donald M Morris, Dylan E O'Sullivan, Winson Y Cheung, and Darren R Brenner.
• Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta.
• CMAJ. 2023 Jun 12; 195 (23): E804E812E804-E812.

BackgroundThe COVID-19 pandemic is suspected to have affected cancer care and outcomes among patients in Canada. In this study, we evaluated the impact of the state of emergency period during the COVID-19 pandemic (Mar. 17 to June 15, 2020) on cancer diagnoses, stage at diagnosis and 1-year survival in Alberta.MethodsWe included new diagnoses of the 10 most prevalent cancer types from Jan. 1, 2018, to Dec. 31, 2020. We followed patients up to Dec. 31, 2021. We used interrupted time series analysis to examine the impact of the first COVID-19-related state of emergency in Alberta on the number of cancer diagnoses. We used multivariable Cox regression to compare 1-year survival of the patients who received a diagnosis during 2020 after the state of emergency with those who received a diagnosis during 2018 and 2019. We also performed stage-specific analyses.ResultsWe observed significant reductions in diagnoses of breast cancer (incidence rate ratio [IRR] 0.67, 95% confidence interval [CI] 0.59-0.76), prostate cancer (IRR 0.64, 95% CI 0.56-0.73) and colorectal cancer (IRR 0.64, 95% CI 0.56- 0.74) and melanoma (IRR 0.57, 95% CI 0.47-0.69) during the state of emergency period compared with the period before it. These decreases largely occurred among early-stage rather than late-stage diagnoses. Patients who received a diagnosis of colorectal cancer, non-Hodgkin lymphoma and uterine cancer in 2020 had lower 1-year survival than those diagnosed in 2018; no other cancer sites had lower survival.InterpretationThe results from our analyses suggest that health care disruptions during the COVID-19 pandemic in Alberta considerably affected cancer outcomes. Given that the largest impact was observed among early-stage cancers and those with organized screening programs, additional system capacity may be needed to mitigate future impact.© 2023 CMA Impact Inc. or its licensors.

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