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Changes in the Number of US Patients With Newly Identified Cancer Before and During the Coronavirus Disease 2019 (COVID-19) Pandemic

Educational Objective
To understand the changes in number of US Patients With Newly Identified Cancer Before and During COVID-19

In response to the coronavirus disease (COVID-19) pandemic, the American Society of Clinical Oncology recommends, “to conserve health system resources and reduce patient contact with health care facilities,… that cancer screening procedures that require clinic/center visits, such as screening mammograms and colonoscopy, be postponed for the time being.”1 A Washington Post headline reported, “Patients with heart attacks, strokes, and even appendicitis vanish from hospitals.”2 A study from 9 high-volume US cardiac catheterization laboratories3 found a 38% decrease in patients treated for ST-elevation myocardial infarction, considered a life-threatening condition. In this study, we analyzed weekly changes in the number of patients with newly identified cancer before and during the COVID-19 pandemic.

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Article Information

Accepted for Publication: July 8, 2020.

Published: August 4, 2020. doi:10.1001/jamanetworkopen.2020.17267

Correction: This article was corrected on September 10, 2020, to fix the percentage of patients included in the COVID-19 period and the number of women with pancreatic cancer in the baseline and COVID-19 periods, to correct errors in the date ranges that appear in the Figure legend, and to add a column for esophageal cancer in the Figure.

Open Access: This is an open access article distributed under the terms of the CC-BY-NC-ND License. © 2020 Kaufman HW et al. JAMA Network Open.

Corresponding Author: Harvey W. Kaufman, MD, Quest Diagnostics, 500 Plaza Dr, Secaucus, NJ 07094 (harvey.w.kaufman@questdiagnostics.com).

Author Contributions: Dr Kaufman and Ms Chen had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Chen.

Drafting of the manuscript: Kaufman, Chen, Niles.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Chen, Niles.

Administrative, technical, or material support: Fesko.

Conflict of Interest Disclosures: Drs Kaufman and Fesko, Ms Chen, and Mr Niles reported being employed by and owning stock in Quest Diagnostics outside the submitted work.

References
1.
American Society of Clinical Oncology. Cancer screening, diagnosis, staging, and surveillance. Updated June 22, 2020. Accessed July 13, 2020. https://www.asco.org/asco-coronavirus-resources/care-individuals-cancer-during-covid-19/cancer-screening-diagnosis-staging
2.
Bernstein  L , Sellers  FS . Patients with heart attacks, strokes and even appendicitis vanish from hospitals. Published April 19, 2020. Accessed April 27, 2020. https://www.washingtonpost.com/health/patients-with-heart-attacks-strokes-and-even-appendicitis-vanish-from-hospitals/2020/04/19/9ca3ef24-7eb4-11ea-9040-68981f488eed_story.html
3.
Garcia  S , Albaghdadi  MS , Meraj  PM ,  et al.  Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic.   J Am Coll Cardiol. 2020;75(22):2871-2872. doi:10.1016/j.jacc.2020.04.011PubMedGoogle ScholarCrossref
4.
Surveillance, Epidemiology, and End Results Program. Cancer stat facts: esophageal cancer. Accessed April 27, 2020. https://seer.cancer.gov/statfacts/html/esoph.html
5.
IJzerman M, Emery J. Is a delayed cancer diagnosis a consequence of COVID-19? Published April 30, 2020. Accessed May 1, 2020. https://pursuit.unimelb.edu.au/articles/is-a-delayed-cancer-diagnosis-a-consequence-of-covid-19
6.
Lai  A , Pasea  L , Banerjee  A ,  et al . Estimating excess mortality in people with cancer and multimorbidity in the COVID-19 emergency.  medRxiv. Preprint posted online June 1, 2020. doi:10.13140/RG.2.2.34254.82242
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