CANCER rates of survival during the first year after diagnosis declined significantly in the United States during 2020 and 2021, with population-level data showing excess cancer-related deaths associated with pandemic-era disruptions to care. These findings highlight the importance of resilient healthcare systems during global public health emergencies worldwide.
Assessing Cancer Survival During the Pandemic
Disruptions to cancer screening, diagnosis, and treatment during the COVID-19 pandemic have been widely reported, yet their effect on short-term outcomes has remained largely unclear. This population-based cohort study examined one year cause-specific survival among individuals diagnosed with invasive cancer during 2020 and 2021, compared with pre-pandemic trends from 2015–2019. Using high-quality data from the Surveillance, Epidemiology, and End Results 21 Registries, investigators analysed outcomes for more than one million individuals diagnosed with cancer during the first two years of the pandemic.
Survival Declines Across Disease Stage
Compared with pre-pandemic trends, significant absolute reductions in one year cancer survival were observed for both early and late-stage disease. For early-stage diagnoses, one year cause-specific survival declined by 0.44 percentage points in 2020 (95% CI: −0.54–−0.34) and by 0.27 percentage points in 2021 (95% CI: −0.37–−0.16). Larger declines were seen among patients diagnosed with late-stage disease, with reductions of 1.34 percentage points in 2020 (95% CI: −1.75–−0.93) and 1.20 percentage points in 2021 (95% CI: −1.69–−0.71). These reductions translated into an estimated 17 390 additional cancer-related deaths within one year of diagnosis, representing a 13.1% increase above expected levels.
Disparities And Site-Specific Effects
Survival declines were not uniform across different populations. Absolute reductions exceeding 1.00 percentage point were observed among individuals aged 65 years or older and among individuals of other non-Hispanic race and ethnicity, including American Indian and Alaska Native and Asian or Pacific Islander groups, for late-stage diagnoses in both years. Site-specific analyses also identified significant survival reductions for early-stage oesophageal and colorectal cancers, as well as for late-stage prostate cancer.
Reference
Burus T et al. Survival of patients diagnosed with cancer during the covid-19 pandemic. JAMA Oncol. 2026; 10.1001/jamaoncol.2025.6332.
