The impact of the COVID-19 pandemic on all-cause mortality among oncological patients: a population-based study.

backgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, COVID-19 was not the only threat to the health of patients with tumors. The response policy and the collapse of the health system also posed serious threats to patients with tumors. Our study aimed to quantify the changes in all-cause mortality among oncological patients in the United States during the COVID-19 pandemic.

methodsFirst, we extracted information about all oncological patients who died between 2018 and 2021 from the Surveillance, Epidemiology, and End Results (SEER) 22 registries database. Descriptive analysis was performed to analyze the distribution of deaths attributed to COVID-19 among oncological patients in 2020 and 2021. Second, we obtained the age-adjusted all-cause mortality rates for the entire cohort and stratified the data on the basis of demographic and tumor characteristics. We evaluated the difference between the mortality rates during the pandemic period (2020-2021) and the prepandemic period (2018-2019).

resultsA total of 1,911,877 patients were included in this study. Between 2018 and 2019, 903,521 deaths occurred among oncological patients, and this number increased to 1,008,356 between 2020 and 2021. In addition, COVID-19 accounted for 63,947 deaths among oncological patients in 2020 and 2021. We also reported that 59.5% of the deaths attributed to COVID-19 occurred in patients who had been diagnosed with tumors more than five years prior. The mortality rate among oncology patients increased significantly, by 7.1% (rate ratio: 1.0708, 95% CI: 1.0674-1.0742), during the COVID-19 pandemic compared with the prepandemic period. Patients with meningiomas experienced the greatest increase in mortality, at 28.3% (rate ratio: 1.2828, 95% CI: 1.2499-1.3166), across all histological types. In terms of the tumor site, the greatest increase in mortality (28.9%) was observed in patients with tumors of the cranial nerves and other parts of the nervous system (rate ratio: 1.2892, 95% CI: 1.2581-1.321). The only exception was patients with lung and bronchial tumors (rate ratio: 0.9488, 95% CI: 0.9406-0.9571), who experienced a significant decrease in mortality.

conclusionOur findings suggest that the COVID-19 pandemic significantly affected mortality rates among patients with tumors, with most groups exhibiting a notable increase in mortality during the pandemic. However, the decreasing trend in the mortality rates of patients with lung and bronchial cancer has not been interrupted. Hopefully, public health authorities and clinicians can derive valuable insights from the experiences of patients with lung and bronchial cancer during the COVID-19 pandemic.