Cancer diagnostics in Norway during covid-19

The Cancer Registry of Norway reports on how cancer diagnostics has been affected by the covid-19 pandemic.
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The aim of this report is to provide an overview of cancer diagnoses in Norway in 2020, compared to 2019, to examine consequences of the covid-19 pandemic and the national measures that were implemented.

We used number of pathology reports submitted to the Cancer Registry of Norway as a measure of the number of cancer diagnoses.

Pathology reports are a large and very important source of information, but do not include all cancer cases. The number of cases in this report is therefore not synonymous with the actual number of cancer cases during a year, but nevertheless provides a good basis for comparing trends over time.

Markedly decline from March

Our preliminary analysis show that cancer diagnoses declined markedly in 2020, especially in connection with the first period of closure from 12 March to the end of April.

In total, for all diagnoses (cancer, precancerous lesions and some benign tumors), we see a decrease of 12.7 % from March to September 2020 compared to 2019.

The decrease in the period March–May was as much as 23 %. For the malignant diagnoses, we see a total decrease of 9.1 %, with a decrease of 15.8 % in the period March–May.

Breast cancer/premalignant cases of breast cancer and lung cancer had the largest decline in the period March–September, while melanoma, breast cancer/premalignant cases of breast and cervical cancer/premalignant
cases of cervical cancer have the largest decline in the period March–May.

The large decline in the latter cancers is probably related to the fact that invitations/reminders in the national BreastScreen Norway and CervicalScreen Norway programs were temporarily halted and that the population visited the health service less frequently during this period.

For skin cancer and lymphomas/leukemias, more cases have been diagnosed in total in the period March–September 2020 than in the corresponding period in 2019.

We know that there is an upward trend for the incidence of skin cancer in general, but we need additional data to understand the reasons why the curve for this cancer site does not follow the curve of e.g. melanoma.

Still too early to fully understand the consequences 

Further analysis are needed to understand consequences the covid-19 pandemic has had for cancer diagnoses in Norway.

It will probably take several years before we can provide solid answers to whether patients have been diagnosed at a more advanced stage as a consequence of the pandemic and how this affects cancer survival and
the needs for treatment/follow-up in the health service.