Minimal Impact of COVID-19 on One-Year Mortality on US Patients with Cancer Diagnosed Early during the Pandemic - Research Article

Sep 23, 2026

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Study evaluates cause-specific mortality among US patients with cancer diagnosed early in the COVID-19 pandemic, comparing 2020 with 2018 using SEER-22 data. It examines one-year risks from cancer, COVID-19, and other competing causes by cancer type, stage, and age. In 2020, 15.8% died of cancer, 3.3% from other causes, and 0.7% from COVID-19; among deaths, COVID-19 accounted for 9% to 1.2% depending on cancer site. A counterfactual analysis suggests similar cancer or other-cause proportions if COVID-19 were eliminated, indicating limited influence of COVID-19 on competing-cause mortality while informing healthcare disruption mitigation strategies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Significance

Introduction

Materials and Methods

RESEARCH ARTICLE [https://doi.org/10.1158/2767-9764.CRC-25-0286](https://doi.org/10.1158/2767-9764.CRC-25-0286) OPEN ACCESS Minimal Impact of COVID-19 on One-Year Mortality on US Patients with Cancer Diagnosed Early during the Pandemic Anne-Michelle Noone1, Nadia Howlader1, Angela B. Mariotto1, Yoon Duk Hong1, and Ruth M. Pfeiffer2 􀀶 ABSTRACT Patients with cancer diagnosed early in the COVID-19 pandemic may have been particularly vulnerable due to immunosuppression caused by their cancer. The objective was to assess cause of death due to COVID-19, cancer, and other causes among patients with cancer during the pandemic. We thus examined causes of death (cancer, COVID-19, other causes) among patients with cancer diagnosed in 2020 (N ¼ 503,128) compared with 2018 (N ¼ 537,006) in the Surveillance, Epidemiology, and End Results-22. We focused on 1-year cause-specific mortality by cancer type, stage, and age at diagnosis. In a counterfactual analysis, we estimated the number and proportions of patients with cancer dying of cancer or other competing causes if COVID-19 were eliminated as a possible cause of death. Among 2020 patients with cancer, 15.8% died of cancer, 3.3% from other causes, and 0.7% from COVID-19. Among those who died, COVID- 19 mortality was 9%, 7.6%, 2.8%, 2.8%, and 1.2% of all deaths for prostate, breast, colorectal, lung, and pancreatic cancers, respectively. In a counterfactual analysis assuming that COVID-19 had not occurred, similar percentages would have died of cancer or other causes, except for lung and pancreatic cancers. In summary, cancer was the leading cause of death in 2020, but COVID-19 did not have a large influence on competing-cause mortality. These findings inform healthcare strategies to mitigate excess mortality among patients with cancer during future healthcare disruptions. Significance: These findings show that, among patients with cancer, cancer remains a leading cause of death during the COVID-19 pandemic. These results underscore the importance of cancer care even amid other public health emergencies. Introduction People living with cancer have faced a twofold greater risk of dying of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), than the general US population ( 1) . Patients with cancer diagnosed during the first year of the pandemic in 2020, when COVID- 19 vaccination and therapeutic treatments were not available, may have been especially susceptible to COVID-19 fatality (2, 3) . This analysis aims to assess underlying causes of death due to COVID-19, cancer, and other causes among patients with cancer diagnosed during 2020 and characterize the 1-year cause-specific mortality for these competing 1Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland. 2Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland. Corresponding Author: Anne-Michelle Noone, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892. E-mail: [anne-michelle.noone@nih.gov](anne-michelle.noone@nih.gov) [doi:](doi: 10.1158/2767-9764)[ 10.1158/2767-9764](doi: 10.1158/2767-9764) .CRC-25-0286 This open access article is distributed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license. ©2025 The Authors; Published by the American Association for Cancer Research causes based on patient characteristics such as sex, cancer type, age, and stage at diagnosis. Whereas the acute phase of the COVID-19 pandemic has passed, understanding its impact on patients with cancer remains highly relevant for several reasons. First, it highlights the potential role of emerging infectious diseases on immunosuppressed populations, offering valuable lessons for future pandemic preparedness and public health planning.

FAQs

What was the objective of assessing one-year mortality in this study?

To quantify causes of death due to COVID-19, cancer, and other causes among patients with cancer diagnosed during the pandemic, focusing on one-year cause-specific mortality.

How did the study compare 2020 outcomes with earlier data?

It compared patients diagnosed in 2020 (N=503,128) with those diagnosed in 2018 (N=537,006) using SEER-22 registries, excluding Illinois and Massachusetts.

What were the main findings about COVID-19’s influence on competing-cause mortality?

Cancer remained the leading cause of death in 2020, while COVID-19 had a limited effect on competing-cause mortality; cancer and other causes had similar proportions under a counterfactual scenario where COVID-19 was eliminated.

Sep 23, 2026

Uploaded by Kurz