Trends in breast, colon, pancreatic, and uterine cancers in women during the COVID-19 pandemic in North Carolina

Sep 21, 2026

COVID-19 reduced primary care and cancer screening visits, potentially delaying diagnosis and altering the incidence and characteristics of cancers detected in women. This study assessed changes in cancer incidence among female patients (age ≥18) diagnosed with breast, colon, pancreatic, or uterine cancer at three North Carolina hospitals. Interrupted time-series compared March–November 2020 with January 2016–February 2020.

LanguageEnglish

CategoryResearch & Report

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Pages11

Reading Time28 min

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Introduction

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Study population

DOI: 10. 1002/cam4 .7156 RESEAR CH ARTICLE Trends in breast, colon, pancreatic, and uterine cancers in women during the COVID-19 pandemic in North Carolina Sarah J. Nyante1,2 | Allison M. Deal2 | Hillary M. Heiling2 | Kyung Su Kim2 | Cherie M. Kuzmiak1 | Benjamin C. Calhoun2,3 | Emily M. Ray2,4 1Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA 2Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA 3Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA 4Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Correspondence Sarah J. Nyante, Department of Radiology, CB\#7515, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7515, USA. Email: [sarah_nyante@med.unc.edu](sarah_nyante@med.unc.edu) Funding information National Cancer Institute, Grant/Award Number: R03CA267469; National Center for Advancing Translational Sciences, Grant/Award Number: UL1TR002489 Abstract Importance: The COVID-19 pandemic led to reductions in primary care and cancer screening visits, which may delay detection of some cancers. The impact on incidence has not been fully quantified. We examined change in cancer incidence to determine how the COVID-19 pandemic may have altered the characteristics of cancers diagnosed among women. Methods: This study included female patients aged ≥18years and diagnosed with breast (n = 9489), colon (n = 958), pancreatic (n = 669), or uterine (n = 1991) cancer at three hospitals in North Carolina. Using interrupted time series, we compared incidence of cancers diagnosed between March 2020 and November 2020 (during pandemic) with cancers diagnosed between January 2016 and February 2020 (pre-pandemic) . Results: During the pandemic, incidence of breast and uterine cancers was significantly lower than expected compared to pre-pandemic (breast—18%, p = 0.03; uterine −20%, p = 0.05) . Proportions of advanced pathologic stage and hormone receptor-negative breast cancers, and advanced clinical stage and large size uterine cancers were more prevalent during the pandemic. No significant changes in incidence were detected for pancreatic (−20%, p = 0.08) or colon (+14%, p = 0.30) cancers. Conclusion and Relevance: In women, the COVID-19 pandemic resulted ina significant reduction in the incidence of breast and uterine cancers, but not colon or pancreatic cancers. A change in the proportion of poor prognosis breast and uterine cancers suggests that some cancers that otherwise would have been diagnosed at an earlier stage will be detected in later years. Continued analysis of long-term trends is needed to understand the full impact of the pandemic on cancer incidence and outcomes. KEYWORDS breast cancer, colon cancer, epidemiology, pancreatic cancer, prognosis, uterine cancer, women This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. Cancer Medicine. 2024;13:e7156 . [https://doi.org/10.1002/cam4.7156](https://doi.org/10.1002/cam4.7156) [wileyonlinelibrary.com/journal/cam4](wileyonlinelibrary.com/journal/cam4) 1 of 11 1 | INTRODUCTION The COVID-19 pandemic disrupted cancer care, with US institutions reporting 80%–99% reductions in mammography and 45%–86% reductions in colon cancer screenings at the height of pandemic restrictions.1–11 Prior to the pandemic, a majority of eligible women participated in recommended cancer screening. As of 2018, 66% of women >40 years old had a recent mammogram and 64% of women >50 years old had guideline concordant colon cancer screening. 12,13 Thus, pandemic-re

FAQs

Which cancers and what patient age range were included in the study?

The study included women aged 18 and older diagnosed with breast, colon, pancreatic, or uterine cancer.

How were pandemic-period and pre-pandemic comparisons performed?

Incidence between March 2020 and November 2020 was compared with incidence between January 2016 and February 2020 using an interrupted time series approach.

What major incidence changes were observed during the COVID-19 pandemic?

Incidence of breast and uterine cancers was significantly lower than expected during the pandemic, while pancreatic and colon cancers showed no significant incidence changes.

Sep 21, 2026

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