Effect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021

Abstract Purpose Swiss healthcare institutions conducted only urgent procedures during the COVID-19 lockdown, potentially leading to a lack of care for other severe diseases, such as cancer. We examined the effects of the pandemic on cancer stage distribution and time between cancer diagnosis and tr...

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Main Authors: Flurina Suter, Miriam Wanner, Andreas Wicki, Dimitri Korol, Sabine Rohrmann
Format: Article
Language:English
Published: Springer 2025-02-01
Series:Journal of Cancer Research and Clinical Oncology
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Online Access:https://doi.org/10.1007/s00432-025-06140-x
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author Flurina Suter
Miriam Wanner
Andreas Wicki
Dimitri Korol
Sabine Rohrmann
author_facet Flurina Suter
Miriam Wanner
Andreas Wicki
Dimitri Korol
Sabine Rohrmann
author_sort Flurina Suter
collection DOAJ
description Abstract Purpose Swiss healthcare institutions conducted only urgent procedures during the COVID-19 lockdown, potentially leading to a lack of care for other severe diseases, such as cancer. We examined the effects of the pandemic on cancer stage distribution and time between cancer diagnosis and treatment initiation using population-based cancer registry data. Methods The study was based on data of the cancer registry of the cantons of Zurich and Zug from 2018 to 2021. Cancer stage distribution was analysed descriptively and with a Pearson’s Chi-squared test. Time between cancer diagnosis and treatment initiation was determined in days and analysed descriptively and by fitting Quasipoisson regression models. Results For all-cancer and colorectal, lung, and prostate cancer statistically significant evidence for a difference in cancer stages distribution among the incidence years was observed. Based on the all-cancer regression models, longer time to treatment initiation (TTI) was observed for patients diagnosed in 2021 and receiving surgery (Rate Ratio = 1.08 [95% confidence interval 1.03, 1.14]) or hormone therapy (1.20 [1.03, 1.40]) compared to those diagnosed in 2018/19 receiving those therapies. We observed no difference in TTI between cancer patients diagnosed in 2020 compared to 2018/19 for any of the therapies investigated, except for chemotherapy with shorter TTI (0.92 [0.86, 0.98]). Conclusion The observed effects on cancer outcomes in 2020 and 2021 compared to 2018/19 coincided with the beginning of the COVID-19 pandemic in Switzerland in 2020 onwards. Short- and long-term effects of the pandemic on cancer outcomes and the public healthcare system were observed. However, we cannot exclude that the implementation of the new Swiss law on cancer registration in 2020 explains part of our observations.
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spelling doaj-art-51db5f3a0be14974be167f83cdc30de02025-08-20T02:56:12ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-02-01151211310.1007/s00432-025-06140-xEffect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021Flurina Suter0Miriam Wanner1Andreas Wicki2Dimitri Korol3Sabine Rohrmann4Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of ZurichCancer Registry Zurich, Zug, Schaffhausen and Schwyz, Institute of Pathology and Molecular Pathology, University Hospital ZurichDepartment of Medical Oncology and Hematology, Faculty of Medicine, University and University Hospital ZurichCancer Registry Zurich, Zug, Schaffhausen and Schwyz, Institute of Pathology and Molecular Pathology, University Hospital ZurichDivision of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of ZurichAbstract Purpose Swiss healthcare institutions conducted only urgent procedures during the COVID-19 lockdown, potentially leading to a lack of care for other severe diseases, such as cancer. We examined the effects of the pandemic on cancer stage distribution and time between cancer diagnosis and treatment initiation using population-based cancer registry data. Methods The study was based on data of the cancer registry of the cantons of Zurich and Zug from 2018 to 2021. Cancer stage distribution was analysed descriptively and with a Pearson’s Chi-squared test. Time between cancer diagnosis and treatment initiation was determined in days and analysed descriptively and by fitting Quasipoisson regression models. Results For all-cancer and colorectal, lung, and prostate cancer statistically significant evidence for a difference in cancer stages distribution among the incidence years was observed. Based on the all-cancer regression models, longer time to treatment initiation (TTI) was observed for patients diagnosed in 2021 and receiving surgery (Rate Ratio = 1.08 [95% confidence interval 1.03, 1.14]) or hormone therapy (1.20 [1.03, 1.40]) compared to those diagnosed in 2018/19 receiving those therapies. We observed no difference in TTI between cancer patients diagnosed in 2020 compared to 2018/19 for any of the therapies investigated, except for chemotherapy with shorter TTI (0.92 [0.86, 0.98]). Conclusion The observed effects on cancer outcomes in 2020 and 2021 compared to 2018/19 coincided with the beginning of the COVID-19 pandemic in Switzerland in 2020 onwards. Short- and long-term effects of the pandemic on cancer outcomes and the public healthcare system were observed. However, we cannot exclude that the implementation of the new Swiss law on cancer registration in 2020 explains part of our observations.https://doi.org/10.1007/s00432-025-06140-xCoronavirus disease 2019Cancer stage distributionTime to treatment initiationSwitzerlandCancer registry
spellingShingle Flurina Suter
Miriam Wanner
Andreas Wicki
Dimitri Korol
Sabine Rohrmann
Effect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021
Journal of Cancer Research and Clinical Oncology
Coronavirus disease 2019
Cancer stage distribution
Time to treatment initiation
Switzerland
Cancer registry
title Effect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021
title_full Effect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021
title_fullStr Effect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021
title_full_unstemmed Effect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021
title_short Effect of the COVID-19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021
title_sort effect of the covid 19 pandemic and lockdown on cancer stage distribution and time to treatment initiation using cancer registry data of the swiss cantons of zurich and zug from 2018 to 2021
topic Coronavirus disease 2019
Cancer stage distribution
Time to treatment initiation
Switzerland
Cancer registry
url https://doi.org/10.1007/s00432-025-06140-x
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