The COVID-19 pandemic has placed a significant strain on healthcare systems worldwide andhas also impacted the diagnosis and treatment of cancer. In Germany, there was a notabledecline in cancer diagnoses during the pandemic, partly due to delays in early detectionand limited access to medical treatments.This study examines how the number of cancer cases in Bavaria changed before and duringthe pandemic, taking various factors into account, such as the socioeconomic status ofdifferent regions, the age of affected individuals, and the severity of the pandemic ineach region.We aim to determine whether certain regions or specific types of tumors experiencedgreater declines in diagnoses, particularly for cancers with regular screening programs.The study seeks to provide a better understanding of how different social andgeographical conditions influenced cancer diagnoses during the pandemic. These insightscould help improve future preparedness for health crises like the pandemic and ensurethat cancer treatment continues to function effectively even in times of crisis.
The COVID-19 pandemic has exerted significant pressure on healthcare systems worldwide,
particularly impacting the diagnosis and treatment of non-communicable diseases such as
cancer. In Germany, substantial declines in cancer diagnoses have been observed,
primarily due to delays in early detection and limited access to medical services during
the pandemic. This study aims to investigate the regional and temporal variations in
cancer incidence in Bavaria before and during the pandemic, taking into account
socio-economic, demographic factors, and the severity of the pandemic.
This registry-based study utilizes data from the Bavarian Cancer Registry spanning from
2018 to 2023. The analysis adopts a spatiotemporal approach to examine changes in cancer
incidence over time at the district level in Bavaria. A Bayesian spatiotemporal Poisson
model with a Conditional Autoregressive (CAR) structure will be employed to account for
both spatial and temporal variations, as well as spatial correlations between neighboring
districts. The analysis will incorporate demographic characteristics, socio-economic
status, tumor-specific data, and regional variations in the severity of the pandemic.
It is hypothesized that the pandemic has led to regional disparities in cancer incidence,
with socio-economically disadvantaged areas potentially being more severely affected.
Tumors associated with established screening programs, such as breast, colon, and
cervical cancer, may have experienced a greater reduction in diagnoses compared to other
cancer types.
The findings of this study will provide valuable insights into how geographical and
socio-economic factors influenced cancer incidence during the pandemic and how these
inequalities were exacerbated. The results could inform future health policies aimed at
ensuring the continued accessibility of cancer detection and treatment, even during
public health crises.
Inclusion Criteria:
- All incident cancer cases among individuals aged 18 years and older, including
carcinoma in situ, diagnosed between 2018 and 2023 within Bavaria and recorded in
the Bavarian Cancer Registry.
Exclusion Criteria:
- Death Certificate Only (DCO) cases. as they lack essential clinical information and
the recorded date of diagnosis is in most cases the date of death, leading to
temporal distortions in incidence estimates.
Bavarian Cancer Registry, Bavarian Health and Food Safety Authority
Munich, Bavaria, Germany
Verena Loidl, Ph.D.
+49913168084714
verena.loidl@lgl.bayern.de
Sven Voigtländer, Dr. P.H.
+49913168082927
Sven.Voigtlaender@lgl.bayern.de
Jacqueline Müller-Nordhorn, Prof. Dr., Principal Investigator
Bavarian Cancer Registry, Bavarian Health and Food Safety Authority