Survival of patients with malignant neoplasms to be screened as part of the adult medical examination during the COVID-19 pandemic

Purpose of the study . To assess the variations of survival in malignant neoplasms subject to screening as part of the regular adult population check-up (index MN, iMN) during the COVID-19 pandemic according to the data of the Arkhangelsk Regional Cancer Registry (ARCR). Materials and methods . Data on nine iMN in the Arkhangelsk region were extracted from the ARCR database. Using the actuarial method, 1-year cancer-specific (CSS) and overall (OS) survival were estimated during the COVID-19 pandemic in 2020–2021. This period was compared with the 2018–2019 period before the pandemic. Differences between the periods were assessed using the log-rank method. Cox regression analysis was used to identify possible causes of differences in survival between the periods. Results . A total of 12,354 records of nine iMNs were selected to analyze the survival during the COVID-19 pandemic. For all malignant neoplasms, there was a decrease in the one-year OSR rates, which was statistically significant for lung cancer (from 42.4 % to 32.8 %, p = 0.0001) and cervical cancer (from 90.3 % to 80.8 %, p = 0.02), and OS (by 2.6 %–11.0 %, significant for seven of the nine iMNs). Compared with the pre-COVID period, during the pandemic, the proportion of deaths of patients with iMNs from respiratory diseases increased by 1.5 times and the proportion of deaths from external causes increased from 3 % to 9 %, chi-square (4) = 41.8, p = 0.00001. In the regression models of CSS and OS, after adjusting for stage, the hazard ratio decreased from 1.15 (95 % confidence interval (CI) 1.07–1.24) to 1.10 (95 % CI 1.03–1.19) and from 1.22 (95 % CI 1.14–1.31) to 1.18 (95 % CI 1.10–1.26). In multivariable regression, the risk of cancer-specific and all-cause death in patients with malignant neoplasms during the pandemic remained higher by 16 % and 24 %. Conclusion . The 15–33 % higher risk of cancer-specific and all-cause death during the COVID-19 pandemic is explained by an increase in the proportion of advanced stages due to limited access to screening. Longer-term survival analysis is required.