The Impact of the COVID‐19 Pandemic on Childhood Cancer Survival: A Population‐Based Assessment of Survival Patterns Between 2015 and 2023 in Germany

BACKGROUND: Numerous international studies have reported declines in new cancer diagnoses, delayed diagnoses and disruptions in cancer treatment following the implementation of COVID-19 pandemic public health measures, raising concerns that these effects may ultimately contribute to increased cancer mortality. We conducted one of the first population-based assessments of the impact of the COVID-19 pandemic on childhood cancer survival. PROCEDURE: Using data from the national German Childhood Cancer Registry, we identified all children aged 0-14 years with a new cancer diagnosis in Germany between 2015 and 2023 (N = 16,664) and compared early mortality (death within 90 days after diagnosis) and 3-year overall survival (OS) during the pandemic with the respective pre-pandemic patterns (2015-2019). RESULTS: We found no indications of adverse effects of the pandemic on childhood cancer survival in Germany. Early mortality was already low in the pre-pandemic period at 1.5% for childhood cancer overall, and decreased slightly during the pandemic, with reductions seen for virtually all diagnostic groups. This decline was most pronounced in 2020, when overall early mortality among children with cancer fell to 0.7%. Three-year OS slightly increased for childhood cancer overall, from 88.8% in 2015-2019 to 90.3% in 2021, with increases observed for most diagnostic groups. CONCLUSIONS: Unlike other international studies reporting both reduced access to care and care interruptions among children with cancer during the pandemic, worse in low- and middle-income countries, these findings from Germany showed no evidence of adverse effects on childhood cancer survival, highlighting the resilience of the healthcare system in this context.