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Impact of COVID-19 Pandemic on Cancer Diagnoses and Oncological Care in Germany

It has been five years since COVID-19 first appeared and countries around the world instated wide-ranging societal restrictions, stay-at home policies, and other public health measures. As global health researchers, CLIC members are very interested in the impact of COVID-19 on childhood cancer risk, diagnosis, and treatment. For example, acute lymphoblastic leukemia (ALL), the most common type of childhood cancer, may be related to an abnormal immune response to a virus or infection (Greaves, 2018). After a five-year period, the impact of COVID-19 on the world’s population can be assessed in many different ways. 

CLIC partner Dr. Friederike Erdmann from Germany recently worked with her colleagues at a scientific workshop, “COVID & Cancer,” to evaluate the changes in cancer diagnosis, oncological care, and patient well-being after the pandemic in Germany (Erdmann et al., 2024). Looking at adult cancers, the German state cancer registries consistently reported a lower number of new cancer diagnoses during the first months of the pandemic compared to the respective months of the years before the pandemic; however, a marked increase in the incidence of childhood cancer was observed in 2020 compared to the five years before the pandemic (2015–2019). In 2021, the estimated incidence of leukemias and central nervous system (CNS) tumors was still somewhat elevated, but the incidence of childhood cancer lymphomas and non-CNS solid tumors diagnosis dropped significantly. Since then, the incidence levels of lymphomas and non-CNS tumors did not return to pre-pandemic levels, but the research team stated that there were no signs of missed or delayed childhood cancer diagnoses throughout 2020–2021. 

The participating scientists from the “COVID & Cancer”  Workshop in German concluded that the ways in which the pandemic had adversely affected cancer diagnoses, oncological care, and created service backlogs in Germany (and also worldwide) were still not adequately understood, and important questions remain unanswered (Erdmann et al., 2024). The pandemic may have impacted the health system and the personal lives of patients in Germany in ways that have not yet appeared in research. As time goes on, more long-term impacts of COVID-19 on cancer will be revealed. For more information on cancer (and specifically childhood cancer) and COVID-19 in Germany, see Dr. Erdmann’s publications listed below.

Citations: 

Erdmann F, Wellbrock M, De Santis KK, Hübner J, Voigtländer S, Arndt V. Impact of the COVID-19 pandemic on cancer diagnoses, oncological care and cancer patients in Germany: a report from the “COVID & Cancer” workshop 2023 of the German Society for Epidemiology (DGEpi). J Cancer Res Clin Oncol. 2024;150(11):491. Published 2024 Nov 9. doi:10.1007/s00432-024-06019-3

Erdmann F, Spix C, Schrappe M, Borkhardt A, Schüz J. Temporal changes of the incidence of childhood cancer in Germany during the COVID-19 pandemic: Updated analyses from the German Childhood Cancer Registry. Lancet Reg Health Eur. 2022;17:100398. doi:10.1016/j.lanepe.2022.100398

Erdmann F, Wellbrock M, Trübenbach C, et al. Impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020: Evidence from the German Childhood Cancer Registry and a qualitative survey. Lancet Reg Health Eur. 2021;9:100188. doi:10.1016/j.lanepe.2021.100188

Greaves, M. A causal mechanism for childhood acute lymphoblastic leukaemia. Nat Rev Cancer 18, 471–484 (2018). https://doi.org/10.1038/s41568-018-0015-6