Prevalence and outcomes of COVID-19 in cancer patients: A population-based registry study in Lampang Province, Thailand
Keywords:
cancer, COVID-19, prevalence, case fatality rate, survival rateAbstract
Introduction: The COVID-19 pandemic has a significant impact on global health. Cancer patients are at high risk due to their weakened immune systems, and COVID-19 infection can lead to severe complications and higher mortality rates compared to the general population. Moreover, during the pandemic, delays in cancer diagnosis and treatment have been observed, which may affect the survival outcomes of cancer patients.
Objectives: To study the prevalence, mortality rate, and survival rate of cancer patients infected with COVID-19 in Lampang Province and compare the survival rates between cancer patients diagnosed during the normal situation and those diagnosed during the COVID-19 outbreak.
Methods: A retrospective study was conducted using data from the Lampang Population-Based Cancer Registry between 2018 and 2020, as well as data on cancer patients with COVID-19 collected between 2020 and 2023. Analyses included the prevalence, mortality rate, observed survival rate, and relative survival rate. The survival rates of cancer patients diagnosed during the normal situation and those diagnosed during the COVID-19 outbreak were compared using the Log-rank test.
Results: In this study, a total of 4,878 cancer patients were enrolled, 428 were infected with COVID-19. The prevalence of COVID-19 infection among cancer patients in Lampang province was 8.8%. The case fatality rate among cancer patients with COVID-19 was 9.35% and the overall 5-year survival rate was 86.2%. When comparing cancer patients diagnosed during the pre-pandemic period with those diagnosed during the COVID-19 pandemic, the overall 3-year survival rate significantly declined from 96.9% in the pre-pandemic period to 83.8% during the pandemic period (p < 0.001).
Conclusion: Cancer patients diagnosed and infected with COVID-19 during the outbreak experienced a decreased survival rate compared to those diagnosed during the normal situation. Therefore, if future outbreaks occur, it is crucial to prioritize appropriate management, treatment planning, and enhanced cancer patient care.
References
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi: 10.1001/jama.2020.2648.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3.
Tenforde MW, Kim SS, Lindsell CJ, Billig Rose E, Shapiro NI, Files DC, et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network - United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(30):993-8. doi: 10.15585/mmwr.mm6930e1.
Department of Medical Services, Ministry of Public Health. Guidelines on clinical practice, diagnosis, treatment, and prevention of healthcare-associated infection for COVID-19 [Internet]. Nonthaburi: Department of Medical Services; c2021 [updated 2021 Sep 9]. Available from: https://covid19.dms.go.th/backend///Content//Content_File/Covid_Health/Attach/25640909181401PM_CPG_COVID_v.18.2_ns_20210909%20-.pdf [In Thai]
Royal Thai Government. Emergency Decree on Public Administration in Emergency Situations B.E. 2548 (Section 9, Notification No. 1). Royal Gazette Vol.137, No. 69D (2020 Mar 25). Available from: https://www.ratchakitcha.soc.go.th/DATA/PDF/2563/E/069/T_0010.PDF [In Thai]
King Chulalongkorn Memorial Hospital. COVID-19 and cancer patients [Internet]. Bangkok: King Chulalongkorn Memorial Hospital; c2021 [updated 2021 Sep 13; cited 2022 Oct 14]. Available from: https://chulalongkornhospital.go.th/kcmh/line/โรคโควิด-19-กับผู้ป่วยมะเ/ [In Thai]
Han S, Zhuang Q, Chiang J, Tan SH, Chua GWY, Xie C, et al. Impact of cancer diagnoses on the outcomes of patients with COVID-19: a systematic review and meta-analysis. BMJ Open. 2022;12(2):e044661. doi: 10.1136/bmjopen-2020-044661.
Johannesen TB, Smeland S, Aaserud S, Buanes EA, Skog A, Ursin G, Helland Å. COVID-19 in Cancer Patients, Risk Factors for Disease and Adverse Outcome, a Population-Based Study From Norway. Front Oncol. 2021;11:652535. doi: 10.3389/fonc.2021.652535.
Sud A, Torr B, Jones ME, Broggio J, Scott S, Loveday C, et al. Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study. Lancet Oncol. 2020;21(8):1035-44. doi: 10.1016/S1470-2045(20)30392-2.
Patt D, Gordan L, Diaz M, Okon T, Grady L, Harmison M, et al. Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors. JCO Clin Cancer Inform. 2020;4:1059-71. doi: 10.1200/CCI.20.00134.
Ministry of Public Health, Health data center. Population registration 2022, Lampang Province [Internet]. Nonthaburi: Health data center; c2022 [update 2022 Jan 1; cited 2023 Dec 14]. Available from: https://hdc.moph.go.th/center/public/standard-report-detail/09cf07164c9b7cfbfe724bee8c6b20c3 [In Thai]
Center for COVID-19 Situation Administration, Lampang. COVID-19 situation in Lampang by district [Internet]. Lampang: Center for COVID-19 Situation Administration, Lampang; c2022 [updated 2022 Jun 30; cited 2022 Sep 29]. Available from: https://www.facebook.com/photo?fbid=352029767103480 [In Thai]
MacLennan R. Cancer registration: principles and methods. Items of patient information which may be collected by registries. IARC Sci Publ. 1991;(95):43-63..
Ministry of Public Health. Update on COVID-19 in Thailand: 02 May 2024 [Internet]. Bangkok: Ministry of Public Health; c2024 [updated 2024 Mar 5; cited 2025 May 2]. Available from: https://cdn.who.int/media/docs/default-source/searo/thailand/2024_05_02_tha-sitrep-covid19.pdf [In Thai]
Fillmore NR, La J, Szalat RE, Tuck DP, Nguyen V, Yildirim C, et al. Prevalence and Outcome of COVID-19 Infection in Cancer Patients: A National Veterans Affairs Study. J Natl Cancer Inst. 2021;113(6):691-8. doi: 10.1093/jnci/djaa159.
Payet E, Perez J, Sarria G, Neciosup S, Berrospi F, Vilchez S, et al. Characteristics of COVID-19 in cancer patients: a cross-sectional study in Peru. Ecancermedicalscience. 2021;15:1246. doi: 10.3332/ecancer.2021.1246.
Péron J, Dagonneau T, Conrad A, Pineau F, Calattini S, Freyer G, et al. COVID-19 Presentation and Outcomes among Cancer Patients: A Matched Case-Control Study. Cancers (Basel). 2021;13(21):5283. doi: 10.3390/cancers13215283.
Pongnikorn D, Daoprasert K, Wongkaw B, Sangkam S, Praditkay M, Meemark S. Trends in cancer incidence and mortality in Northern Thailand, 1993–2017 [Internet]. Lampang: LPCH Cancer Registry Publication; c2020 [updated 2020 Feb]. Available from: https://www2.lpch.go.th/lpch/uploads/20200617093948752932.pdf [In Thai]
Ben Kridis W, Khmeri S, Lajnef M, Khanfir A. 1584P Prevalence and risk factors of COVID-19 in cancer patients: A prospective monocentric study. Ann Oncol. 2021;32:S1141. doi: 10.1016/j.annonc.2021.08.1577.
Zhang H, Han H, He T, Labbe KE, Hernandez AV, Chen H, et al. Clinical Characteristics and Outcomes of COVID-19-Infected Cancer Patients: A Systematic Review and Meta-Analysis. J Natl Cancer Inst. 2021;113(4):371-80. doi: 10.1093/jnci/djaa168.
Russell B, Moss CL, Shah V, Ko TK, Palmer K, Sylva R, et al. Risk of COVID-19 death in cancer patients: an analysis from Guy's Cancer Centre and King's College Hospital in London. Br J Cancer. 2021;125(7):939-47. doi: 10.1038/s41416-021-01500-z.
Cancer Registry Unit, Lampang Cancer Hospital. Hospital based cancer registry Annual Report 2023, Lampang Cancer Hospital [Internet]. Lampang: Cancer Registry Unit; c2024 [updated 2024 Feb 7]. Available from: https://www2.lpch.go.th/lpch/uploads/20240716114124143579.pdf [In Thai]
Soerjomataram I, Cabasag C, Bardot A, Fidler-Benaoudia MM, Miranda-Filho A, Ferlay J, et al. Cancer survival in Africa, central and south America, and Asia (SURVCAN-3): a population-based benchmarking study in 32 countries. Lancet Oncol. 2023;24(1):22-32. doi: 10.1016/S1470-2045(22)00704-5.
Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR, et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395(10241):1907-18. doi: 10.1016/S0140-6736(20)31187-9.
Al-Quteimat OM, Amer AM. The Impact of the COVID-19 Pandemic on Cancer Patients. Am J Clin Oncol. 2020;43(6):452-5. doi: 10.1097/COC.0000000000000712.
Derosa L, Melenotte C, Griscelli F, Gachot B, Marabelle A, Kroemer G, et al. The immuno-oncological challenge of COVID-19. Nat Cancer. 2020 Oct;1(10):946-64. doi: 10.1038/s43018-020-00122-3.
Riera R, Bagattini ÂM, Pacheco RL, Pachito DV, Roitberg F, Ilbawi A. Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review. JCO Glob Oncol. 2021;7:311-23. doi: 10.1200/GO.20.00639.
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