The COVID-19 pandemic has interrupted oncology services including screening, diagnosis, and treatment. In this study pathology services were investigated as a proxy for cancer screening, diagnosis, and treatment delays to assess the effect of the pandemic on oncology services. In order to quantify the impact of COVID-19 we reviewed all pathology reports from January 1 through November 30 in 2018, 2019, and 2020 from 5 central registries in the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Using the SEER Data Management System and SAS, pathology reports were counted by cancer site (breast, lung, colorectal, prostate, other), patient age category (<50, 50-64, 65-74, >75 years), bi-weekly collection interval, and registry. Only pathology laboratories with monthly electronic reporting to their central registry throughout the study period were included. The reporting counts from 2020 were compared to those of the prior two years. In comparison to the 2019 baseline volume, March through November 2020 had an 11.2% decrease in pathology volume (48,779 fewer reports) in the 5 central registries. Over 75% of this decrease in volume occurred over a 10-week period, March through May 2020, with 30.2% fewer (37,127 reports) than expected pathology reports during this initial peak of the COVID-19 pandemic. The maximum bi-weekly decrease observed was 41.7% (>10,000 reports) from the 2019 baseline, which occurred in April 2020. During this 10-week period the decrease in volume by age category ranged 29.6-32.2%, cancer site ranged 27.5-39.1% and central registry ranged 26.1-36.8%. Two additional periods of volume decrease also occurred, both of shorter duration and magnitude, mid-July through August and mid-October through mid-November. Since the onset of the pandemic there remains a deficit (>11%) in the expected pathology volume compared to 2019, reflecting the continued impact of COVID-19 across oncology services. The majority of the pathology volume decrease in 2020 occurred during the initial peak of the COVID-19 pandemic. This period of decreased reporting volume along with two smaller decreases align with the 3 peaks of COVID-19 new cases reported by the CDC COVID Data Tracker. Prior to the onset of the pandemic the 2020 volume started at a bi-weekly rate greater than 2019, and the 2019 volume was consistently greater than 2018. Therefore, the 2020 expected values would be greater than those of the 2019 comparison year, i.e., the volume decreases reported would likely represent conservative estimates of the actual volume decrease. Continued longitudinal monitoring and the addition of more registries to this analysis are planned as well as pathology report type categorization (screening, surveillance, or treatment). This study also demonstrates the ability of the NCI SEER program to assist with near real time reporting of cancer data in quantifying the effect on the healthcare system of the COVID-19 pandemic.

Citation Format: Todd Golden, Linda Coyle, Jennifer Stevens, Serban Negoita. Quantifying the impact of COVID-19 on cancer care: Pathology volume change in SEER cancer registries [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S12-01.