The impact of COVID-19 on cancer screening and treatment in older adults: The Multiethnic Cohort Study

COVID-19 pandemic shifted epidemiology for cancer screening sites: breast, cervix, colon, and rectum

Background

This study aimed to assess the epidemiological changes in breast, cervical, colon, and rectal cancers in Kazakhstan before and during COVID-19, including early-onset cancer (EOC) diagnosed between the ages of 20 and 49, using data from the oncological service of the Republic of Kazakhstan for the 2017-2022 period.

Methods

The cohort comprised patients aged 20 to 49 years (EOC) and 50 years and older [late-onset cancer (LOC)] from the total number of patients diagnosed each year during the study period of 2017 to 2022 for breast, cervical, colon, or rectal cancer. In order to indicate a difference in one-time intervals and characterize the global trend over the entire study period, annual percentage change (APC) and average APC (AAPC) were calculated, respectively.

Results

Breast cancer detection rates increased by 22.8% for EOC and 15.9% for LOC from 2017 to 2022, and AAPC increased by 4.3% for EOC and 3.6% for LOC. During the COVID-19 restriction period, breast cancer detection rates decreased by 6.1% for EOC and 15.6% for LOC. Cervical cancer detection rates increased by 2.3% for EOC and 7.5% for LOC from 2017 to 2022, and AAPC increased by 0.9% for EOC and 1.6% for LOC. During the COVID-19 restriction period, cervical cancer detection rates decreased by 11.3% for EOC and 3.1% for LOC. Colon cancer detection rates increased by 18.4% for EOC and 14.3% for LOC from 2017 to 2022, and AAPC increased by 3.7% for EOC and 2.9% for LOC. During the COVID-19 restriction period, colon cancer detection rates decreased by 14.4% for EOC and 5.8% for LOC. Rectal cancer detection rates increased by 13.6% for EOC and 19.2% for LOC from 2017 to 2022, and AAPC increased by 3.0% for EOC and by 3.9% for LOC. During the COVID-19 restriction period, rectal cancer detection rates increased by 18.6% for EOC and decreased by 12.0% for LOC.

Conclusion

The epidemiological indicators of population cancer screening worsened during the COVID pandemic; the detection rate decreased by 6.1% for breast EOC and 11.3% for cervical EOC, while there was an increase by 38.0% in EOC for colon cancer in men and by 8.0% in EOC for rectal cancer in men and 31.1% in women.

The impact of COVID-19 on 2020 monthly incidence trends of primary brain and other CNS tumors

BACKGROUND

To mitigate disease spread, restrictions implemented in the United States surrounding the COVID-19 pandemic created an environment that led to delays in cancer diagnosis. The data needed to accurately analyze the impact of the pandemic on brain and CNS tumor incidence has not been available until now. Utilizing incidence data from the Central Brain Tumor Registry of the United States (CBTRUS) we analyzed the impact of the COVID-19 pandemic on primary brain and other CNS tumor incidence for the first year of the pandemic.

METHODS

Monthly age-adjusted incidence rates and incidence trends for 2019 and 2020 were determined for age at diagnosis, sex, race, ethnicity, diagnostic confirmation, behavior, tumor histopathology, and county-level urbanization. Monthly incidence rate ratios comparing 2020 and 2019 were evaluated for the same factors.

RESULTS

Overall, there was a notable decrease in incidence rates in March-May 2020 when compared to 2019. These decreases were driven by nonmalignant tumors, with a 50% incidence decrease between March 2020 and 2019. Individuals who were Black had a larger incidence decrease in early 2020 than individuals who were White. Radiographically confirmed tumors saw larger incidence decreases than histologically confirmed tumors. There were no changes in monthly incidence of glioblastoma in 2020 compared to 2019.

CONCLUSIONS

These data provide evidence that disruptions in medical care, such as governmental and health care mandates, in response to the COVID-19 pandemic resulted in an overall decreased incidence of primary brain tumors in early 2020.

MBIP promotes ESCC metastasis by activating MAPK pathway

MBIP is a component of the Ada2A containing complex (ATAC) and has been identified as a susceptibility gene in several cancers. However, the role and molecular mechanism of MBIP in esophageal squamous cell carcinoma (ESCC) remain unclear. Our finding indicated that the expression level of MBIP in ESCC was higher than that in normal tissue (P < 0.05) based on the data from the Cancer Gene Atlas (TCGA) and Gene Expression Omnibus (GEO). Kaplan-Meier analysis showed that high MBIP expression was closely associated with deeper invasion and worse prognosis. Transwell assay and mouse xenograft assay demonstrated that MBIP overexpression promoted migration and invasion in vitro and in vivo, while MBIP knockdown played the opposite role. Furthermore, the results of RNA-seq, qRT-PCR, western blotting and rescue experiments revealed that MBIP promoted epithelial-mesenchymal transition (EMT) via the phosphorylation JNK/p38 in ESCC. Our study indicates that MBIP plays a significant role in the prognosis and metastasis of ESCC, suggesting that MBIP might serve as an ESCC prognostic biomarker.