The COVID-19 pandemic prompted significant reductions in procedures used to diagnose cancers as well as new cancer diagnoses in the United States, according to research published in Cancer.

Researchers examined nationwide Veterans’ Affairs Healthcare System data from 4.1 million cancer-related encounters that occurred from January 1, 2018, through December 31, 2020.

The data included 3.9 million relevant diagnostic and screening procedures and 251,647 new cancer diagnoses. Cancer types included prostate (n=139,960), lung (n=51,224), colorectal (n=27,697), and bladder (n=32,766) cancers.

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Procedures decreased significantly in 2020, compared with the annual averages in 2018 through 2019. Colonoscopies decreased by 45%, prostate biopsies by 29%, cystoscopies by 21%, fecal occult blood tests (FOBTs) by 13%, and chest CT scans by 12%.

Diagnoses of new cancers decreased in 2020 as well. New diagnoses of prostate cancer decreased by 23%, colorectal cancer by 20%, bladder cancer by 18%, and lung cancer by 13%.

The reductions in these diagnoses and procedure rates persisted even as pandemic-related restrictions began to ease, the researchers noted. They wrote that “we have yet to enter a ‘catching-up’ period where we are clearing the backlog in diagnoses and procedures.”

There is an exception to this, however. The use of screening chest CT scans rebounded later in 2020 so that there was no overall deficit by the end of the year.

To help states and institutions clear the remaining backlog, the researchers devised a nomogram. A detailed explanation of the tool can be found in the reference.


Englum BR, Prasad NK, Lake RE, et al. Impact of the COVID-19 pandemic on diagnosis of new cancers: A national multicenter study of the Veterans Affairs Healthcare System. Cancer. Published online December 6, 2021. doi:10.1002/cncr.34011