Cancer incidence trends in Baden-Württemberg (Southwest Germany) during and after the COVID-19 pandemic (2020-2023).
While several countries reported an impact of the coronavirus disease (COVID-19) pandemic on cancer incidence in 2020, little is known about trends in the following years. This study examined changes in cancer incidence in Baden-Württemberg between 2015 and 2023.
Data from the Baden-Württemberg Cancer Registry were used to calculate age-standardized and age-specific incidence rates for all cancers combined and for colorectal, lung, prostate, and breast cancer. Incidence rates for 2020 to 2023 were compared with those from a pre-pandemic reference period (2017-2019) and with expected rates based on modeled trends between 2015 and 2019 using standardized incidence ratios (SIRs).
Among men, the age-standardized overall cancer incidence declined significantly from 734.0 per 100,000 in 2019 to 672.9-681.7 during 2020-2023. In women, incidence declined from 542.2 in 2019 to 504.3-524.4, with statistically significant reductions in 2022 and 2023. Compared to 2017-2019 levels, 14,214 fewer cases (-5.5%) were diagnosed in 2020-2023; relative to model-based expectations, 19,525 fewer cases (-7.6%) were reported. Site-specific analyses showed significantly lower colorectal cancer incidence in both sexes from 2020 onwards (SIRs: 0.81-0.90). For men, part of this decline may reflect a pre-existing downward trend. No significant deviations were found for lung and prostate cancer. Female breast cancer incidence was significantly lower only in 2020 (SIR: 0.93).
Cancer incidence in Baden-Württemberg remained consistently below pre-pandemic and expected levels from 2020 through 2023. Further research is warranted to disentangle potential contributing factors, including post-pandemic effects, competing mortality risks, and migration-related population changes.
Data from the Baden-Württemberg Cancer Registry were used to calculate age-standardized and age-specific incidence rates for all cancers combined and for colorectal, lung, prostate, and breast cancer. Incidence rates for 2020 to 2023 were compared with those from a pre-pandemic reference period (2017-2019) and with expected rates based on modeled trends between 2015 and 2019 using standardized incidence ratios (SIRs).
Among men, the age-standardized overall cancer incidence declined significantly from 734.0 per 100,000 in 2019 to 672.9-681.7 during 2020-2023. In women, incidence declined from 542.2 in 2019 to 504.3-524.4, with statistically significant reductions in 2022 and 2023. Compared to 2017-2019 levels, 14,214 fewer cases (-5.5%) were diagnosed in 2020-2023; relative to model-based expectations, 19,525 fewer cases (-7.6%) were reported. Site-specific analyses showed significantly lower colorectal cancer incidence in both sexes from 2020 onwards (SIRs: 0.81-0.90). For men, part of this decline may reflect a pre-existing downward trend. No significant deviations were found for lung and prostate cancer. Female breast cancer incidence was significantly lower only in 2020 (SIR: 0.93).
Cancer incidence in Baden-Württemberg remained consistently below pre-pandemic and expected levels from 2020 through 2023. Further research is warranted to disentangle potential contributing factors, including post-pandemic effects, competing mortality risks, and migration-related population changes.