Pandemic-era increases in late-stage pediatric cancer diagnoses, 2020-2022

Abstract COVID-19 pandemic-related disruptions may have altered pediatric cancer detection in the US. Using the National Childhood Cancer Registry, we compared observed incidence rates among individuals aged 0–17 years during 2020–2022 to expected rates with 95% credible intervals (CrI) derived from pre-pandemic trends. Rates were evaluated overall and by race/ethnicity, cancer site, and stage-at-diagnosis. Among 27,996 cancers diagnosed in 2020–2022, total incidence was 17.44 per 100,000, similar to the expected rate of 17.39 (95% CrI, 16.80–17.98). Annual patterns showed an incidence reduction in 2020, followed by modestly higher-than-expected rates in 2021-2022. Pandemic-era late-stage incidence was significantly higher than expected, however (10.58 vs 10.19 per 100,000). Overall, pediatric cancer incidence during the COVID-19 pandemic matched expectations, but late-stage diagnoses increased, underscoring the need to restore timely evaluation and maintain diagnostic access during health-system disruptions.