Changes in cancer incidence and stage during the COVID-19 pandemic in 2020–2021 in the Nordic countries

Authors

  • Anna Johansson Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden https://orcid.org/0000-0002-1191-7231
  • Anna Skog Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
  • Tom Børge Johannesen Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
  • Tor Åge Myklebust Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway; Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
  • Simon M. Kønig Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
  • Charlotte Wessel Skovlund Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
  • Lina Steinrud Mørch Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
  • Søren Friis Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
  • Marnar Fríðheim Kristiansen Center of Health Science, Faculty of Health Sciences, Tórshavn, Faroe Islands; National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
  • David Pettersson National Board of Health and Welfare, Stockholm, Sweden
  • Eva María Gudmundsdóttir ICS Research and Registration Center, Icelandic Cancer Society, Reykjavík, Iceland
  • Nanna Margrét Kristinsdóttir ICS Research and Registration Center, Icelandic Cancer Society, Reykjavík, Iceland
  • Helgi Birgisson ICS Research and Registration Center, Icelandic Cancer Society, Reykjavík, Iceland
  • Sandra Irenaeus Regional Cancer Center Central Sweden, Akademiska sjukhuset, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
  • Johan Ahlgren Regional Cancer Center Central Sweden, Akademiska sjukhuset, Uppsala, Sweden
  • Mats Lambe Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Regional Cancer Center Central Sweden, Akademiska sjukhuset, Uppsala, Sweden
  • Elli Hirvonen Finnish Cancer Registry, Helsinki, Finland
  • Janne Pitkäniemi Finnish Cancer Registry, Helsinki, Finland
  • Giske Ursin Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway; Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

DOI:

https://doi.org/10.2340/1651-226X.2025.42079

Keywords:

COVID-19, cancer, incidence, cancer staging, Nordic

Abstract

Background and purpose: The COVID-19 pandemic impacted substantially on cancer healthcare, including the temporary suspension of screening activities. We compared cancer incidence rates and stage during 2020–2021 to pre-pandemic rates in the Nordic countries.

Material and methods: Using data from the national cancer registries in Denmark, Finland, Iceland, Norway, and Sweden, we estimated age-, sex-, and period-adjusted incidence rate ratios, expressed as relative percentage change (%) with 95% confidence intervals (CIs), comparing rates in 2020–2021 to those in 2017–2019 (pre-pandemic).

Results: In 2020–2021, 340,675 cancer cases were diagnosed. The incidence rates declined during the first pandemic wave (Q2 2020), ranging from –21.7% [95% CI: –23.3%; –20.2%] (Sweden) to –7.9% [–17.7%; 3.0%] (Iceland). Incidence rates also declined in the second pandemic wave (Q1 2021), ranging from –8.6% [–10.2%; –6.9%] (Sweden) to –2.3% [–4.6%; 0.1%] (Norway), and in Sweden also by –3.1% [–4.8%; –1.3%] in the third pandemic wave (Q4 2021). Stage I breast cancer incidence declined during 2020 in Denmark/Norway/Sweden, with some catch-up in stage II incidence in 2021. Prostate cancer rates declined in Denmark/Finland/Norway/Sweden during 2020–2021, while melanoma rates declined in Finland in 2020. During 2020, colon cancer rates declined in Denmark and Iceland, while rectal cancer rates declined in Denmark, and lung and kidney cancer rates declined in Norway.

Interpretation: During 2020–2021, cancer incidence rates declined across the Nordic countries with the largest declines in Sweden. During the third pandemic wave, the incidence rates were mostly similar to pre-pandemic rates. Changes in cancer stage may reflect reduced screening activities.

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2025-02-12

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Johansson, A., Skog, A., Johannesen, T. B., Myklebust, T. Åge, Kønig, S. M., Skovlund, C. W., … Ursin, G. (2025). Changes in cancer incidence and stage during the COVID-19 pandemic in 2020–2021 in the Nordic countries. Acta Oncologica, 64, 257–266. https://doi.org/10.2340/1651-226X.2025.42079

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Vol. 64 (2025): Acta Oncologica

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Copyright (c) 2025 Anna Johansson, Anna Skog, Tom Børge Johannesen, Tor Åge Myklebust, Simon M. Kønig, Charlotte Wessel Skovlund, Lina Steinrud Mørch, Søren Friis, Marnar Fríðheim Kristiansen, David Pettersson, Eva María Gudmundsdóttir, Nanna Margrét Kristinsdóttir, Helgi Birgisson, Sandra Irenaeus, Johan Ahlgren, Mats Lambe, Elli Hirvonen, Janne Pitkäniemi, Giske Ursin

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