Background. We sought to quantify the impact of the COVID-19 pandemic on cancer mortality and identify associated factors in Pennsylvania. Methods. The retrospective study analyzed cross-sectional cancer mortality data from CDC WONDER for 2015 through 2020 for Pennsylvania and its 67 counties. The spatial distributions of 2019, 2020, and percentage change in age-adjusted mortality rates by county were analyzed via choropleth maps and spatial autocorrelation. A Wilcoxon Signed Rank Test was used to analyze whether the rates differed between 2019 and 2020. Quasi-Poisson and geographically weighted regression at the county level were used to assess the association between the 2019 rates, sex (percent female), race (percent non-White), ethnicity (percent Hispanic/Latino), rural–urban continuum codes, and socioeconomic status with the 2020 rates. Results. At the state level, the rate in 2020 did not reflect the declining annual trend (−2.7 per 100,000) in the rate since 2015. Twenty-six counties had an increase in the rate in 2020. Of the factors examined, the 2019 rates were positively associated with the 2020 rates, and the impact of sociodemographic and geographic factors on the 2020 rates varied by county. Conclusions. In Pennsylvania, the 2020 cancer mortality rates did not decline as much as reported before the COVID-19 pandemic. The top five cancer types by rate were the same type for 2019 and 2020. Future cancer control efforts may need to address the impact of the COVID-19 pandemic on trends and geospatial distribution in cancer mortality.
背景：本研究旨在量化COVID-19大流行对宾夕法尼亚州癌症死亡率的影响，并识别相关影响因素。方法：这项回顾性研究分析了美国疾病控制与预防中心WONDER数据库中2015年至2020年宾夕法尼亚州及其67个县的横断面癌症死亡率数据。通过分级统计地图和空间自相关分析，研究了2019年、2020年各县年龄调整死亡率及其百分比变化的空间分布。采用Wilcoxon符号秩检验分析2019年与2020年死亡率是否存在差异。通过准泊松回归和县级地理加权回归，评估2019年死亡率、性别（女性比例）、种族（非白人比例）、民族（西班牙裔/拉丁裔比例）、城乡连续体代码及社会经济地位与2020年死亡率之间的关联。结果：在州级层面，2020年癌症死亡率未延续2015年以来的年度下降趋势（每10万人减少2.7例），26个县的死亡率在2020年出现上升。在考察的因素中，2019年死亡率与2020年死亡率呈正相关，而社会人口统计学和地理因素对2020年死亡率的影响因县而异。结论：在宾夕法尼亚州，2020年癌症死亡率未如COVID-19大流行前报告的那样显著下降。2019年与2020年死亡率前五位的癌症类型保持一致。未来的癌症防控工作可能需要关注COVID-19大流行对癌症死亡率趋势和地理空间分布的影响。
肿瘤(癌症)患者之家