Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination: A systematic review and meta-analysis

Julia Steinberg; Suzanne Hughes; Harriet Hui; Matthew J. Allsop; Sam Egger; Michael David; Michael Caruana; Peter Coxeter; Chelsea Carle; Tonia Onyeka; Isabel Rewais; Maria J. Monroy Iglesias; Nuria Vives; Feixue Wei; Derrick Bary Abila; Giulia Carreras; Marilina Santero; Emma L. O'Dowd; Gigi Lui; Musliu Adetola Tolani; Maeve Mullooly; Shing Fung Lee; Rebecca Landy; Sharon J.B. Hanley; Gemma Binefa; Charlene M. McShane; Muluken Gizaw; Poongulali Selvamuthu; Houda Boukheris; Annet Nakaganda; Isil Ergin; Fabio Ynoe Moraes; Nahari Timilshina; Ashutosh Kumar; Diama B. Vale; Ana Molina-Barceló; Lisa M. Force; Denise Joan Campbell; Yuqing Wang; Fang Wan; Anna Lisa Baker; Ramnik Singh; Rehana Abdus Salam; Susan Yuill; Richa Shah; Iris Lansdorp-Vogelaar; Aasim Yusuf; Ajay Aggarwal; Raul Murillo; Julie S. Torode; Erich V. Kliewer; Freddie Bray; Kelvin K.W. Chan; Stuart Peacock; Timothy P. Hanna; Ophira Ginsburg; Mieke Van Hemelrijck; Richard Sullivan; Felipe Roitberg; André M. Ilbawi; Isabelle Soerjomataram; Karen Canfell

doi:10.1002/ijc.34798

Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination: A systematic review and meta-analysis

Julia Steinberg
, Suzanne Hughes
, Harriet Hui
, Matthew J. Allsop
, Sam Egger
, Michael David
, Michael Caruana
, Peter Coxeter
, Chelsea Carle
, Tonia Onyeka
, Isabel Rewais
, Maria J. Monroy Iglesias
, Nuria Vives
, Feixue Wei
, Derrick Bary Abila
, Giulia Carreras
, Marilina Santero
, Emma L. O'Dowd
, Gigi Lui
, Musliu Adetola Tolani

Maeve Mullooly, Shing Fung Lee, Rebecca Landy, Sharon J.B. Hanley, Gemma Binefa, Charlene M. McShane, Muluken Gizaw, Poongulali Selvamuthu, Houda Boukheris, Annet Nakaganda, Isil Ergin, Fabio Ynoe Moraes, Nahari Timilshina, Ashutosh Kumar, Diama B. Vale, Ana Molina-Barceló, Lisa M. Force, Denise Joan Campbell, Yuqing Wang, Fang Wan, Anna Lisa Baker, Ramnik Singh, Rehana Abdus Salam, Susan Yuill, Richa Shah, Iris Lansdorp-Vogelaar, Aasim Yusuf, Ajay Aggarwal, Raul Murillo, Julie S. Torode, Erich V. Kliewer, Freddie Bray, Kelvin K.W. Chan, Stuart Peacock, Timothy P. Hanna, Ophira Ginsburg, Mieke Van Hemelrijck, Richard Sullivan, Felipe Roitberg, André M. Ilbawi, Isabelle Soerjomataram, Karen Canfell

Department of Internal Medicine

University of Sydney
University of Leeds, School of Medicine
Griffith University Queensland
University of Nigeria
IVAN Research Institute
King's College London
Institute Catala Oncologia
CIBER of Epidemiology and Public Health
International Agency for Research on Cancer
Makerere University
Prevention and Clinical Network (ISPRO)
Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (IIB Sant Pau)
Nottingham University Hospitals NHS Trust
Ahmadu Bello University
Royal College of Surgeons in Ireland
National University Hospital
Hong Kong Hospital Authority
National Cancer Institute (NCI)
University of Aberdeen
Hokkaido University
Hospital Universitari de Bellvitge
Queen's University Belfast
Addis Ababa University
Martin Luther University Halle-Wittenberg
Voluntary Health Services
University of Béjaïa
Uganda Cancer Institute
Ege University
Queen's University Kingston
University of Toronto
All India Institute of Medical Sciences, Patna
Universidade Estadual de Campinas
Biomedical Research Foundation FISABIO
University of Washington
Erasmus University Rotterdam
Shaukat Khanum Memorial Cancer Hospital and Research Centre
London School of Hygiene and Tropical Medicine
Guy's and St Thomas' NHS Foundation Trust
Hospital Universitario San Ignacio
Guy’s Hospital
Provincial Health Services Authority
Canadian Centre for Applied Research in Cancer Control
Simon Fraser University
Queen's University
World Health Organization
Hospital Sirio-Libanes
Rede Ebserh

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

While previous reviews found a positive association between pre-existing cancer diagnosis and COVID-19-related death, most early studies did not distinguish long-term cancer survivors from those recently diagnosed/treated, nor adjust for important confounders including age. We aimed to consolidate higher-quality evidence on risk of COVID-19-related death for people with recent/active cancer (compared to people without) in the pre-COVID-19-vaccination period. We searched the WHO COVID-19 Global Research Database (20 December 2021), and Medline and Embase (10 May 2023). We included studies adjusting for age and sex, and providing details of cancer status. Risk-of-bias assessment was based on the Newcastle-Ottawa Scale. Pooled adjusted odds or risk ratios (aORs, aRRs) or hazard ratios (aHRs) and 95% confidence intervals (95% CIs) were calculated using generic inverse-variance random-effects models. Random-effects meta-regressions were used to assess associations between effect estimates and time since cancer diagnosis/treatment. Of 23 773 unique title/abstract records, 39 studies were eligible for inclusion (2 low, 17 moderate, 20 high risk of bias). Risk of COVID-19-related death was higher for people with active or recently diagnosed/treated cancer (general population: aOR = 1.48, 95% CI: 1.36-1.61, I² = 0; people with COVID-19: aOR = 1.58, 95% CI: 1.41-1.77, I² = 0.58; inpatients with COVID-19: aOR = 1.66, 95% CI: 1.34-2.06, I² = 0.98). Risks were more elevated for lung (general population: aOR = 3.4, 95% CI: 2.4-4.7) and hematological cancers (general population: aOR = 2.13, 95% CI: 1.68-2.68, I² = 0.43), and for metastatic cancers. Meta-regression suggested risk of COVID-19-related death decreased with time since diagnosis/treatment, for example, for any/solid cancers, fitted aOR = 1.55 (95% CI: 1.37-1.75) at 1 year and aOR = 0.98 (95% CI: 0.80-1.20) at 5 years post-cancer diagnosis/treatment. In conclusion, before COVID-19-vaccination, risk of COVID-19-related death was higher for people with recent cancer, with risk depending on cancer type and time since diagnosis/treatment.

Original language	English
Pages (from-to)	1394-1412
Number of pages	19
Journal	International Journal of Cancer
Volume	154
Issue number	8
DOIs	https://doi.org/10.1002/ijc.34798
State	Published - 15 Apr 2024

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

COVID-19
cancer
death
meta-analysis
systematic review

Access to Document

10.1002/ijc.34798

Cite this

Steinberg, J., Hughes, S., Hui, H., Allsop, M. J., Egger, S., David, M., Caruana, M., Coxeter, P., Carle, C., Onyeka, T., Rewais, I., Monroy Iglesias, M. J., Vives, N., Wei, F., Abila, D. B., Carreras, G., Santero, M., O'Dowd, E. L., Lui, G., ... Canfell, K. (2024). Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination: A systematic review and meta-analysis. International Journal of Cancer, 154(8), 1394-1412. https://doi.org/10.1002/ijc.34798

@article{e2912321c4994e6d8eb0b786e5fec6a7,

title = "Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination: A systematic review and meta-analysis",

abstract = "While previous reviews found a positive association between pre-existing cancer diagnosis and COVID-19-related death, most early studies did not distinguish long-term cancer survivors from those recently diagnosed/treated, nor adjust for important confounders including age. We aimed to consolidate higher-quality evidence on risk of COVID-19-related death for people with recent/active cancer (compared to people without) in the pre-COVID-19-vaccination period. We searched the WHO COVID-19 Global Research Database (20 December 2021), and Medline and Embase (10 May 2023). We included studies adjusting for age and sex, and providing details of cancer status. Risk-of-bias assessment was based on the Newcastle-Ottawa Scale. Pooled adjusted odds or risk ratios (aORs, aRRs) or hazard ratios (aHRs) and 95\% confidence intervals (95\% CIs) were calculated using generic inverse-variance random-effects models. Random-effects meta-regressions were used to assess associations between effect estimates and time since cancer diagnosis/treatment. Of 23 773 unique title/abstract records, 39 studies were eligible for inclusion (2 low, 17 moderate, 20 high risk of bias). Risk of COVID-19-related death was higher for people with active or recently diagnosed/treated cancer (general population: aOR = 1.48, 95\% CI: 1.36-1.61, I2 = 0; people with COVID-19: aOR = 1.58, 95\% CI: 1.41-1.77, I2 = 0.58; inpatients with COVID-19: aOR = 1.66, 95\% CI: 1.34-2.06, I2 = 0.98). Risks were more elevated for lung (general population: aOR = 3.4, 95\% CI: 2.4-4.7) and hematological cancers (general population: aOR = 2.13, 95\% CI: 1.68-2.68, I2 = 0.43), and for metastatic cancers. Meta-regression suggested risk of COVID-19-related death decreased with time since diagnosis/treatment, for example, for any/solid cancers, fitted aOR = 1.55 (95\% CI: 1.37-1.75) at 1 year and aOR = 0.98 (95\% CI: 0.80-1.20) at 5 years post-cancer diagnosis/treatment. In conclusion, before COVID-19-vaccination, risk of COVID-19-related death was higher for people with recent cancer, with risk depending on cancer type and time since diagnosis/treatment.",

keywords = "COVID-19, cancer, death, meta-analysis, systematic review",

author = "Julia Steinberg and Suzanne Hughes and Harriet Hui and Allsop, \{Matthew J.\} and Sam Egger and Michael David and Michael Caruana and Peter Coxeter and Chelsea Carle and Tonia Onyeka and Isabel Rewais and \{Monroy Iglesias\}, \{Maria J.\} and Nuria Vives and Feixue Wei and Abila, \{Derrick Bary\} and Giulia Carreras and Marilina Santero and O'Dowd, \{Emma L.\} and Gigi Lui and Tolani, \{Musliu Adetola\} and Maeve Mullooly and Lee, \{Shing Fung\} and Rebecca Landy and Hanley, \{Sharon J.B.\} and Gemma Binefa and McShane, \{Charlene M.\} and Muluken Gizaw and Poongulali Selvamuthu and Houda Boukheris and Annet Nakaganda and Isil Ergin and Moraes, \{Fabio Ynoe\} and Nahari Timilshina and Ashutosh Kumar and Vale, \{Diama B.\} and Ana Molina-Barcel{\'o} and Force, \{Lisa M.\} and Campbell, \{Denise Joan\} and Yuqing Wang and Fang Wan and Baker, \{Anna Lisa\} and Ramnik Singh and Salam, \{Rehana Abdus\} and Susan Yuill and Richa Shah and Iris Lansdorp-Vogelaar and Aasim Yusuf and Ajay Aggarwal and Raul Murillo and Torode, \{Julie S.\} and Kliewer, \{Erich V.\} and Freddie Bray and Chan, \{Kelvin K.W.\} and Stuart Peacock and Hanna, \{Timothy P.\} and Ophira Ginsburg and \{Van Hemelrijck\}, Mieke and Richard Sullivan and Felipe Roitberg and Ilbawi, \{Andr{\'e} M.\} and Isabelle Soerjomataram and Karen Canfell",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors. International Journal of Cancer published by John Wiley \& Sons Ltd on behalf of UICC.",

year = "2024",

month = apr,

day = "15",

doi = "10.1002/ijc.34798",

language = "English",

volume = "154",

pages = "1394--1412",

journal = "International Journal of Cancer",

issn = "0020-7136",

publisher = "John Wiley and Sons Inc.",

number = "8",

}

Steinberg, J, Hughes, S, Hui, H, Allsop, MJ, Egger, S, David, M, Caruana, M, Coxeter, P, Carle, C, Onyeka, T, Rewais, I, Monroy Iglesias, MJ, Vives, N, Wei, F, Abila, DB, Carreras, G, Santero, M, O'Dowd, EL, Lui, G, Tolani, MA, Mullooly, M, Lee, SF, Landy, R, Hanley, SJB, Binefa, G, McShane, CM, Gizaw, M, Selvamuthu, P, Boukheris, H, Nakaganda, A, Ergin, I, Moraes, FY, Timilshina, N, Kumar, A, Vale, DB, Molina-Barceló, A, Force, LM, Campbell, DJ, Wang, Y, Wan, F, Baker, AL, Singh, R, Salam, RA, Yuill, S, Shah, R, Lansdorp-Vogelaar, I, Yusuf, A, Aggarwal, A, Murillo, R, Torode, JS, Kliewer, EV, Bray, F, Chan, KKW, Peacock, S, Hanna, TP, Ginsburg, O, Van Hemelrijck, M, Sullivan, R, Roitberg, F, Ilbawi, AM, Soerjomataram, I & Canfell, K 2024, 'Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination: A systematic review and meta-analysis', International Journal of Cancer, vol. 154, no. 8, pp. 1394-1412. https://doi.org/10.1002/ijc.34798

TY - JOUR

T1 - Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination

T2 - A systematic review and meta-analysis

AU - Steinberg, Julia

AU - Hughes, Suzanne

AU - Hui, Harriet

AU - Allsop, Matthew J.

AU - Egger, Sam

AU - David, Michael

AU - Caruana, Michael

AU - Coxeter, Peter

AU - Carle, Chelsea

AU - Onyeka, Tonia

AU - Rewais, Isabel

AU - Monroy Iglesias, Maria J.

AU - Vives, Nuria

AU - Wei, Feixue

AU - Abila, Derrick Bary

AU - Carreras, Giulia

AU - Santero, Marilina

AU - O'Dowd, Emma L.

AU - Lui, Gigi

AU - Tolani, Musliu Adetola

AU - Mullooly, Maeve

AU - Lee, Shing Fung

AU - Landy, Rebecca

AU - Hanley, Sharon J.B.

AU - Binefa, Gemma

AU - McShane, Charlene M.

AU - Gizaw, Muluken

AU - Selvamuthu, Poongulali

AU - Boukheris, Houda

AU - Nakaganda, Annet

AU - Ergin, Isil

AU - Moraes, Fabio Ynoe

AU - Timilshina, Nahari

AU - Kumar, Ashutosh

AU - Vale, Diama B.

AU - Molina-Barceló, Ana

AU - Force, Lisa M.

AU - Campbell, Denise Joan

AU - Wang, Yuqing

AU - Wan, Fang

AU - Baker, Anna Lisa

AU - Singh, Ramnik

AU - Salam, Rehana Abdus

AU - Yuill, Susan

AU - Shah, Richa

AU - Lansdorp-Vogelaar, Iris

AU - Yusuf, Aasim

AU - Aggarwal, Ajay

AU - Murillo, Raul

AU - Torode, Julie S.

AU - Kliewer, Erich V.

AU - Bray, Freddie

AU - Chan, Kelvin K.W.

AU - Peacock, Stuart

AU - Hanna, Timothy P.

AU - Ginsburg, Ophira

AU - Van Hemelrijck, Mieke

AU - Sullivan, Richard

AU - Roitberg, Felipe

AU - Ilbawi, André M.

AU - Soerjomataram, Isabelle

AU - Canfell, Karen

PY - 2024/4/15

Y1 - 2024/4/15

N2 - While previous reviews found a positive association between pre-existing cancer diagnosis and COVID-19-related death, most early studies did not distinguish long-term cancer survivors from those recently diagnosed/treated, nor adjust for important confounders including age. We aimed to consolidate higher-quality evidence on risk of COVID-19-related death for people with recent/active cancer (compared to people without) in the pre-COVID-19-vaccination period. We searched the WHO COVID-19 Global Research Database (20 December 2021), and Medline and Embase (10 May 2023). We included studies adjusting for age and sex, and providing details of cancer status. Risk-of-bias assessment was based on the Newcastle-Ottawa Scale. Pooled adjusted odds or risk ratios (aORs, aRRs) or hazard ratios (aHRs) and 95% confidence intervals (95% CIs) were calculated using generic inverse-variance random-effects models. Random-effects meta-regressions were used to assess associations between effect estimates and time since cancer diagnosis/treatment. Of 23 773 unique title/abstract records, 39 studies were eligible for inclusion (2 low, 17 moderate, 20 high risk of bias). Risk of COVID-19-related death was higher for people with active or recently diagnosed/treated cancer (general population: aOR = 1.48, 95% CI: 1.36-1.61, I2 = 0; people with COVID-19: aOR = 1.58, 95% CI: 1.41-1.77, I2 = 0.58; inpatients with COVID-19: aOR = 1.66, 95% CI: 1.34-2.06, I2 = 0.98). Risks were more elevated for lung (general population: aOR = 3.4, 95% CI: 2.4-4.7) and hematological cancers (general population: aOR = 2.13, 95% CI: 1.68-2.68, I2 = 0.43), and for metastatic cancers. Meta-regression suggested risk of COVID-19-related death decreased with time since diagnosis/treatment, for example, for any/solid cancers, fitted aOR = 1.55 (95% CI: 1.37-1.75) at 1 year and aOR = 0.98 (95% CI: 0.80-1.20) at 5 years post-cancer diagnosis/treatment. In conclusion, before COVID-19-vaccination, risk of COVID-19-related death was higher for people with recent cancer, with risk depending on cancer type and time since diagnosis/treatment.

AB - While previous reviews found a positive association between pre-existing cancer diagnosis and COVID-19-related death, most early studies did not distinguish long-term cancer survivors from those recently diagnosed/treated, nor adjust for important confounders including age. We aimed to consolidate higher-quality evidence on risk of COVID-19-related death for people with recent/active cancer (compared to people without) in the pre-COVID-19-vaccination period. We searched the WHO COVID-19 Global Research Database (20 December 2021), and Medline and Embase (10 May 2023). We included studies adjusting for age and sex, and providing details of cancer status. Risk-of-bias assessment was based on the Newcastle-Ottawa Scale. Pooled adjusted odds or risk ratios (aORs, aRRs) or hazard ratios (aHRs) and 95% confidence intervals (95% CIs) were calculated using generic inverse-variance random-effects models. Random-effects meta-regressions were used to assess associations between effect estimates and time since cancer diagnosis/treatment. Of 23 773 unique title/abstract records, 39 studies were eligible for inclusion (2 low, 17 moderate, 20 high risk of bias). Risk of COVID-19-related death was higher for people with active or recently diagnosed/treated cancer (general population: aOR = 1.48, 95% CI: 1.36-1.61, I2 = 0; people with COVID-19: aOR = 1.58, 95% CI: 1.41-1.77, I2 = 0.58; inpatients with COVID-19: aOR = 1.66, 95% CI: 1.34-2.06, I2 = 0.98). Risks were more elevated for lung (general population: aOR = 3.4, 95% CI: 2.4-4.7) and hematological cancers (general population: aOR = 2.13, 95% CI: 1.68-2.68, I2 = 0.43), and for metastatic cancers. Meta-regression suggested risk of COVID-19-related death decreased with time since diagnosis/treatment, for example, for any/solid cancers, fitted aOR = 1.55 (95% CI: 1.37-1.75) at 1 year and aOR = 0.98 (95% CI: 0.80-1.20) at 5 years post-cancer diagnosis/treatment. In conclusion, before COVID-19-vaccination, risk of COVID-19-related death was higher for people with recent cancer, with risk depending on cancer type and time since diagnosis/treatment.

KW - COVID-19

KW - cancer

KW - death

KW - meta-analysis

KW - systematic review

UR - https://www.scopus.com/pages/publications/85179341144

U2 - 10.1002/ijc.34798

DO - 10.1002/ijc.34798

M3 - Article

AN - SCOPUS:85179341144

SN - 0020-7136

VL - 154

SP - 1394

EP - 1412

JO - International Journal of Cancer

JF - International Journal of Cancer

IS - 8

ER -

Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination: A systematic review and meta-analysis

Abstract

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Cite this