"People with cancer, especially blood cancers, who may be immunocompromised, and prostate cancer, who tend to be older, may be at greater risk of COVID-19 complications and death," said study author Xuesong Han, scientific director of health services research at the American Cancer Society.
For the study, researchers identified 3,142 cancer deaths with COVID-19 as a contributing cause and 13,419 COVID-19 deaths with cancer as a contributing cause from March 2020 to December 2020 using death certificate information for U.S. residents. During this time, there were nearly 337,400 cancer deaths that were not related to COVID-19.
There were significantly more COVID-19-related cancer deaths than there were cancer deaths not related to COVID-19 in people with blood cancers, 23.3% vs. 9.6%, respectively, and prostate cancer, 12.4% vs. 5.5%, respectively, the study showed.
COVID-related cancer deaths were more likely to occur in large cities and in males, people aged 85 years or older, and racial/ethnic minorities.
"People receiving cancer treatment generally have a weakened immune system because of the cancer itself and/or its treatment," Han explained. "Moreover, people diagnosed with cancer tend to be older and have other co-morbid conditions that are associated with severe COVID-19 illness, such as heart disease, chronic diseases of the lung and kidney, diabetes and obesity."
Most cancer deaths that were unrelated to COVID-19 occurred at home or in hospice facilities. In contrast, COVID-complicated deaths from cancer were more likely to take place in hospitals or nursing homes/long-term care facilities, the study showed.
The message is clear: People being treated for cancer must take precautions to lower their risk of contracting COVID-19, including staying current on vaccinations, avoiding crowded indoor spaces and wearing masks in public, Han said.
"Up-to-date vaccination is important even if patients had a prior COVID-19 infection because people can be infected with COVID-19 more than once," she said. "It is also important for family members and informal caregivers to be up to date with COVID-19 vaccinations, to minimize the risk of transmission."
The new data predates the availability of COVID vaccines and medications to treat the virus.
"When more recent surveillance data for 2021 and 2022 become available for research, we plan to monitor if and how much COVID-related cancer [deaths] decreased nationally after the vaccines became available," Han said. "Research should closely monitor the lasting symptoms of COVID-19 infection among cancer patients and survivors, to inform clinical practice."
The research was published Sept. 29 in the journal JAMA Oncology.
The findings mirror what Dr. Tobias Hohl witnessed in his practice during the early days of the pandemic. He is the chief of infectious diseases service at Memorial Sloan Kettering Cancer Center in New York City.
The risk of dying from COVID-19 was also higher in people with lung cancer at his hospital, he said.
"COVID-19's main target organ is the lung and respiratory tract so when you have cancer at the same site, it can create problems that you aren’t able to compensate for," explained Hohl, who was not part of the study.
The vaccine has definitely saved lives, he added.
"We are in a much better place than we were in 2020," Hohl said. "Now, we have fewer cancer patients with severe COVID-19 than we did in 2020, despite the rapidly spreading Omicron variants."
His advice? Get the updated booster shots as soon as you are eligible and don't forget your annual flu shot to keep your immune system primed. "We are much better at treating COVID-19, so patients do better," he said. "Cancer is a far more significant health problem in 2022 than the risk of COVID-19."
Medical oncologist Dr. Marleen Meyers agreed. She is director of the survivorship program at NYU Langone's Perlmutter Cancer Center in New York City.
"In the very early days of the pandemic, before masks were recommended, susceptible [cancer] patients were in hospitals and offices with high exposure to the virus," said Meyers, who had no role in the study.
Vaccines have definitely helped. Still, "there are some instances where the timing of the vaccine must be considered so all patients should check with their doctors," she said.
The U.S. National Cancer Institute has more on what people with cancer should know.
SOURCES: Xuesong Han, PhD, scientific director, health services research, American Cancer Society, Atlanta; Tobias Hohl, MD, PhD, chief, infectious diseases service, Memorial Sloan Kettering Cancer Center, New York City; Marleen Meyers, MD, medical oncologist and director, survivorship program, NYU Langone's Perlmutter Cancer Center, New York City; JAMA Oncology, Sept. 29, 2022