COVID-19 大流行导致医疗保健（包括癌症护理）的获取中断。接受癌症治疗的变化程度尚不清楚。旨在评估 2020 年（大流行的第一年）期间向新诊断癌症患者提供的绝对数量、比例和癌症治疗方式的变化。在这项队列研究中，使用国家癌症数据库确定了 2018 年 1 月 1 日至 2020 年 12 月 31 日期间诊断出患有任何实体瘤的 18 岁及以上人群。数据分析于2022年9月19日至2023年7月28日进行。COVID-19大流行的第一年。2020年每种治疗方式（手术、放疗、化疗、免疫治疗和激素治疗）的预期手术数量为使用历史数据（2018年1月1日至2019年12月31日）采用向量自回归方法计算。在计数数据泊松分布的假设下，使用广义估计方程评估预期数字和观察数字之间的差异。采用加性离群值法评估2020年开始的不同类型癌症治疗比例的变化。 共有3504342名患者（2018年1214918名，平均[SD]年龄，64.6[13.6]岁；1235584名患者） 2019 年，平均 [SD] 年龄为 64.8 [13.6] 岁；2020 年，平均 [SD] 年龄为 64.9 [13.6] 岁，包括 1053840 人。与往年趋势的预期治疗相比，2020 年进行的治疗性手术减少了约 98000 例，化疗方案减少了 38800 例，放疗方案减少了 55500 例，免疫治疗方案减少了 6800 例，开始的激素治疗减少了 32000 例。对大多数癌症部位和阶段进行评估，在大流行的第一年中提供的癌症治疗类型没有统计学上的显着变化，例外是同时接受保乳手术和放疗的患者比例出现统计学上的显着下降。在大流行的头几个月里，接受乳房切除术治疗 I 期乳腺癌的患者比例在统计上显着增加。在这项大型全国队列研究中，注意到大流行第一年提供的癌症治疗数量存在显着不足2019冠状病毒病大流行。数据表明，癌症治疗数量的不足与癌症诊断数量的减少有关，而不是治疗策略的变化。

The COVID-19 pandemic led to disruptions in access to health care, including cancer care. The extent of changes in receipt of cancer treatment is unclear.To evaluate changes in the absolute number, proportion, and cancer treatment modalities provided to patients with newly diagnosed cancer during 2020, the first year of the pandemic.In this cohort study, adults aged 18 years and older diagnosed with any solid tumor between January 1, 2018, and December 31, 2020, were identified using the National Cancer Database. Data analysis was conducted from September 19, 2022, to July 28, 2023.First year of the COVID-19 pandemic.The expected number of procedures for each treatment modality (surgery, radiotherapy, chemotherapy, immunotherapy, and hormonal therapy) in 2020 were calculated using historical data (January 1, 2018, to December 31, 2019) with the vector autoregressive method. The difference between expected and observed numbers was evaluated using a generalized estimating equation under assumptions of the Poisson distribution for count data. Changes in the proportion of different types of cancer treatments initiated in 2020 were evaluated using the additive outlier method.A total of 3 504 342 patients (1 214 918 in 2018, mean [SD] age, 64.6 [13.6] years; 1 235 584 in 2019, mean [SD] age, 64.8 [13.6] years; and 1 053 840 in 2020, mean [SD] age, 64.9 [13.6] years) were included. Compared with expected treatment from previous years' trends, there were approximately 98 000 fewer curative intent surgical procedures performed, 38 800 fewer chemotherapy regimens, 55 500 fewer radiotherapy regimens, 6800 fewer immunotherapy regimens, and 32 000 fewer hormonal therapies initiated in 2020. For most cancer sites and stages evaluated, there was no statistically significant change in the type of cancer treatment provided during the first year of the pandemic, the exception being a statistically significant decrease in the proportion of patients receiving breast-conserving surgery and radiotherapy with a simultaneous statistically significant increase in the proportion of patients undergoing mastectomy for treatment of stage I breast cancer during the first months of the pandemic.In this large national cohort study, a significant deficit was noted in the number of cancer treatments provided in the first year of the COVID-19 pandemic. Data indicated that this deficit in the number of cancer treatments provided was associated with decreases in the number of cancer diagnoses, not changes in treatment strategies.