@article{Steinberg_J-2023_162636,
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},
author = {Steinberg, J. and Hughes, S. and Hui, H. and Allsop, M. and Egger, S. and David, M. and Caruana, M. and Coxeter, P. and Carle, C. and Onyeka, T. and Rewais, I. and Monroy Iglesias, M. and Vives, N. and Wei, F. and Abila, D. and Carreras, G. and Santero, M. and O'Dowd, E. and Lui, G. and Tolani, M. and Mullooly, M. and Lee, S. and Landy, R. and Hanley, S. and Binefa, G. and McShane, C. and Gizaw, M. and Selvamuthu, P. and Boukheris, H. and Nakaganda, A. and Ergin, I. and Moraes, F. and Timilshina, N. and Kumar, A. and Vale, D. and Molina-Barceló, A. and Force, L. and Campbell, D. and Wang, Y. and Wan, F. and Baker, A. and Singh, R. and Salam, R. and Yuill, S. and Shah, R. and Lansdorp-Vogelaar, I. and Yusuf, A. and Aggarwal, A. and Murillo, R. and Torode, J. and Kliewer, E. and Bray, F. and Chan, K. and Peacock, S. and Hanna, T. and Ginsburg, O. and Van Hemelrijck, M. and Sullivan, R. and Roitberg, F. and Ilbawi, A. and Soerjomataram, I. and Canfell, K.},
month = {dec},
year = {2023},
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.},
journal = {International Journal of Cancer},
publisher = {Wiley},
url = {https://doi.org/10.1002/ijc.34798},
}
