Covid 19 infection leading to a subsequent new primary cancer diagnosis, Real-world data (RWD) analysis on members of Belong.life, a global cancer application

Researched by Belong.Life and published by ASCO

Authors: Daniel A. Vorobiof, Bozhena Haikin, Alon Litvin, Irad Deutsch, Eliran Malki.

Background:

Some known viral infections can lead to a diagnosis of cancer (e.g: HPV, HIV, EBV, etc.) Anecdotical reports of a Covid 19 infection, and the subsequent diagnosis of a new cancer have been mentioned by few patients (pts). This relationship has not yet been fully documented. Covid 19 infected persons have been identified to have a suppressed adaptive immunity, which one of its principal functions is to maintain occult cancer cells in an equilibrium state. We studied the possible role of a Covid 19 infection and the subsequent diagnosis of a new primary cancer happening during the Covid pandemic (01/2020 – 12/2021). A survey was sent to all new members of Belong.life, a free and anonymous global cancer app for pts and their caregivers. This study took place prior to the omicron variant surge.

Methods:

2579 Belong.life members received randomly, in the app various cancer groups, a 10 questions voluntary survey regarding the onset of a Covid 19 infection and the development of a subsequent new primary cancer diagnosis. 262 replied of whom 124 fulfilled the eligibility criteria and confirmed having had a Covid 19 infection followed by a new cancer diagnosis. Data on the 124 pts was analyzed by Belong analysts, according to age, sex, geographical distribution, Covid 19 infection onset and type and timing of the cancer diagnosis.

Results:

Most pts were USA based (102/124, 82%), and 1/3 were < 49 years, followed by a 1/3 in the 50-59 and > 60 groups. 71% (88/124) were females. All had a prior Covid 19 infection and only 14 (11%) required hospitalization. 109/124 (88%) had a primary cancer diagnosis and 15 (12%) had disease recurrence. Breast cancer was diagnosed in 38% (47/124), followed by lung and gynecological cancers (10/124, 8% respectively). Time from Covid 19 infection to primary cancer diagnosis was < 6 months in 57 /124 (46%) and 6-12 months in 40/124 (32%). Breast cancer developed earlier (< 12 months) in 87% of the pts. In total 97/124 (78%) pts had their disease diagnosed within less than a year.

Conclusions:

Known viruses might precede the onset of a new cancer. The role of corona viruses and subsequent development of a cancer is unknown. Adaptive immunity maintains occult cancer cells in a steady state, while a Covid 19 infection interferes with it, causing a weak and delayed immune response, which could be responsible, after a period, for the onset of a new primary cancer. We are presenting RWD on 124 pts with new primary cancers diagnosed after a Covid 19 infection. This represents a 5% incidence in a random pts group (124/2579) as described above. Further studies should be planned to investigate this real world increased incidence and testing of the diverse immune parameters are also warranted to further understand the intersection pathways of Covid 19 infection and cancer development.

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