Impact of the COVID-19 Pandemic on cancer incidence: A Joinpoint Analysis from Kenitra, Morocco

Background

The COVID-19 pandemic disrupted healthcare systems worldwide, causing delays in cancer diagnosis, reporting, and access to care. These disruptions likely had a greater impact in Low- and Middle-Income Countries (LMICs), where cancer surveillance systems are often fragile. In Morocco, evidence on the pandemic’s effect on cancer incidence at the city level remains limited.

Objectives

To assess the impact of the COVID-19 period on cancer incidence trends in Kenitra, Morocco, from 2017 to 2022.

Methods

A retrospective time-trend analysis was conducted using consolidated cancer incidence data from public and private diagnostic centers in Kenitra. Annual case counts were analyzed overall and by sex. The COVID-19 period was defined as 2020. Year-to-year percentage changes and annual percent hanges (APCs) were calculated. Joinpoint regression was applied to identify significant changes in trends, with segmented APCs and 95% confidence intervals (CI).

Results

A total of 2,682 cancer cases were recorded. A decline in incidence was observed in 2020 (−8.64%) compared to 2019, affecting females (−6.81%) and males (−10.04%), interrupting the pre-pandemic trend. Joinpoint analysis identified two segments: a non-significant decrease during 2017–2020 (APC = −2.12%; 95% CI: −10.12 to 3.22; p = 0.33) and a significant increase during 2020–2022 (APC = 13.91%; 95% CI: 4.50 to 22.86; p < 0.001). Following the decline, cases rebounded in 2021 (+16.67%) and 2022 (+12.37%), with a greater increase among males. Overall APCs were 0.95% in females, 4.97% in males, and 3.21% overall.

Conclusions

The pandemic was associated with a temporary decline in cancer incidence, followed by a sharp rebound, likely reflecting delayed diagnoses rather than true changes in risk. These findings highlight the vulnerability of cancer surveillance systems in LMICs and the need to ensure continuity of diagnostic services during health crises.

Key messages

• Highlights the hidden cancer burden caused by COVID-19 diagnostic delays, emphasizing the need for resilient health systems that ensure continuity of cancer detection during crises.

• Provides evidence to guide policy and strengthen cancer surveillance in LMICs, ensuring early diagnosis is maintained even during major disruptions like pandemics.