Colorectal cancer incidence before and during the COVID-19 pandemic: a non-linear interrupted time-series analysis.

Publication date: May 25, 2026

The COVID-19 pandemic affected healthcare worldwide. This study analysed age-standardised incidence rates (ASIR) of colorectal cancer (CRC) in Bavaria to assess the COVID-19 pandemic’s impact. We modelled CRC ASIR, overall and in the subgroups (sex, age group, site and stage), in the pre-pandemic (01/2007 to 02/2020) and pandemic (03/2020 to 02/2022) periods using interrupted time-series analyses. Predictions for the third year of the pandemic (03/2022 to 02/2023) were compared to expected ASIR. Comparing expected and observed CRC ASIR during the first year of the pandemic showed a significant relative change of -8. 8% (95% CI: -12. 7% to -4. 6%), improving to 1. 4% (95% CI: -4. 5% to 7. 2%) in the third year of the pandemic. Likewise, ASIR significantly decreased across almost all subgroups during the first year of the pandemic, recovering during the second and the third year of the pandemic. Early stages showed a significant estimated reduction, persisting until the third year of the pandemic (-4. 7%; 95% CI: -8. 6% to -0. 9%). In contrast, for women aged 70 years and above and women with colon cancer, ASIR experienced a significant excess. In the first year of the pandemic, estimated CRC ASIR experienced significant decline, returning to the expected rates during the third year of the pandemic, for most, but not all subgroups. The relative difference remained significantly negative for early stages. A significant catch-up effect occurred in the subgroups of women aged 70 years and above and women with colon cancer. Overall, estimations indicate a recovery of CRC ASIR.

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Concepts Keywords
Bavaria Adult
Cancer Aged
Healthcare Aged, 80 and over
Pandemic Cancer registry data
Colorectal cancer
Colorectal Neoplasms
COVID-19
COVID-19 pandemic
Female
Germany
Humans
Incidence
Incidence
Interrupted time-series analysis
Male
Middle Aged
Pandemics
Prediction
SARS-CoV-2

Semantics

Type Source Name
disease MESH Colorectal cancer
pathway KEGG Colorectal cancer
disease MESH COVID-19 pandemic
disease MESH colon cancer
disease MESH included
disease MESH cancers
drug DRUGBANK Coenzyme M
disease MESH ICD
disease MESH death
pathway KEGG Coronavirus disease
disease MESH melanoma
pathway KEGG Melanoma
disease MESH breast cancer
pathway KEGG Breast cancer
disease MESH skin cancer
disease MESH infection
disease MESH rectal cancer
drug DRUGBANK Guanosine
disease MESH ACF
drug DRUGBANK Diethylstilbestrol
disease MESH des
pathway REACTOME Reproduction

Original Article

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