American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation.

No abstract

The incidence of BCC in Lithuania is lower than that reported in Northern and Western Europe. The population-based data for BCC from Lithuania are closely comparable, with regard to age, tumour localization and place of residence, with the existing literature from other European cancer registries.

The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) of Lithuania. We assessed the time period from 1 February 2020 to 31 December 2020 and compared it to the same period of 2019. Data for our analysis were extracted from the NCI Hospital Information System (HIS) and the National Health Insurance Fund (NHIF). Contingency table analysis and ANOVA were performed. The COVID-19 pandemic negatively affected the cancer services provided by NCI. Reductions in diagnostic radiology (−16%) and endoscopy (−29%) procedures were accompanied by a decreased number of patients with ongoing medical (−30%), radiation (−6%) or surgical (−10%) treatment. The changes in the number of newly diagnosed cancer patients were dependent on tumor type and disease stage, showing a rise in advanced disease at diagnosis already during the early period of the first lockdown. The extent of out-patient consultations (−14%) and disease follow-up visits (−16%) was also affected by the pandemic, and only referrals to psychological/psychiatric counselling were increased. Additionally, the COVID-19 pandemic had an impact on the structure of cancer services by fostering the application of modified systemic anticancer therapy or hypofractionated radiotherapy. The most dramatic drop occurred in the number of patients participating in cancer prevention programs; the loss was 25% for colon cancer and 62% for breast cancer screening. Marked restriction in access to preventive cancer screening and overall reduction of the whole spectrum of cancer services may negatively affect cancer survival measures in the nearest future.

This study used population-based census-linked cancer incidence data to identify patterns of educational differentials in the risk of cancer by detailed sites of cancer in Lithuania. The study is based on the linkage between all records of the 2001 population census, all records from the Lithuanian Cancer Registry (cancer incidence), and all death and emigration records from Statistics Lithuania for the period between 6 April 2001 and 31 December 2009. The study population (cohort) includes all permanent residents of Lithuania aged 30-74 years on the day of the census (6 April 2001). The study found that cancers of the lip, mouth, and pharynx, esophagus, stomach, larynx, urinary bladder, pancreas, and lung for men and cancers of the cervix uteri, lung, and colon for women show a statistically significant inverse educational gradient with excess incidence in the lowest educational group. At the same time, a reversed cancer risk gradient with the highest incidence for the higher education group was observed for thyroid cancer, melanoma, nonmelanoma skin cancers, and non-Hodgkin lymphomas. This group also includes prostate cancer, kidney cancer, and multiple myeloma for men and cancer of the pancreas, breast cancer, cancer of the colon, and cancer of the uterus for women. The associations between education and cancer incidence observed in this study reflect the concordance between social status and lifestyle-related risk factors for cancer. Cancer awareness in society has also contributed toward the observed higher risk of cancer, which is usually promoted more by patients with higher education.