ABSTRACT
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.
ABSTRACT
Background: The COVID-19 pandemic continues to have a serious impact on many people, including cancer pts. The US CDC and oncology groups (ASCO, ESMO, ACS) made recommendations as to what high risk groups should be vaccinated first which includes cancer pts. Users of Belong.life, a worldwide, free, and voluntary, digital health application for cancer pts, replied to a targeted survey including demographic & clinical questions related to the pts cancers, ongoing therapies and the Covid 19 vaccination characteristics, and interactions. Methods: In this prospective study, 1069 cancer pts, Belong.life users, voluntarily replied to a survey asking demographic and clinical questions related to their Covid 19 vaccination and cancer status characteristics. Results: Most of the pts were North American based (91 %), with 6.3 % from Europe and 2.6% from the rest of the world. 72% were between 50-69 years of age, and 79.5% were females. Five most common diagnosis were Breast Cancer (35.2%), gynecological (14.4%), gastrointestinal (13.3%), lung cancers (9.7%) and genitourinary (7%). 59% of the pts received chemotherapy,14.2% immunotherapy and 32.8% had radiotherapy over the past 12 months prior to receive the Covid 19 vaccination, which consisted of mRNA vaccines in 82.2% (Pfizer 46.2%, Moderna 36%). 4.9% of the pts refused vaccination. 82.3% of the pts had none (39.3%) or mild (43%) side-effects (S/E) and only 2.4% reported severe S/E. Most S/E lasted 1-3 days (89.4%) consisting mainly of sore arm (42.5%), headache (23.3%), fatigue (21.1%), and temperature (18.5%). Swollen lymph-nodes and allergic reactions were only reported in 0.7% (each). 49% of the pts were vaccinated while actively engaged on treatment, and in 96% there was no delay, interruption, or stoppage of the anticancer therapy. Conclusions: This is the first large report on Real word data voluntarily obtained from 1069 Belong.life users undergoing anticancer treatment with 90% of them receiving a Covid 19 vaccination. The large majority of pts had none or mild S/E (82.3%), and those were short lived (1-3 days in 89.4%) while only in 2% it was graded as severe. In 96% of the pts their ongoing anticancer therapy did not necessitate to be delayed, interrupted, or stopped. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: E. Sapir: Financial Interests, Personal, Advisory Role, Consultant: Belong.life;Financial Interests, Personal, Advisory Role, Consultant: MSD;Financial Interests, Personal, Advisory Role, Consultant: AstraZeneca. N. Moisa: Financial Interests, Personal, Full or part-time Employment: BelongTail. A. Litvin: Financial Interests, Personal, Full or part-time Employment: BelongTail. E. Malki: Financial Interests, Personal, Full or part-time Employment: BelongTail;Financial Interests, Personal, Full or part-time Employment: Belong.life. D.A. Vorobiof: Financial Interests, Personal, Full or part-time Employment: BelongTail;Financial Interests, Personal, Full or part-time Employment: Belong.life.