---
title: "Childhood Cancer in Sweden During the COVID-19 Pandemic: Incidence and Survival in a Nationwide"
id: "plos-medicine-28-childhood-cancer-in-sweden-during-the-covid-19-pandemic-temporal-patterns-in-incidence-and-survival-in-a-nationwide-register-based-cohort-study"
canonical_url: "https://medichelpline.com/clinical-feed/plos-medicine-28-childhood-cancer-in-sweden-during-the-covid-19-pandemic-temporal-patterns-in-incidence-and-survival-in-a-nationwide-register-based-cohort-study"
content_type: "clinical_feed_article"
specialty: "Research Highlights"
source_name: "PLOS Medicine"
source_url: "https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004934"
published_at: "2026-03-05T14:00:00.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Childhood Cancer in Sweden During the COVID-19 Pandemic: Incidence and Survival in a Nationwide
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/plos-medicine-28-childhood-cancer-in-sweden-during-the-covid-19-pandemic-temporal-patterns-in-incidence-and-survival-in-a-nationwide-register-based-cohort-study
- **Specialty:** [Research Highlights](https://medichelpline.com/clinical-feed/research-highlights.md)
- **Primary Source:** PLOS Medicine
- **Source URL:** [Original Journal Publication](https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004934)
- **Published At:** 2026-03-05T14:00:00.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
In this nationwide, register-based study from Sweden, incidence and short-term survival of childhood and adolescent cancers (0–19 years) diagnosed 2015–2022 were examined to assess potential pandemic-related disruptions. The study included 3,333 cases (2,069 pre-pandemic, 1,264 during the pandemic) classified by ICCC-3 and linked to the Swedish National Cancer Register. Overall incidence remained largely stable when comparing 2020–2022 to the 2015–2019 average, with an age-standardized incidence rate (ASR) of 179.5 per 1,000,000 (pre-pandemic) versus 174.7 (2020), 176.5 (2021), and 181.2 (2022). Diagnostic groups showed variable patterns: acute lymphoblastic leukemia (ALL) declined from February 2020 with a subsequent rebound in 2021; acute myeloid leukemia (AML) declined across 2020–2022 without rebound; lymphomas declined in mid-2020 and then normalized; CNS tumors showed a transient rise in 2020. Overall 1-year survival was 94.8% pre-pandemic and 95.9% during the pandemic. Adjusted 6- and 12-month mortality showed no increase; point estimates suggested possible lower 1-year mortality for ALL and CNS tumors, though imprecision existed. The main limitation was statistical uncertainty for some diagnostic groups due to small numbers.
## Clinical Analysis & Structured Key Points
Sweden’s pediatric cancer patterns during COVID-19: overall stability with group-specific shifts Context and design - This nationwide, register-based cohort study evaluated cancer incidence and survival in children and adolescents (0–19 years) diagnosed with cancer (ICCC-3) in Sweden from 2015 to 2022 (N = 3,333; 2,069 pre-pandemic, 1,264 during the pandemic). - The pandemic period analyzed spanned 2020–2022, with comparisons of quarterly age-standardized incidence rates (ASR) per 1,000,000 to the 2015–2019 baseline. - Survival was assessed via Kaplan–Meier estimates for 3, 6, and 12 months post-diagnosis, and mortality was examined with logistic regression adjusted for age at diagnosis, sex, and maternal education. - Acknowledged limitation: limited precision for some diagnostic groups due to small case numbers. Overall incidence and patterns by diagnostic group - Across the cohort, total cancer incidence remained largely stable during the pandemic, with ASR values hovering near the pre-pandemic baseline (2015–2019 ASR: 179.5; 2020: 174.7; 2021: 176.5; 2022: 181.2 per million). - Diagnostic groups showed variable trajectories: - Acute lymphoblastic leukemia (ALL): incidence declined from February 2020, followed by a rebound in 2021. - Acute myeloid leukemia (AML): incidence declined across 2020–2022 without evidence of rebound. - Lymphomas: incidence declined mid-2020 and then returned to pre-pandemic levels. - Central nervous system (CNS) tumors: transiently increased in 2020. - The timing and magnitude of these group-specific fluctuations are noted, but overall illness incidence did not show dramatic nationwide disruption. Survival outcomes and interpretation - Overall 1-year survival remained high: 94.8% pre-pandemic vs 95.9% during the pandemic. - No evidence of increased short-term mortality during the pandemic; point estimates for ALL and CNS tumors suggested possible, though imprecise, reductions in 1-year mortality (ALL aOR ~0.37; CNS ~0.61) but with wide confidence intervals and non-significant p-values. - Six- and 12-month mortality did not rise; the data imply that any disruptions did not translate into worse short-term survival up to one year after diagnosis. Context and limitations - The authors interpret the stability in overall incidence and survival as indicating no major deterioration in pediatric cancer outcomes during Sweden’s relatively relaxed pandemic restrictions. - They caution that observed fluctuations by diagnostic group might reflect delayed diagnoses or changes in disease triggers; however, the ALL decline without a AML rebound challenges simple explanations solely based on diagnostic delay. - The principal constraint is statistical uncertainty for certain disease subgroups due to small numbers, limiting precise subgroup conclusions. Operational takeaways for clinicians - In Sweden, pandemic-era cancer care did not appear to compromise short-term survival at the population level for children and adolescents with cancer. - Group-specific incidence changes warrant awareness of potential delays in diagnosis for ALL, lymphomas, and AML, though survival did not worsen in the observed intervals.
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