# paper.pdf ## Metadata - PDFFormatVersion=1.7 - IsLinearized=false - IsAcroFormPresent=false - IsXFAPresent=false - IsCollectionPresent=false - IsSignaturesPresent=false - Author=bardota - CreationDate=D:20260507120516+02'00' - Creator=PDFCreator Free 5.3.2 - ModDate=D:20260521162531+01'00' - Producer=GPL Ghostscript 10.04.0 - Title=Appendix - pdf:producer=GPL Ghostscript 10.04.0 - xmp:modifydate=2026-05-21T16:25:31+01:00 - xmp:createdate=2026-05-07T12:05:16+02:00 - xmp:creatortool=PDFCreator Free 5.3.2 - xmp:metadatadate=2026-05-21T16:25:31+01:00 - xmpmm:documentid=uuid:bef2836b-4c57-11f1-0000-9488476a5998 - xmpmm:instanceid=uuid:bf7fa950-7c14-b148-91ba-5dd2c707e8b6 - dc:format=application/pdf - dc:title=Appendix - dc:creator=bardota ## Contents ### Page 1 Supplementary appendixThis appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Morgan E, Bardot A, Langselius O, et al. International disruptions to cancer diagnosis and stage at presentation during the COVID-19 pandemic in 2020: an International Cancer Benchmarking Partnership (ICBP) population-based study.Lancet Oncol 2026; 27: 738–50. ### Page 2 1Supplementary Material Table of ContentsICBP Investigators and corresponding jurisdiction/ institution .............................................................................................. 2Table S1: New cases included in analysis and quality indicators, 2015-2020, by cancer site and jurisdiction ...................... 5Table S2: Number of new cases diagnosed and age-standardised rates (per 100,000) during April to December in 2020 (predicted and observed), and percentage change in observed cases compared to predicted cases in 2020, by cancer site and jurisdiction ..................................................................................................................................................................... 10Table S3: Number of new cases (predicted and diagnosed) during April to December in 2015-2019 (average) and 2020, and percentage change in cases diagnosed 2020 compared to predicted for each cancer site and jurisdiction, by age group..................................................................................................................................................................................... 14Table S4: Societal lockdowns and pauses in cancer screening services due to Covid-19, 2020*** .................................... 23Table S5: Sensitivity analysis comparing predicted number of cases in 2020 estimated using 1) original approach, 2) Model 1 (using cases in 2019 to predict 2020 cases) and 3) Model 2 (using age-specific annual percentage change rates during 2015-2019. ................................................................................................................................................................ 26Figure S1. Data collection and harmonization for ICBP COVID-19 commissioned project. ................................................. 27Figure S2. Distribution of basis of diagnosis by month of diagnosis and jurisdiction, 2019-2020. ...................................... 28Figure S3: Observed and predicted incidence rates (age-standardised) by month of diagnosis by cancer site and jurisdiction. Observed cases (solid line) and predicted cases for the same period based on previous five years (dotted line). Blue shading represents first four months of restrictions........................................................................................... 35Figure S4: Observed and predicted incidence new cases by month of diagnosis by cancer site and country in 2020. Observed cases (solid line) and predicted cases based on previous five years (dotted line). Blue shading represents first four months of restrictions. .................................................................................................................................................. 42Figure S5: Observed and predicted new cases by month of diagnosis by cancer site and jurisdiction in 2020. Observed cases (solid line) and predicted cases (dotted line) based on previous five years (2015-2019). Blue shading represents first four months of restrictions. .......................................................................................................................................... 49Figure S6: Stage distribution of mapped SEER during April to December in 2020 compared to 2018-2019, by cancer and country .................................................................................................................................................................................. 50 ### Page 3 2ICBP Investigators and corresponding jurisdiction/ institutionAlexa Bishop, Cancer Research UK Aline Brennan, Ireland Angela Eckstrand, Canada, Alberta Anna Chiarelli, Canada, Ontario Asif Mehmood, Canada, New Brunswick Aude Bardot, IARC Bin Zhang, Canada, New Brunswick Bogdan Pylypenko, Canada, Ontario Carol McClure, Canada, Prince Edward Island Christian Finley, Canada, Ontario Christopher Jackson, New Zealand Connie Marano, Canada, Ontario Damien Bennett, UK, Northern Ireland David Ransom, Australia, Western David Morrison, UK, Scotland David Cameron, UK, Scotland David Tran, Canada, Saskatchewan Deirdre Murray, Ireland Deirdre Fitzpatrick, UK, Northern Ireland Diana Sarfati, New Zealand Donna Turner, Canada, Manitoba Duha Gheasuddin, Cancer Research UK Dyfed Huws, UK, Wales Eileen Morgan, IARC Elinor Millar, New Zealand Eshwar Kumar, Canada, New Brunswick Freddie Bray, IARC Giske Ursin, Norway Grace Liu, Canada, Ontario ### Page 4 3Grant McArthur, Australia, Victoria Greig Stanners, UK, Scotland Grethe Breie, Norway Hamza Cakan, Australia, Western Harriet Hall, Cancer Research UK Hazem Abd Elkader, New Zealand Isabelle Soerjomataram, IARC Jack Hannah, UK, Scotland Janice Kwon, Canada, British Columbia Jessica Gugusheff, Australia, New South Wales John Butler, Cancer Research UK Jon Kirknes, Norway Karen Phillips, Canada, Prince Edward Island Kate Gregory, New Zealand Kate Green, Cancer Research UK Kate X. Fleming, UK, England Kerry Pearson, Cancer Research UK Kris Ivanova, Australia, Victoria Laci Davies, Canada, Saskatchewan Laura Woodings, Australia, Victoria Leon May, UK, Wales Lina Steinrud Mørch , Denmark Lorraine Shack, Canada, Alberta Luc te Marvelde, Australia, Victoria Marianne Luettschwager, Canada, Ontario Marianne Grønlie Guren, Norway Mark Lawler, UK, Northern Ireland Mark Rutherford, IARC Mary Jane King, Canada, Ontario Maryjane Nweje, Cancer Research UK ### Page 5 4Meghan Walker, Canada, Ontario Micheal MacAskill, New Zealand Michelle Liu, New Zealand Nathalie St-Jacques, Canada, Nova Scotia Nicola Creighton, Australia, New South Wales Nicole Stanton, New Zealand Oliver Bucher, Canada, Manitoba Oliver Langselius, IARC Paul Cranston, Cancer Research UK Paula Tierney, Ireland Prithwish De, Canada, Ontario Qinwei Liu, New Zealand Rami Rahal, New Zealand Raymond Asamoah-Barnieh, Canada, Alberta Richard Walton, Australia, New South Wales Ron A. Dewar, Canada, Nova Scotia Ryan Woods, Canada, British Columbia Sally Vernon, UK, England Samantha Harrison, Cancer Research UK Serena Kozie, Canada, Saskatchewan Shruthi Poojala, New Zealand Simon Kønig, Denmark Siri Larønningen, Norway Stephanie Smits, UK, Wales Sue Evans, Australia, Victoria Tala Barakat, Australia, New South Wales Todd Norwood, Canada, Ontario Tom Ferguson, Australia, Western Tom Børge Johannesen, Norway Xiaoyi Tian, Canada, Alberta ### Page 6 5Table S1: New cases included in analysis and quality indicators, 2015-2020, by cancer site and jurisdiction12015-2019 2020Cancer Site/Country Cases DCO1/Autopsyonly (%)MV2(%)Qualitycontrol3MultiplecancersIneligibleage4 Cases DCO1/Autopsyonly (%)MV2(%)Qualitycontrol3MultiplecancersIneligibleage4Colon (C18)Australia, New South Wales 17,551 0.8 94.8 0 48 208 3,200 0.9 93.7 0 6 37Australia, Victoria 13,209 2.9 93.1 0 37 141 2,542 2.8 92.1 0 9 35Australia, Western Australia 4,537 1.9 93.0 71 8 53 814 4.4 91.8 9 5 15Canada, Alberta 6,943 0.3 95.2 <5 311 52 1,257 0.2 94.4 0 37 9Canada, British Columbia 10,431 1.0 93.3 0 0 44 1,866 0.6 93.5 0 0 13Canada, Manitoba 2,804 0.1 94.2 0 149 17 485 0.4 94.8 0 20 <5Canada, New Brunswick 2,059 0.4 93.5 0 81 5 346 0.6 93.9 0 17 <5Canada, Ontario 29,802 1.8 93.5 <5 2,050 199 5,554 1.9 93.2 0 371 36Canada, Prince Edward Island 398 2.3 90.5 0 14 <5 60 1.7 90.0 0 <5 0Canada, Saskatchewan 2,446 0.4 95.1 0 132 12 408 0.2 95.1 0 19 <5Denmark 18,059 1.1 96.6 15 349 58 3,205 1.9 96.3 8 73 25Ireland 9,280 0.8 93.9 0 340 126 1,556 0.7 92.7 0 48 17New Zealand 10,613 0.7 91.8 <5 30 99 2,285 0.7 92.0 0 9 34Norway 16,250 1.3 95.3 0 875 98 3,357 1.8 95.1 0 185 19UK, England 121,585 1.4 84.8 153 2,670 373 23,865 2.9 81.4 10 557 22UK, Northern Ireland 3,973 0.3 86.5 <5 117 <5 751 0.5 84.7 <5 28 <5UK, Scotland 13,631 0.2 84.0 <5 502 56 2,420 0.5 77.6 0 77 12UK, Wales 7,967 0.8 84.9 <5 222 49 1,495 0.6 81.5 0 36 6Rectum (C19-20)Australia, New South Wales 8,035 0.9 96.0 0 9 9 1,616 1.4 93.6 0 <5 <5Australia, Victoria 6,426 0.7 96.3 0 <5 5 1,095 0.6 96.7 0 <5 <5Australia, Western Australia 2,203 0.8 96.4 15 <5 7 392 1.5 96.7 <5 0 <5Canada, Alberta 3,347 0.2 97.9 0 48 <5 560 0.0 97.5 0 9 <5Canada, British Columbia 5,165 0.6 97.0 0 0 5 865 0.3 96.3 0 0 <5Canada, Manitoba 1,431 0.0 97.9 0 22 5 271 0.4 95.6 0 <5 0Canada, New Brunswick 981 0.1 96.8 0 13 <5 198 0.5 97.0 0 <5 0Canada, Ontario 13,716 1.8 94.8 <5 658 32 2,510 2.0 93.5 0 54 7 ### Page 7 6Canada, Prince Edward Island 191 1.0 96.9 0 <5 0 25 0.0 96.0 0 <5 <5Canada, Saskatchewan 1,175 0.4 97.2 0 19 <5 186 0.0 97.8 0 0 0Denmark 8,037 0.4 98.5 17 <5 5 1,340 1.3 99.1 8 0 <5Ireland 4,448 0.7 96.4 0 15 <5 758 1.1 94.5 0 5 <5New Zealand 5,214 0.3 96.1 0 5 6 1,133 0.4 96.4 0 <5 <5Norway 6,822 0.5 98.1 0 43 5 1,406 0.6 98.5 0 13 <5UK, England 58,850 1.0 93.5 43 87 49 10,768 2.1 91.0 <5 24 10UK, Northern Ireland 1,884 0.4 93.2 <5 8 <5 350 1.7 92.6 0 0 0UK, Scotland 5,929 0.3 91.5 0 27 8 946 0.2 89.1 0 6 0UK, Wales 4,002 0.4 92.9 0 13 <5 653 0.8 89.7 0 0 0Trachea, bronchus and lung (C33-34)Australia, New South Wales 20,630 2.7 86.2 0 106 16 4,310 3.0 85.6 0 24 <5Australia, Victoria 15,475 3.8 84.9 0 137 19 3,326 3.3 84.5 0 32 <5Australia, Western Australia 6,151 3.6 85.1 301 58 9 1,169 9.5 81.5 60 23 <5Canada, Alberta 11,873 0.2 83.1 <5 650 6 2,393 0.3 81.4 0 146 <5Canada, British Columbia 17,764 0.8 79.3 <5 0 14 3,469 0.4 79.0 <5 0 <5Canada, Manitoba 4,642 0.1 76.8 0 257 <5 961 0.5 77.6 0 44 0Canada, New Brunswick 4,168 0.3 82.0 0 196 <5 822 0.1 82.2 0 67 0Canada, Ontario 50,843 2.8 85.1 0 2,775 23 9,785 2.8 82.5 0 536 9Canada, Prince Edward Island 747 1.2 70.3 0 32 <5 151 2.0 77.5 0 5 0Canada, Saskatchewan 3,973 0.8 79.8 0 136 <5 696 0.4 81.5 0 29 <5Denmark 24,310 2.8 93.4 15 106 11 5,125 3.4 92.9 11 35 5Ireland 13,594 0.8 83.0 0 467 11 2,661 0.6 80.8 0 99 <5New Zealand 11,651 1.8 77.1 <5 74 9 2,520 2.0 77.3 0 19 <5Norway 16,710 2.7 86.6 5 490 11 3,430 2.4 86.2 0 87 <5UK, England 198,637 2.1 69.3 1,091 3,277 94 37,768 3.8 64.0 176 853 17UK, Northern Ireland 6,747 0.5 67.2 35 59 <5 1,321 0.6 62.6 15 14 0UK, Scotland 26,913 0.4 62.4 106 962 8 5,089 0.6 57.7 13 243 <5UK, Wales 12,662 1.2 69.0 10 308 <5 2,313 0.6 62.8 <5 62 <5Melanoma of Skin (C43)Australia, New South Wales 24,357 0.1 99.2 0 <5 244 4,924 0.1 99.1 0 <5 42 ### Page 8 7Australia, Victoria 14,492 0.1 99.5 0 0 104 2,596 0.2 99.6 0 0 17Australia, Western Australia 7,491 0.2 99.4 113 17 59 1,368 0.6 99.1 30 <5 11Canada, Alberta 4,152 0.0 100.0 0 285 35 791 0.0 100.0 0 70 8Canada, British Columbia 6,026 0.2 99.2 0 0 37 1,145 0.1 99.7 0 0 6Canada, Manitoba 1,369 0.0 99.9 0 80 8 271 0.0 100.0 0 26 <5Canada, New Brunswick 1,095 0.0 99.9 0 75 8 190 0.0 100.0 0 14 0Canada, Ontario 19,457 0.2 98.9 0 1,922 151 3,727 0.2 98.2 0 847 18Canada, Prince Edward Island 321 0.3 99.4 0 16 0 50 0.0 100.0 0 <5 <5Canada, Saskatchewan 1,038 0.1 99.8 0 75 7 252 0.4 99.2 0 22 <5Denmark 13,073 0.2 99.9 18 0 187 2,716 0.4 99.9 <5 0 20Ireland 6,131 0.1 99.8 0 361 72 1,246 0.1 99.7 0 92 9New Zealand 13,042 0.1 99.7 0 17 69 2,632 0.1 99.7 0 5 11Norway 12,245 0.0 100.0 0 814 115 2,655 0.0 100.0 0 209 31UK, England 71,823 0.1 99.4 1,166 1,956 711 12,481 0.3 99.3 103 486 114UK, Northern Ireland 2,028 0.0 99.8 10 40 37 339 0.3 98.8 16 7 5UK, Scotland 7,018 0.0 99.8 83 459 89 1,197 0.0 99.9 13 77 17UK, Wales 4,493 0.0 99.3 <5 210 33 757 0.4 99.1 0 38 7Breast (C50)Australia, New South Wales 29,064 0.5 98.8 0 11 17 5,816 0.6 98.7 0 <5 <5Australia, Victoria 22,629 0.8 98.4 0 32 15 4,379 0.4 98.9 0 7 <5Australia, Western Australia 8,949 0.4 98.9 19 22 8 1,854 0.8 99.0 5 <5 <5Canada, Alberta 14,615 0.1 99.3 <5 1,024 18 2,875 0.1 99.3 0 227 <5Canada, British Columbia 19,064 0.5 98.6 <5 0 8 3,758 0.5 98.7 0 0 <5Canada, Manitoba 4,650 0.1 99.0 0 284 <5 912 0.1 99.2 0 61 0Canada, New Brunswick 3,150 0.4 97.9 0 182 <5 598 0.8 98.7 0 41 0Canada, Ontario 56,927 0.6 98.3 <5 4,653 55 10,445 0.6 98.4 0 1,038 7Canada, Prince Edward Island 602 0.0 98.7 0 38 0 113 0.0 100.0 0 <5 0Canada, Saskatchewan 3,889 0.5 98.4 <5 239 0 729 0.3 98.6 0 48 <5Denmark 24,782 0.4 99.6 32 306 27 4,895 0.4 99.8 23 65 <5Ireland 17,992 0.2 99.2 0 1,018 8 3,172 0.2 98.9 0 210 0New Zealand 16,936 0.4 98.7 0 7 19 3,439 0.3 99.0 <5 <5 <5Norway 19,336 0.4 99.4 0 1,170 19 3,825 0.6 99.3 0 270 5 ### Page 9 8UK, England 234,030 0.4 98.4 3,256 9,121 152 40,030 0.9 97.5 316 1,940 35UK, Northern Ireland 7,394 0.2 99.0 5 447 5 1,355 0.7 98.5 14 75 0UK, Scotland 24,051 0.1 98.3 <5 1433 14 4,319 0.3 98.0 0 264 0UK, Wales 14,007 0.5 97.9 <5 822 6 2,323 0.3 97.5 0 159 <5Ovary (C48.1-2, C56, C57.0)Australia, New South Wales 2,810 1.6 92.3 0 <5 57 577 1.6 92.4 0 <5 12Australia, Victoria 2,022 2.7 91.3 0 <5 44 393 3.3 89.1 0 0 9Australia, Western Australia 689 2.8 89.7 41 <5 13 107 0.9 92.5 <5 0 <5Canada, Alberta 1,379 0.2 94.1 <5 10 27 275 0.4 94.2 0 <5 9Canada, British Columbia 2,064 0.8 92.4 0 0 27 459 0.2 95.2 0 0 <5Canada, Manitoba 447 0.0 91.7 0 <5 5 101 0.0 95.0 0 0 <5Canada, New Brunswick 308 0.0 90.9 0 <5 <5 68 0.0 88.2 0 0 0Canada, Ontario 6,549 1.3 90.7 0 304 93 1,325 1.3 89.9 0 42 20Canada, Prince Edward Island 70 1.4 91.4 0 0 <5 18 0.0 88.9 0 0 0Canada, Saskatchewan 395 0.5 89.1 0 <5 7 64 0.0 98.4 0 <5 0Denmark 2,858 1.5 97.8 10 39 32 591 3.9 97.0 <5 <5 9Ireland 2,126 1.4 91.0 0 7 20 487 0.6 91.0 0 5 <5New Zealand 1,575 1.0 91.2 0 <5 33 328 1.2 93.0 0 0 8Norway 2,429 1.4 95.0 0 12 22 387 2.1 94.3 0 <5 7UK, England 28,452 1.9 88.7 724 121 334 5,373 4.0 87.2 110 20 60UK, Northern Ireland 909 0.2 90.1 7 8 8 146 0.7 88.4 5 0 <5UK, Scotland 2,832 0.2 87.7 39 10 28 539 0.4 86.6 9 0 5UK, Wales 1,635 1.5 85.7 <5 <5 13 304 1.3 84.9 0 <5 <5Prostate (C61)Australia, New South Wales 33,846 0.8 96.6 0 <5 <5 7,634 0.8 96.9 0 0 0Australia, Victoria 25,885 1.3 95.8 0 <5 0 5,462 1.0 96.3 0 0 0Australia, Western Australia 10,595 0.8 96.3 45 <5 0 2,466 1.4 98.1 6 0 0Canada, Alberta 12,624 0.1 92.9 0 20 <5 2,467 0.1 90.3 0 7 0Canada, British Columbia 16,146 0.5 92.9 7 0 <5 3,301 0.4 95.2 0 0 0Canada, Manitoba 3,947 0.2 94.0 0 8 0 925 0.5 95.2 0 <5 0Canada, New Brunswick 2,817 0.1 96.1 0 0 0 606 0.0 96.2 0 0 <5 ### Page 10 9Canada, Ontario 43,622 0.6 96.6 0 20 <5 7,501 0.7 95.1 <5 7 0Canada, Prince Edward Island 530 3.2 95.1 0 <5 0 114 0.9 93.9 0 0 0Canada, Saskatchewan 3,522 0.6 91.7 <5 8 0 694 0.4 92.5 0 <5 0Denmark 22,877 0.5 97.6 44 <5 0 4,490 0.5 97.1 14 0 0Ireland 18,624 0.4 94.5 0 8 <5 3,748 0.3 94.2 0 <5 <5New Zealand 18,921 1.4 93.5 0 16 <5 4,002 1.0 94.1 0 5 0Norway 25,592 1.2 94.9 0 <5 7 5,109 1.0 94.4 0 0 <5UK, England 225,080 0.7 85.2 35 15 6 36,628 1.6 82.3 <5 7 <5UK, Northern Ireland 6,219 0.3 84.6 <5 <5 0 1,224 0.9 83.8 14 0 <5UK, Scotland 19,031 0.1 81.3 0 <5 0 3,502 0.2 79.7 0 0 0UK, Wales 14,564 0.7 86.4 0 <5 <5 2,261 0.9 82.6 0 0 01 DCO = Death Certificate Only cases2 MV = Proportion of Morphologically verified cases3 Quality Control: These cases were excluded because of missing values or inconsistencies among or between the following variables: dates, basis of diagnosis, vital status,topography, morphology, behavior, sex and age.4 Age <25 years2 ### Page 11 10Table S2: Number of new cases diagnosed and age-standardised rates (per 100,000) during3April to December in 2020 (predicted and observed), and percentage change in observed4cases compared to predicted cases in 2020, by cancer site and jurisdiction52020 predicted 2020 observedPerc. change inpredicted vs. observed cases 2020 Missed cases (April- Dec)Cancer type (ICD- 10)/jurisdiction Cases ASR Cases ASR April- July Aug- Dec April- DecemberColon (C18)Australia,NSW 2699 41.01 2403 36.94 -17 -6 -11 296Australia,Victoria 2007 39.09 1901 36.59 -12 0 -5 106Australia,Western 683 34.05 603 30.36 -30 3 -12 80Canada,Alberta 1009 32.50 919 29.42 -17 -2 -9 90Canada,BC 1558 31.46 1378 29.35 -19 -5 -12 180Canada,Manitoba 458 41.31 365 33.34 -34 -10 -20 93Canada,NBR 321 37.60 258 33.66 -24 -16 -20 63Canada,Ontario 4330 34.16 4064 31.96 -21 6 -6 266Canada,PEI 73 45.57 48 33.42 -49 -21 -35 25Canada,Saskatchewan 349 37.07 305 30.97 -27 0 -13 44Denmark 2412 42.09 2422 42.59 -7 6 0 -10Ireland 1371 37.01 1131 30.16 -34 -4 -18 240New Zealand 1698 41.82 1683 42.21 -4 1 -1 15Norway 2426 49.90 2513 51.03 3 4 4 -87UK,England 19690 37.87 17266 33.06 -29 1 -12 2424UK,N.Ireland 624 37.60 525 31.80 -23 -11 -16 99UK,Scotland 2289 44.24 1735 32.38 -31 -19 -24 554UK,Wales 1327 41.46 1062 33.71 -29 -13 -20 265Rectum (C19-20)Australia,NSW 1245 21.79 1215 21.67 -9 3 -2 30Australia,Victoria 985 22.19 797 18.14 -26 -13 -19 188Australia,Western 344 19.35 308 16.92 -18 -5 -11 36Canada,Alberta 446 15.72 408 14.09 -18 -1 -8 38Canada,BC 706 16.75 605 14.50 -35 4 -14 101Canada,Manitoba 196 20.04 203 21.11 -8 14 4 -7Canada,NBR 157 21.64 146 22.13 -5 -8 -7 11Canada,Ontario 2161 19.23 1799 16.06 -30 -6 -17 362Canada,PEI 28 23.45 16 15.20 -73 -24 -43 12Canada,Saskatchewan 172 19.85 135 16.19 -31 -14 -21 37Denmark 1062 20.88 1003 19.53 -14 1 -6 59Ireland 692 20.49 548 16.27 -32 -12 -21 144New Zealand 908 25.58 841 23.72 -10 -6 -7 67Norway 982 22.95 1066 24.76 -7 21 9 -84UK,England 9444 20.60 7669 16.73 -39 -3 -19 1775UK,N.Ireland 324 23.22 271 18.81 -26 -9 -16 53UK,Scotland 941 19.99 661 13.64 -42 -20 -30 280UK,Wales 638 22.20 466 16.88 -40 -16 -27 172 ### Page 12 11Trachea, bronchus and lung(C33-34)Australia,NSW 3314 50.39 3251 48.89 -3 -1 -2 63Australia,Victoria 2625 49.45 2457 46.31 -7 -6 -6 168Australia,Western 1015 47.98 847 39.39 -12 -20 -17 168Canada,Alberta 1877 57.17 1786 53.96 -11 0 -5 91Canada,BC 2924 56.46 2544 49.06 -15 -12 -13 380Canada,Manitoba 752 63.84 718 62.93 -2 -7 -5 34Canada,NBR 612 70.76 614 72.22 -5 5 0 -2Canada,Ontario 7802 59.03 7111 53.93 -16 -3 -9 691Canada,PEI 118 71.68 114 71.91 2 -8 -4 4Canada,Saskatchewan 616 59.81 503 51.02 -24 -14 -18 113Denmark 3791 68.33 3804 68.88 -3 3 0 -13Ireland 2206 59.87 1928 52.83 -12 -13 -13 278New Zealand 1832 46.15 1877 46.61 -1 5 2 -45Norway 2597 54.52 2501 52.09 -10 2 -4 96UK,England 30745 57.90 27716 52.02 -19 -3 -10 3029UK,N.Ireland 1063 64.89 956 58.22 -12 -8 -10 107UK,Scotland 4081 75.08 3720 68.67 -20 0 -9 361UK,Wales 1913 56.53 1637 49.91 -18 -12 -14 276Melanoma of Skin(C43)Australia,NSW 3809 67.08 3507 60.97 -20 1 -8 302Australia,Victoria 2088 46.19 1781 39.47 -22 -9 -15 307Australia,Western 1132 62.32 950 52.15 -19 -14 -16 182Canada,Alberta 835 29.57 574 19.97 -44 -20 -31 261Canada,BC 1073 25.21 829 19.87 -40 -8 -23 244Canada,Manitoba 239 25.20 209 21.70 -13 -12 -12 30Canada,NBR 182 26.39 145 22.00 -16 -24 -20 37Canada,Ontario 3400 29.91 2739 24.24 -36 -6 -19 661Canada,PEI 50 38.78 37 29.34 -61 3 -26 13Canada,Saskatchewan 177 21.66 190 22.55 -14 27 7 -13Denmark 2247 54.96 2117 52.16 -6 -5 -6 130Ireland 1025 31.18 922 27.67 -25 2 -10 103New Zealand 2076 58.52 1853 52.14 -19 -5 -11 223Norway 2060 51.99 2022 50.58 -10 5 -2 38UK,England 12035 29.78 8915 21.97 -40 -15 -26 3120UK,N.Ireland 318 25.81 213 17.04 -40 -28 -33 105UK,Scotland 1178 28.23 842 21.54 -42 -18 -29 336UK,Wales 803 33.05 545 23.50 -45 -22 -32 258Breast (C50)Australia,NSW 4626 177.94 4250 163.33 -20 1 -8 376Australia,Victoria 3629 173.04 3209 154.94 -26 0 -12 420Australia,Western 1484 175.22 1368 158.13 -13 -3 -8 116Canada,Alberta 2510 183.04 2110 150.65 -34 -1 -16 400Canada,BC 3269 166.75 2748 142.71 -27 -6 -16 521Canada,Manitoba 798 164.91 665 145.50 -31 -5 -17 133Canada,NBR 419 126.18 444 137.92 -18 25 6 -25 ### Page 13 12 Canada,Ontario 9215 172.89 7470 142.45 -36 -5 -19 1745Canada,PEI 98 155.51 85 135.14 -34 4 -14 13Canada,Saskatchewan 645 161.54 503 123.76 -33 -13 -22 142Denmark 3954 183.55 3745 174.31 -14 1 -5 209Ireland 2927 189.76 2207 139.29 -34 -17 -25 720New Zealand 2709 171.33 2604 165.86 -19 8 -4 105Norway 3088 174.46 2758 154.38 -24 -1 -11 330UK,England 36836 184.18 28414 142.77 -41 -8 -23 8422UK,N.Ireland 1118 173.29 995 153.70 -30 4 -11 123UK,Scotland 3684 178.22 3062 151.67 -34 -3 -17 622UK,Wales 2090 172.27 1631 135.40 -37 -9 -22 459Ovary (C48.1-2, C56,C57.0)Australia,NSW 411 13.89 416 14.65 2 1 1 -5Australia,Victoria 287 12.67 289 12.56 2 0 1 -2Australia,Western 75 8.17 77 8.46 6 -1 2 -2Canada,Alberta 228 16.21 205 14.63 -12 -9 -10 23Canada,BC 291 13.58 347 16.75 15 23 19 -56Canada,Manitoba 63 13.09 73 15.23 1 30 16 -10Canada,NBR 59 15.99 48 12.27 -5 -28 -19 11Canada,Ontario 977 18.02 945 17.71 -14 6 -3 32Canada,PEI 12 19.83 12 16.75 -66 59 -2 0Canada,Saskatchewan 49 11.39 50 12.36 13 -4 3 -1Denmark 402 16.63 440 18.40 14 6 9 -38Ireland 296 17.90 362 22.51 15 29 22 -66New Zealand 221 12.69 243 14.36 12 8 10 -22Norway 320 16.46 267 13.62 -16 -17 -17 53UK,England 4337 19.19 3933 16.88 -18 -2 -9 404UK,N.Ireland 133 17.84 103 13.85 -32 -14 -22 30UK,Scotland 398 16.79 402 17.12 -7 8 1 -4UK,Wales 227 16.27 221 15.55 -12 4 -3 6Prostate (C61)Australia,NSW 5420 182.80 5776 194.12 2 10 7 -356Australia,Victoria 5062 221.07 3835 167.96 -25 -24 -24 1227Australia,Western 1941 205.93 1869 200.27 -9 0 -4 72Canada,Alberta 2160 148.85 1843 126.58 -30 -2 -15 317Canada,BC 2876 126.84 2436 107.43 -21 -10 -15 440Canada,Manitoba 784 149.54 695 132.14 0 -20 -11 89Canada,NBR 510 139.43 424 116.81 -32 -5 -17 86Canada,Ontario 6591 112.34 5371 90.61 -37 -3 -19 1220Canada,PEI 85 119.34 82 117.00 17 -17 -3 3Canada,Saskatchewan 553 124.51 512 111.78 -34 16 -7 41Denmark 3370 129.68 3317 125.31 -15 8 -2 53Ireland 3269 205.74 2684 169.01 -36 -4 -18 585New Zealand 3556 204.78 3117 179.20 -18 -8 -12 439Norway 3550 164.13 3663 168.40 -5 10 3 -113UK,England 38181 165.19 23815 101.19 -56 -22 -38 14366UK,N.Ireland 1102 149.79 884 120.20 -26 -15 -20 218 ### Page 14 13 UK,Scotland 3110 127.98 2336 95.52 -41 -13 -25 774UK,Wales 2390 167.48 1381 95.22 -55 -32 -42 1009678910111213141516 ### Page 15 14Table S3: Number of new cases (predicted and diagnosed) during April to December in 2015-2019 (average) and 2020, and percentage change in cases diagnosed 2020 compared to predicted for each cancer site and jurisdiction, by age groupAge Group2015-2019cases2020predictedcases2020observedcasesPerc. change in casespredicted vs. observedcases 2020MissedcasesApril-December April-JulyApril-DecemberApril-DecemberColon (C18)Australia,NSW <75 years 1498 1534 1379 -15 -10 155+75 years 1133 1157 1024 -19 -12 133Australia,Victoria <75 years 1115 1168 1093 -14 -7 75+75 years 873 826 808 -9 -2 18Australia,Western <75 years 426 427 363 -33 -15 64+75 years 268 253 240 -23 -5 13Canada,Alberta <75 years 672 663 565 -25 -15 98+75 years 355 344 354 -3 3 -10Canada,BC <75 years 903 847 795 -16 -6 52+75 years 665 720 583 -24 -19 137Canada,Manitoba <75 years 251 279 219 -35 -21 60+75 years 172 179 146 -31 -18 33Canada,NBR <75 years 176 171 148 -28 -14 23+75 years 130 150 110 -20 -27 40Canada,Ontario <75 years 2602 2562 2310 -24 -10 252+75 years 1862 1755 1754 -17 0 1Canada,PEI <75 years 36 42 26 -51 -39 16+75 years 24 31 22 -44 -28 9Canada,Saskatchewan <75 years 210 211 173 -34 -18 38+75 years 160 137 132 -14 -4 5Denmark <75 years 1609 1303 1279 -8 -2 24 ### Page 16 15+75 years 1081 1124 1143 -6 2 -19Ireland <75 years 791 763 600 -35 -21 163+75 years 573 597 498 -35 -17 99New Zealand <75 years 845 931 933 -2 0 -2+75 years 752 757 750 -5 -1 7Norway <75 years 1301 1297 1266 -4 -2 31+75 years 1131 1128 1247 11 11 -119UK,England <75 years 9592 10434 8952 -32 -14 1482+75 years 8789 9200 8314 -26 -10 886UK,N.Ireland <75 years 327 334 282 -18 -16 52+75 years 275 291 243 -29 -16 48UK,Scotland <75 years 1141 1310 894 -39 -32 416+75 years 928 963 841 -18 -13 122UK,Wales <75 years 636 697 565 -27 -19 132+75 years 560 626 497 -31 -21 129Rectum (C19-20)Australia,NSW <75 years 860 893 875 -9 -2 18+75 years 359 348 340 -7 -2 8Australia,Victoria <75 years 691 716 595 -25 -17 121+75 years 284 264 202 -29 -24 62Australia,Western <75 years 252 266 225 -23 -15 41+75 years 86 76 83 6 9 -7Canada,Alberta <75 years 381 348 297 -24 -15 51+75 years 114 94 111 4 18 -17Canada,BC <75 years 556 517 429 -42 -17 88+75 years 212 188 176 -16 -6 12Canada,Manitoba <75 years 154 144 147 -11 2 -3+75 years 59 51 56 -2 10 -5Canada,NBR <75 years 107 110 106 -3 -4 4+75 years 40 48 40 -16 -16 8 ### Page 17 16Canada,Ontario <75 years 1460 1531 1244 -33 -19 287+75 years 602 623 555 -22 -11 68Canada,PEI <75 years 22 21 16 -63 -23 5+75 years 8 7 0 0 0 0Canada,Saskatchewan <75 years 123 122 101 -27 -17 21+75 years 50 48 34 -39 -30 14Denmark <75 years 813 677 633 -17 -7 44+75 years 381 386 370 -10 -4 16Ireland <75 years 468 472 372 -29 -21 100+75 years 192 221 162 -41 -27 59New Zealand <75 years 563 654 588 -14 -10 66+75 years 236 247 253 3 2 -6Norway <75 years 680 652 687 -6 5 -35+75 years 332 329 379 -7 15 -50UK,England <75 years 5610 6099 4898 -40 -20 1201+75 years 3245 3288 2771 -35 -16 517UK,N.Ireland <75 years 185 228 176 -36 -23 52+75 years 98 94 95 5 1 -1UK,Scotland <75 years 585 618 411 -44 -34 207+75 years 317 315 250 -36 -21 65UK,Wales <75 years 374 407 313 -40 -23 94+75 years 229 226 153 -39 -32 73Trachea, bronchus and lung (C33-34)Australia,NSW <75 years 1885 2068 1951 -6 -6 117+75 years 1176 1238 1300 3 5 -62Australia,Victoria <75 years 1395 1543 1426 -7 -8 117+75 years 955 1084 1031 -8 -5 53Australia,Western <75 years 568 615 496 -8 -19 119+75 years 368 399 351 -18 -12 48Canada,Alberta <75 years 1099 1115 1060 -9 -5 55 ### Page 18 17+75 years 688 771 726 -15 -6 45Canada,BC <75 years 1529 1621 1412 -12 -13 209+75 years 1155 1306 1132 -17 -13 174Canada,Manitoba <75 years 416 437 448 1 3 -11+75 years 284 323 270 -9 -16 53Canada,NBR <75 years 401 381 379 -4 -1 2+75 years 228 234 235 -8 1 -1Canada,Ontario <75 years 4642 4759 4372 -14 -8 387+75 years 2980 3044 2739 -19 -10 305Canada,PEI <75 years 64 64 72 4 13 -8+75 years 46 54 42 2 -22 12Canada,Saskatchewan <75 years 347 345 316 -10 -8 29+75 years 253 276 187 -41 -32 89Denmark <75 years 2398 2312 2341 -2 1 -29+75 years 1289 1491 1463 -5 -2 28Ireland <75 years 1275 1309 1169 -9 -11 140+75 years 741 846 648 -21 -23 198New Zealand <75 years 1098 1153 1141 -1 -1 12+75 years 670 678 736 -1 9 -58Norway <75 years 1567 1560 1512 -10 -3 48+75 years 924 1050 989 -12 -6 61UK,England <75 years 16435 16515 14784 -18 -11 1731+75 years 13567 14288 12932 -20 -10 1356UK,N.Ireland <75 years 601 612 536 -13 -12 76+75 years 425 452 420 -11 -7 32UK,Scotland <75 years 2315 2267 2090 -19 -8 177+75 years 1779 1825 1630 -22 -11 195UK,Wales <75 years 1061 1005 903 -13 -10 102+75 years 844 919 734 -24 -20 185Melanoma of Skin (C43) ### Page 19 18Australia,NSW <75 years 2476 2670 2395 -21 -10 275+75 years 1005 1136 1112 -18 -2 24Australia,Victoria <75 years 1479 1453 1228 -26 -16 225+75 years 590 642 553 -16 -14 89Australia,Western <75 years 782 819 680 -18 -17 139+75 years 281 312 272 -22 -13 40Canada,Alberta <75 years 497 633 419 -47 -34 214+75 years 146 201 155 -34 -23 46Canada,BC <75 years 637 705 569 -37 -19 136+75 years 292 372 260 -46 -30 112Canada,Manitoba <75 years 152 177 148 -8 -17 29+75 years 61 63 61 -27 -3 2Canada,NBR <75 years 125 122 109 -6 -11 13+75 years 45 63 36 -38 -43 27Canada,Ontario <75 years 2092 2295 1828 -35 -20 467+75 years 926 1101 911 -37 -17 190Canada,PEI <75 years 36 31 27 -61 -13 4+75 years 15 20 10 -67 -50 10Canada,Saskatchewan <75 years 122 124 137 -16 10 -13+75 years 38 58 53 -19 -8 5Denmark <75 years 1576 1646 1576 -2 -4 70+75 years 460 610 541 -19 -11 69Ireland <75 years 672 688 594 -24 -14 94+75 years 266 342 313 -30 -9 29New Zealand <75 years 1331 1421 1288 -18 -9 133+75 years 584 663 565 -21 -15 98Norway <75 years 1333 1396 1374 -7 -2 22+75 years 540 683 648 -18 -5 35UK,England <75 years 7891 8372 6135 -40 -27 2237+75 years 3198 3699 2780 -39 -25 919 ### Page 20 19UK,N.Ireland <75 years 233 238 152 -42 -36 86+75 years 79 78 61 -33 -22 17UK,Scotland <75 years 765 802 603 -36 -25 199+75 years 319 388 239 -57 -38 149UK,Wales <75 years 477 540 387 -41 -28 153+75 years 211 263 158 -53 -40 105Breast (C50)Australia,NSW <75 years 3582 3766 3434 -22 -9 332+75 years 801 865 816 -16 -6 49Australia,Victoria <75 years 2794 2977 2631 -27 -12 346+75 years 610 654 578 -23 -12 76Australia,Western <75 years 1129 1207 1093 -15 -10 114+75 years 237 279 275 -11 -2 4Canada,Alberta <75 years 1802 2073 1677 -37 -19 396+75 years 400 428 433 -21 1 -5Canada,BC <75 years 2277 2594 2146 -29 -17 448+75 years 606 667 602 -19 -10 65Canada,Manitoba <75 years 540 613 517 -36 -16 96+75 years 159 186 148 -16 -21 38Canada,NBR <75 years 369 314 338 -20 8 -24+75 years 113 107 106 -13 -1 1Canada,Ontario <75 years 6825 7206 5768 -38 -20 1438+75 years 1829 2016 1702 -32 -16 314Canada,PEI <75 years 68 67 66 -21 -2 1+75 years 23 31 19 -60 -40 12Canada,Saskatchewan <75 years 450 493 380 -34 -23 113+75 years 140 153 123 -31 -20 30Denmark <75 years 2849 2864 2763 -12 -4 101+75 years 931 1098 1016 -17 -8 82Ireland <75 years 2172 2320 1653 -38 -29 667 ### Page 21 20+75 years 509 605 532 -20 -12 73New Zealand <75 years 2124 2212 2143 -20 -3 69+75 years 470 498 461 -18 -7 37Norway <75 years 2281 2430 2117 -31 -13 313+75 years 576 664 641 4 -4 23UK,England <75 years 26780 27619 20797 -45 -25 6822+75 years 8660 9234 7617 -30 -18 1617UK,N.Ireland <75 years 858 854 756 -36 -11 98+75 years 258 259 239 -9 -8 20UK,Scotland <75 years 2768 2833 2288 -39 -19 545+75 years 862 840 786 -16 -6 54UK,Wales <75 years 1570 1525 1169 -39 -23 356+75 years 544 568 462 -35 -19 106Ovary (C48.1-2, C56, C57.0)Australia,NSW <75 years 288 282 295 8 5 -13+75 years 118 132 121 -14 -8 11Australia,Victoria <75 years 219 210 198 -9 -6 12+75 years 87 76 91 35 19 -15Australia,Western <75 years 73 55 56 9 2 -1+75 years 29 20 21 -6 4 -1Canada,Alberta <75 years 150 181 159 -10 -12 22+75 years 42 46 46 -14 -1 0Canada,BC <75 years 225 207 248 6 20 -41+75 years 78 88 99 29 13 -11Canada,Manitoba <75 years 54 44 53 24 20 -9+75 years 14 20 20 -42 2 0Canada,NBR <75 years 32 43 29 -32 -32 14+75 years 13 16 19 73 16 -3Canada,Ontario <75 years 744 754 710 -17 -6 44+75 years 233 223 235 -2 5 -12 ### Page 22 21Canada,PEI <75 years 7 8 9 -70 11 -1+75 years <5 <5 <5 -55 -28 1Canada,Saskatchewan <75 years 39 34 41 28 21 -7+75 years 17 16 9 -32 -43 7Denmark <75 years 306 275 296 13 8 -21+75 years 120 126 144 17 14 -18Ireland <75 years 232 222 256 8 15 -34+75 years 82 78 81 1 4 -3New Zealand <75 years 169 166 182 3 10 -16+75 years 63 55 61 41 11 -6Norway <75 years 266 239 195 -19 -19 44+75 years 96 80 72 -6 -10 8UK,England <75 years 2841 2879 2539 -17 -12 340+75 years 1421 1462 1395 -19 -5 67UK,N.Ireland <75 years 94 91 70 -42 -23 21+75 years 43 43 33 -11 -23 10UK,Scotland <75 years 289 272 263 -8 -3 9+75 years 144 125 139 -3 11 -14UK,Wales <75 years 158 147 137 -13 -7 10+75 years 88 82 84 -14 3 -2Prostate (C61)Australia,NSW <75 years 3814 3889 4154 5 7 -265+75 years 1387 1541 1622 -5 5 -81Australia,Victoria <75 years 2947 3695 2806 -24 -24 889+75 years 1037 1365 1029 -27 -25 336Australia,Western <75 years 1227 1428 1377 -5 -4 51+75 years 411 515 492 -20 -4 23Canada,Alberta <75 years 1492 1681 1416 -32 -16 265+75 years 423 476 427 -24 -10 49Canada,BC <75 years 1691 2004 1695 -21 -15 309 ### Page 23 22+75 years 734 861 741 -20 -14 120Canada,Manitoba <75 years 420 543 467 -4 -14 76+75 years 186 241 228 9 -5 13Canada,NBR <75 years 364 424 347 -35 -18 77+75 years 72 86 77 -18 -11 9Canada,Ontario <75 years 4813 4685 3720 -38 -21 965+75 years 1734 1912 1651 -34 -14 261Canada,PEI <75 years 63 68 63 32 -7 5+75 years 15 16 19 -29 18 -3Canada,Saskatchewan <75 years 387 409 352 -36 -14 57+75 years 143 144 160 -27 11 -16Denmark <75 years 2389 2247 2147 -19 -5 100+75 years 1028 1127 1170 -8 4 -43Ireland <75 years 2211 2568 2093 -35 -19 475+75 years 536 665 543 -40 -18 122New Zealand <75 years 2271 2823 2456 -17 -13 367+75 years 637 720 661 -19 -8 59Norway <75 years 2614 2451 2530 -7 3 -79+75 years 1059 1104 1133 -3 3 -29UK,England <75 years 22052 24894 14960 -58 -40 9934+75 years 11860 13122 8855 -52 -33 4267UK,N.Ireland <75 years 616 735 573 -25 -22 162+75 years 327 363 311 -28 -14 52UK,Scotland <75 years 1919 2034 1504 -43 -26 530+75 years 981 1078 832 -37 -23 246UK,Wales <75 years 1447 1652 940 -55 -43 712+75 years 741 720 441 -55 -39 279 ### Page 24 23Table S4: Societal lockdowns and pauses in cancer screening services due to Covid-19, 2020***2020 (national) societal lockdowns, start-end date Cancer screening services pause, start-end date**Country Jurisdiction First Second Third Source for societal lockdown Colorectal Breast Source for screening dataAustraliaNew South Wales16/03/2020- 15/05/2020 - - https://www.parliament.nsw.g ov.au/researchpapers/Docume nts/NSW%20public%20health %20restrictions%20to%20deal %20with%20the%20COVID- 19%20pandemic.pdf -01/03/2020- 31/05/2020https://www.phrp.com.au/issues/online-early/the- impact-of-the-2020-covid-19-related-suspension-of- breastscreen-nsw-on-breast-cancer-tumour-size-and- treatment/Victoria 30/03/2020- 12/05/202008/07/2020- 27/10/2020 - Source from cancer registries - 03/2020-05/2020Western Australia23/03/2020- 26/04/2020 - -COVID-19 in WA bulletin (health.wa.gov.au); https://www.healthywa.wa.go v.au/~/media/Corp/Document s/Reports-and- publications/COVID19-in- Western-Australia/COVID19- in-WA-Bulleltin-1-Impact-on- Lifestyle.pdf; https://www.aph.gov.au/Abou t_Parliament/Parliamentary_d epartments/Parliamentary_Lib rary/pubs/rp/rp2021/Chronolo gies/COVID- 19StateTerritoryGovernmentA nnouncements#_Toc52275801 -27/03/2020- 29/04/2020June-July2020_BSWA_newsletter_FINAL.pdf(health.wa.gov.au)CanadaAlberta 17/03/2020- 15/06/202027/11/2020- end* -https://www.cihi.ca/en/canadi an-covid-19-intervention- timeline 03/2020-06/2020 03/2020-06/2020https://cancer.ca/en/get-involved/advocacy/what-we-are-doing/covid-19-responseBritish Columbia 18/03/2020- end* - -https://www.cihi.ca/en/canadi an-covid-19-intervention- timeline 03/2020-06/2020 03/2020-06/2020https://cancer.ca/en/get-involved/advocacy/what-we-are-doing/covid-19-responseManitoba 20/03/2020- end* - -https://www.cihi.ca/en/canadi an-covid-19-intervention- timeline 03/2020-06/2020 03/2020-06/2020https://cancer.ca/en/get-involved/advocacy/what-we-are-doing/covid-19-response ### Page 25 24New Brunswick 2020-03-19 - 2021-07-30 - -https://www.cihi.ca/en/canadi an-covid-19-intervention- timeline 03/2020-06/2020 03/2020-06/2020https://cancer.ca/en/get-involved/advocacy/what-we-are-doing/covid-19-responseOntario 17/03/2020- 24/07/2020 - -https://www.cihi.ca/en/canadi an-covid-19-intervention- timeline23/03/2020- 26/05/ 202023/03/2020- 26/05/2020Source from cancer registriesPrince Edward Island 16/03/2020- end* - -https://www.cihi.ca/en/canadi an-covid-19-intervention- timeline 03/2020-06/2020 03/2020-06/2020https://cancer.ca/en/get-involved/advocacy/what-we-are-doing/covid-19-responseSaskatchewan 18/03/2020- 11/07/2020 - -https://www.cihi.ca/en/canadi an-covid-19-intervention- timeline 03/2020-06/2020 03/2020-06/2020https://cancer.ca/en/get-involved/advocacy/what-we-are-doing/covid-19-responseIreland Ireland27/03/2020- 18/05/202018/09/2020- 12/01/202031/12/2020- end*First year of the COVID-19 pandemic in Ireland.pdf (hpsc.ie)03/2020-08/202016/03/2020- 27/10/2020BreastCheck: Recovery from COVID - Corporate (hse.ie) Covid-19 and cervical screening in Ireland: a coordinated approach to minimising harm - Corporate (hse.ie) Communication with the cancer registry (march to August 2020)New Zealand New Zealand23/03/2020- 20/04/2020 - -Cancer Control Agency: https://covid19.govt.nz/about- our-covid-19- response/history-of-the-covid- 19-alert-system/-03/2020- 06/2020 03/2020-04/2020Source from cancer registriesNorway Norway12/03/20200 7/04/202005/11/2020- end* -DOI: 10.1002/ijc.34029No nation-wide screening programme during the study period12/03/2020- 11/05/2020United KingdomEngland 23/03/2020- 06/202005/11/2020- 02/12/2020 -Institute for Government analysis 04/2020-06/2020 03/2020-07/2020Northern Ireland23/03/2020- 06/202016/10/2020- 02/12/2020 -Institute for Government analysis16/03/2020 - 17/08/202016/03/2020 - 17/07/2020https://cancerscreening.hscni.net/bowel-screening/overview/#:~:text=The%20bowel%20cancer%20screening%20programme%20was%20paused%20in%20March%202020,waiting%20list%20for%20this%20investigation.https://cancerscreening.hscni.net/breast-screening/overview/Scotland 23/03/2020- 06/202005/11/2020- 02/12/2020 -Institute for Government analysis 03/2020-10/2020 03/2020-08/2020 ### Page 26 25Wales23/03/2020- 06/202023/10/2020- 09/11/202016/12/2020- end*Institute for Government analysis; https://research.senedd.wales /research-articles/coronavirus- timeline-welsh-and-uk- governments-response/; https://www.nature.com/articl es/s41416-022-01830-6 03/2020-10/2020 03/2020-08/2020Denmark Denmark 11/03/2020- 15/04/202007/12/2020- end* - DOI: 10.1002/ijc.34029 - -*End of lockdown measures outside the study period ** Cervical cancer screening pauses were excluded as changes in incidence were not examined in this manuscript. ***The information collected for this table comes from review of government, public health websites, published articles and stakeholder information that should be interpreted with caution ### Page 27 26Table S5: Sensitivity analysis comparing predicted number of cases in 2020 estimated using11) original approach, 2) Model 1 (using cases in 2019 to predict 2020 cases) and 3) Model 22(using age-specific annual percentage change rates during 2015-2019.3Predicted number of cases, 2020Ratio, alternativemodel: original modelCountry Cancer Original approach Model 1 Model 2Model 1: original Model 2: originalCanada Breast (C50) 16948 16839 16940 0.99 1.00Colon (C18) 8096 8379 8072 1.03 1.00Melanoma of Skin (C43) 5946 5877 5974 0.99 1.00Ovary (C48.1-2, C56, C57.0) 1679 1707 1688 1.02 1.01Prostate (C61) 13537 13438 13566 0.99 1.00Rectum (C19-20) 3856 3970 3830 1.03 0.99Trachea, bronchus and lung (C33-34) 14694 14983 14720 1.02 1.00Ireland Breast (C50) 2927 2904 2937 0.99 1.00Colon (C18) 1371 1420 1375 1.03 1.00Melanoma of Skin (C43) 1025 1042 1034 1.02 1.01Ovary (C48.1-2, C56, C57.0) 296 308 296 1.04 1.00Prostate (C61) 3269 3177 3272 0.97 1.00Rectum (C19-20) 692 707 696 1.02 1.01Trachea, bronchus and lung (C33-34) 2206 2222 2210 1.01 1.00UK Breast (C50) 40042 40019 40075 1.00 1.00Colon (C18) 21639 21567 21576 1.00 1.00Melanoma of Skin (C43) 13149 12982 13216 0.99 1.01Ovary (C48.1-2, C56, C57.0) 4697 4765 4693 1.01 1.00Prostate (C61) 41672 40251 41432 0.97 0.99Rectum (C19-20) 10407 10308 10311 0.99 0.99Trachea, bronchus and lung (C33-34) 33718 34050 33807 1.01 1.00AustraliaBreast (C50) 9736 9773 9751 1.00 1.00Colon (C18) 5387 5490 5332 1.02 0.99Melanoma of Skin (C43) 7021 7028 7035 1.00 1.00Ovary (C48.1-2, C56, C57.0) 774 801 774 1.03 1.00Prostate (C61) 12395 12249 12439 0.99 1.00Rectum (C19-20) 2575 2623 2552 1.02 0.99Trachea, bronchus and lung (C33-34) 6953 6943 6938 1.00 1.00New Zealand Breast (C50) 2709 2715 2707 1.00 1.00Colon (C18) 1698 1713 1680 1.01 0.99Melanoma of Skin (C43) 2076 2072 2080 1.00 1.00Ovary (C48.1-2, C56, C57.0) 221 230 221 1.04 1.00Prostate (C61) 3556 3367 3538 0.95 0.99Rectum (C19-20) 908 901 901 0.99 0.99Trachea, bronchus and lung (C33-34) 1832 1864 1832 1.02 1.004 ### Page 28 27Figure S1. Data collection and harmonization for ICBP COVID-19 commissioned project. ### Page 29 28Figure S2. Distribution of basis of diagnosis by month of diagnosis and jurisdiction, 2019- 2020. ### Page 30 29a) Colon ### Page 31 30b) Rectum ### Page 32 31c) Trachea, bronchus and lung (C33-34) ### Page 33 32d) Melanoma of Skin ### Page 34 33e) Breast (C50) ### Page 35 34f) Ovary (C48.1-2, C56, C57.0) ### Page 36 35g) Prostate (C61) Figure S3: Observed and predicted incidence rates (age-standardised) by month of diagnosis by cancer site and jurisdiction. Observed cases (solid line) and predicted cases for the same period based on previous five years (dotted line). Blue shading represents first four months of restrictions.*N.Ireland: Northern Ireland; NSW: New South Wales, PEI: Prince Edward Island, UK: United Kingdom ### Page 37 36a) Colon01002003004005006007008009001000110012001300140015001600170018001900200021002200230024002500260027002800Australia Canada Denmark Ireland New Zealand Norway UKMonth of diagnosis ### Page 38 37b) Rectum050100150200250300350400450500550600650700750800850900950100010501100115012001250Australia Canada Denmark Ireland New Zealand Norway UKMonth of diagnosis ### Page 39 38c) Lung02004006008001000120014001600180020002200240026002800300032003400360038004000Australia Canada Denmark Ireland New Zealand Norway UKMonth of diagnosis ### Page 40 39d) Melanoma ### Page 41 40e) Breast0200400600800100012001400160018002000220024002600280030003200340036003800400042004400460048005000Australia Canada Denmark Ireland New Zealand Norway UKMonth of diagnosis ### Page 42 41f) Ovary020406080100120140160180200220240260280300320340360380400420440460480500520540560Australia Canada Denmark Ireland New Zealand Norway UKMonth of diagnosis ### Page 43 42g) ProstateFigure S4: Observed and predicted incidence new cases by month of diagnosis by cancer site and country in 2020. Observed cases (solid line) and predicted cases based on previous five years (dotted line). Blue shading represents first four months of restrictions.02004006008001000120014001600180020002200240026002800300032003400360038004000420044004600480050005200Australia Canada Denmark Ireland New Zealand Norway UKFirst four months of restrictions Observed PredictedMonth of diagnosis ### Page 44 43a) Colon ### Page 45 44b) Rectum ### Page 46 45c) Trachea, bronchus and lung (C33-34) ### Page 47 46d) Melanoma of Skin ### Page 48 47e) Breast (C50) ### Page 49 48f) Ovary (C48.1-2, C56, C57.0) ### Page 50 49g) Prostate (C61) Figure S5: Observed and predicted new cases by month of diagnosis by cancer site and jurisdiction in 2020. Observed cases (solid line) and predicted cases (dotted line) based on previous five years (2015-2019). Blue shading represents first four months of restrictions. ### Page 51 50Figure S6: Stage distribution of mapped SEER during April to December in 2020 compared to 2018-2019, by cancer and country35 32 21 12 43 30 18 9 22 45 19 14 39 34 23 5 38 33 21 9 41 30 20 8 39 35 16 100 20 40 60 80 100 % of cancer casesUK Norway New Zealand Ireland Denmark Canada Australia2018-201933 33 23 12 40 31 20 9 23 43 20 14 35 34 26 4 39 32 22 7 41 31 21 7 39 34 17 100 20 40 60 80 100 % of cancer casesUK Norway New Zealand Ireland Denmark Canada Australia2020Colon (C18)Localized Regional Distant Missing10 15 60 16 18 17 61 4 17 18 45 20 8 12 61 20 14 13 57 16 20 9 63 70 20 40 60 80 100 % of cancer casesUK New Zealand Ireland Denmark Canada Australia2018-20199 13 62 16 17 20 58 5 17 19 41 24 13 12 61 14 11 16 60 14 20 7 66 60 20 40 60 80 100 % of cancer casesUK New Zealand Ireland Denmark Canada Australia2020Ovary (C48.1-2, C56, C57.0)Localized Regional Distant Missing22 22 48 9 23 36 31 10 7 15 45 32 24 27 47 2 22 22 52 4 24 23 39 13 23 18 39 200 20 40 60 80 100 % of cancer casesUK Norway New Zealand Ireland Denmark Canada Australia2018-201921 19 51 9 25 34 34 7 7 14 49 30 22 24 53 1 24 21 52 4 24 22 42 11 24 18 39 190 20 40 60 80 100 % of cancer casesUK Norway New Zealand Ireland Denmark Canada Australia2020Trachea, bronchus and lung (C33-34)Localized Regional Distant Missing62 26 4 8 67 26 5 2 53 30 3 14 60 33 7 1 61 27 3 9 64 29 6 1 37 30 5 280 20 40 60 80 100 % of cancer casesUK Norway New Zealand Ireland Denmark Canada Australia2018-201959 28 6 8 67 27 4 3 51 31 4 13 54 36 9 1 61 28 4 8 63 29 6 1 38 30 5 270 20 40 60 80 100 % of cancer casesUK Norway New Zealand Ireland Denmark Canada Australia2020Breast (C50)Localized Regional Distant Missing37 35 17 10 38 30 18 14 19 22 16 43 26 16 20 37 40 32 17 11 37 32 19 13 43 23 15 190 20 40 60 80 100 % of cancer casesUK Norway New Zealand Ireland Denmark Canada Australia2018-201934 36 20 10 38 30 19 13 20 19 16 45 21 18 25 36 40 33 18 8 31 36 23 11 43 24 15 190 20 40 60 80 100 % of cancer casesUK Norway New Zealand Ireland Denmark Canada Australia2020Rectum (C19-20)Localized Regional Distant Missing