# Cancer incidence trends in Baden-Württemberg (Southwest Germany) during and after the COVID-19 pandemic (2020–2023)

## TL;DR

Cancer incidence in Baden-Württemberg dropped during and after the pandemic, with notable declines in colorectal cancer.

## Contribution

This study provides new insights into long-term cancer incidence trends in Germany during and after the pandemic.

## Key findings

- Overall cancer incidence declined significantly in both men and women from 2020 to 2023.
- Colorectal cancer incidence was significantly lower in both sexes from 2020 onwards.
- Breast cancer incidence in women was significantly lower only in 2020.

## Abstract

While several countries reported an impact of the coronavirus disease (COVID-19) pandemic on cancer incidence in 2020, little is known about trends in the following years. This study examined changes in cancer incidence in Baden-Württemberg between 2015 and 2023.

Data from the Baden-Württemberg Cancer Registry were used to calculate age-standardized and age-specific incidence rates for all cancers combined and for colorectal, lung, prostate, and breast cancer. Incidence rates for 2020 to 2023 were compared with those from a pre-pandemic reference period (2017–2019) and with expected rates based on modeled trends between 2015 and 2019 using standardized incidence ratios (SIRs).

Among men, the age-standardized overall cancer incidence declined significantly from 734.0 per 100,000 in 2019 to 672.9–681.7 during 2020–2023. In women, incidence declined from 542.2 in 2019 to 504.3–524.4, with statistically significant reductions in 2022 and 2023. Compared to 2017–2019 levels, 14,214 fewer cases (-5.5%) were diagnosed in 2020–2023; relative to model-based expectations, 19,525 fewer cases (-7.6%) were reported. Site-specific analyses showed significantly lower colorectal cancer incidence in both sexes from 2020 onwards (SIRs: 0.81–0.90). For men, part of this decline may reflect a pre-existing downward trend. No significant deviations were found for lung and prostate cancer. Female breast cancer incidence was significantly lower only in 2020 (SIR: 0.93).

Cancer incidence in Baden-Württemberg remained consistently below pre-pandemic and expected levels from 2020 through 2023. Further research is warranted to disentangle potential contributing factors, including post-pandemic effects, competing mortality risks, and migration-related population changes.

The online version contains supplementary material available at 10.1007/s00432-025-06349-w.