Risk of severe COVID-19 outcomes in individuals with prior cancer diagnosis - A nationwide Swedish register-based cohort study.

Authors

Patricia Ernst, Niranjan Ganeshkumar, Ailiana Santosa, Chioma Nwaru, Ola Bratt, Fredrik Nyberg, Huiqi Li

Published in

Cancer epidemiology. Volume 105. Pages 103236. Sep 18, 2026. Epub Sep 18, 2026.

Abstract

Individuals with cancer are recognized as a high-risk group for severe COVID-19, yet population-based evidence across cancer types remains limited. This study assessed associations between previous cancer diagnoses and COVID-19 outcomes among individuals diagnosed with different cancers.
We included the entire Swedish population on 1 Jan 2020 (n = 10,390,479). Cancer diagnoses from 2015 to 2019 were identified from the Swedish National Cancer Register. COVID-19 outcomes (infection, hospitalization, intensive care, and death) from 1 Jan 2020-31 Dec 2021 were retrieved from national registers. Cox regression estimated hazard ratios (HR) with 95% confidence intervals (CI), controlling for age, sex, comorbidity and sociodemographic factors.
We identified 234,582 individuals with cancer diagnosis, among whom 20,329 had COVID-19 infection, 5010 were hospitalized, 423 admitted to intensive care, and 1664 died. Compared with individuals without recent cancer (N = 10,155,897), those with cancer had a slightly lower HR of COVID-19 infection (0.97, 95% CI 0.96-0.99) but higher HRs of hospitalization (1.18, 1.14-1.21) and death (1.18, 1.13-1.25). Those with respiratory cancer had the highest HR for hospitalization (1.51, 1.36-1.68) and death (2.35, 1.98-2.79), and those with breast or prostate cancer showed lower HR for COVID-19 infection (0.95, 0.92-0.98 and 0.83, 0.80-0.86). Only prostate cancer was associated with a slightly lower, non-significant, risk of COVID-19-related death (0.92, 0.81-1.04).
Overall, a previous cancer diagnosis was associated with a slightly lower hazard of recorded COVID-19 infection. The risk of severe COVID-19 outcomes differed across cancer types. Our results highlight heterogeneity in COVID-19 outcomes across types. These findings support consideration of cancer type when assessing vulnerability during public health crisis.

PMID:
42759106
Bibliographic data and abstract were imported from PubMed on 19 Sep 2026.

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