癌症被认为是 COVID-19 死亡的危险因素，但一些国家报告说，在 COVID-19 大流行期间，以癌症为主的死亡人数仍处于历史水平。在这里，我们进一步阐明了美国人口层面的癌症死亡率与 COVID-19 之间的关系。我们根据六种癌症、糖尿病和阿尔茨海默病的潜在死亡和多因 (MC) 死亡数据，比较了与大流行相关的死亡率模式。任何与大流行相关的编码实践变化都应通过研究 MC 数据来消除。 2020 年全国范围内，MC 癌症死亡率仅比大流行前基线上升 3%，相当于超额死亡约 13,600 人。致命性较低的癌症（乳腺癌、结直肠癌和血液癌，2-7%）的死亡率明显高于存活率较低的癌症（肺癌和胰腺癌，0-1%）。相比之下，糖尿病 (37%) 和阿尔茨海默病 (19%) 导致的 MC 死亡人数大幅增加。为了了解这些差异，我们使用 COVID-19 发病率、预期寿命、人口规模以及患有每种疾病的人的平均年龄来模拟每种疾病的预期超额死亡率。我们发现，观察到的死亡率差异主要是由预期寿命的差异来解释的，致命癌症的死亡风险超过了 COVID-19 的死亡风险。

Cancer is considered a risk factor for COVID-19 mortality, yet several countries have reported that deaths with a primary code of cancer remained within historic levels during the COVID-19 pandemic. Here, we further elucidate the relationship between cancer mortality and COVID-19 on a population level in the US. We compared pandemic-related mortality patterns from underlying and multiple cause (MC) death data for six types of cancer, diabetes, and Alzheimer's. Any pandemic-related changes in coding practices should be eliminated by study of MC data. Nationally in 2020, MC cancer mortality rose by only 3% over a pre-pandemic baseline, corresponding to ~13,600 excess deaths. Mortality elevation was measurably higher for less deadly cancers (breast, colorectal, and hematological, 2-7%) than cancers with a poor survival rate (lung and pancreatic, 0-1%). In comparison, there was substantial elevation in MC deaths from diabetes (37%) and Alzheimer's (19%). To understand these differences, we simulated the expected excess mortality for each condition using COVID-19 attack rates, life expectancy, population size, and mean age of individuals living with each condition. We find that the observed mortality differences are primarily explained by differences in life expectancy, with the risk of death from deadly cancers outcompeting the risk of death from COVID-19.