MONDAY, March 21, 2022 (HealthDay News) — The early months of the COVID-19 pandemic kept millions of Americans away from routine cancer screenings. Now, a new study reveals that many US screening programs were still not back to normal in 2021.
The study, of more than 700 cancer facilities nationwide, found that as of January 2021 — a year after COVID emerged in the United States — most had still not had their numbers back. pre-pandemic screening.
There was a particular gap in colon cancer screening, which is often done by colonoscopy.
That means cancer deaths could rise over the next decade, experts fear.
It is well known that cancer screenings dropped dramatically in the early months of the pandemic in the United States. A study published last year estimated that between March and May 2020, more than 9 million Americans missed their routine screenings.
These tests can detect common cancers – including breast, cervical, colon and lung cancers – when they are still in the early stages and most treatable.
It is therefore vital that people resume their screening program or start screenings, if they have not already done so, experts have said.
“We know that cancer screening saves lives,” said Dr. Heidi Nelson, one of the study’s authors and medical director of cancer programs for the American College of Surgeons.
Now is the time for anyone who has delayed a routine screening to “put it on your to-do list,” she said.
COVID-19 precautions are in place and patients can be assured that testing procedures are safe, Nelson said.
The results were published online March 21 in the journal Cancer. They come from a larger study conducted by Nelson’s program and the American Cancer Society, in response to pandemic-related screening declines.
The study enrolled 748 screening programs nationwide in the spring of 2021 to see where they stood in screening rates and to initiate efforts to improve those numbers.
For September 2020 and January 2021 (the most recent month assessed by the study), most programs were still below their pre-pandemic screening counts. This was especially true for colon cancer, with 81% of facilities reporting lower numbers.
The reductions were often minimal across all programs: breast cancer screening fell by 1.6% overall, for example. But the numbers varied widely from program to program, and some had double-digit reductions.
There are likely several reasons why projections were still down in January 2021, Nelson said.
In some centers, she said, limited staff resources may have been assigned to deal with COVID-19 surges, which occurred at different times in different locations across the country.
And then there’s patient hesitation, she said — especially with an invasive procedure like colonoscopy, where distancing between providers and patients isn’t possible.
By definition, screening is done when people have no signs or symptoms of cancer. So it could look like an elective procedure, and one that can be postponed, Nelson noted.
But the goal of screening is to find the cancer as early as possible. “We’re still aspiring to catch it before there are any symptoms,” Nelson said.
In many cases, by the time symptoms appear, the cancer has already spread.
Even when people want to get tested, they may face a wait time for an appointment, according to Dr. Julie Gralow, chief medical officer of the American Society of Clinical Oncology.
It’s possible, she said, that labor shortages have contributed to continued testing shortages in some locations.
At this point, Gralow said, testing rates “have not 100% caught up” to pre-pandemic levels. Omicron’s push, she noted, didn’t help.
Like Nelson, Gralow pointed out that procedures like mammography and colonoscopy can be done safely and that screening saves lives.
Home testing may also be an option, Gralow said – including stool tests to detect possible colon cancer and HPV testing for cervical cancer. She added, however, that positive results from these tests should be followed up with in-person examinations.
Nelson recommended talking to your health care provider about cancer screenings you should have, and which particular tests are best for you.
While it is clear that the pandemic has delayed cancer screening for many Americans, the full repercussions are not yet known. In 2020, the director of the US National Cancer Institute predicted that 10,000 more Americans could die from breast and colon cancers due to missed screenings.
But it will be years before researchers have solid data on cancer deaths, Nelson and Gralow said.
For now, Gralow noted, major medical centers are monitoring their own numbers, to detect any increase in late-stage cancer diagnoses.
Nelson noted that more than 700 programs in this study got involved because they want to reverse pandemic-related trends in testing. They reach out to existing patients to ensure screening is safe and do community outreach to attract people who have not yet started screening.
The hope is that these efforts will help prevent the rise in late-stage cancers – although more will likely need to be done, according to Nelson.
“This work is not finished yet,” she said.
The American Cancer Society has more on cancer screenings during the pandemic.
SOURCES: Heidi Nelson, MD, medical director, Cancer Programs, American College of Surgeons, Chicago; Julie Gralow, MD, executive vice president and chief medical officer, American Society of Clinical Oncology, Alexandria, Va. ; CancerMarch 21, 2022, online
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