Amid widespread lockdowns and fears of visiting the hospital, the U.S. has amassed a cancer screening deficit of roughly 9.4 million, researchers reported Thursday in JAMA Oncology.
There were sharp declines last year in testing to diagnose breast, colorectal and prostate cancers, though providers did witness a rebound as the pandemic progressed. The large diagnostic deficit may require intervention to avoid excess-cancer related deaths, concluded experts with the University of Kansas Medical Center.
“Public health efforts are needed to address the large cancer screening deficit associated with the COVID-19 pandemic, including increased use of screening modalities that do not require a procedure,” Ronald Chen, MD, and co-authors wrote April 29.
To reach their conclusions, scientists analyzed data from the HealthCore Integrated Research Database, which includes claims information from 60 million individuals in Medicare Advantage and commercial plans across the U.S. The analysis covered January through July of 2018-2020, comparing historical screening numbers against the pandemic period.
Chen and colleagues found that screening for all three cancers dropped dramatically between March and May of 2020 versus 2019 data, with the sharpest drop in April. Breast cancer screening saw the biggest fall at 90.8%, followed by colorectal (79.3%) and prostate (63.4%). Both breast and prostate had seen “near complete recovery” of monthly screening rates by July.
The absolute deficit across the entire U.S. population, the authors estimated, was 3.9 million for breast, 3.8 million for colorectal and 1.6 million for prostate cancer. Numbers varied by geography, with the Northeast experiencing the sharpest declines and the West logging a slower recovery when compared to the Midwest and South.
“Our results further revealed that the screening deficit was larger for breast and colorectal cancers, which require procedures (commonly, mammography and colonoscopy), compared with prostate cancer screening, which commonly involves a blood test (i.e., prostate-specific antigen testing). However, further study is needed to ascertain the reasons for the different screening deficits,” the authors noted. “From a public health perspective, increasing the use of alternatives to colonoscopy for colorectal cancer screening may help mitigate this screening deficit,” they added later.
Chen and co-authors cited a recent modeling study from the National Institute of Health as part of their motivation; it found that the U.S. could potentially see 10,000 excess breast and colon cancer deaths over the next decade because of COVID-related screening delays. You can read the rest of his teams investigation in JAMA Oncology here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.