Delays in cancer screenings and early detection brought on by the pandemic could lead to a rise in deaths
- The COVID-19 pandemic has contributed to delays in preventative cancer screenings.
- The delays could lead to cancers detected at a later stage and a rise in the cancer mortality rate.
- Doctors told Insider that worry over COVID-19 should not stop people from getting screenings done.
The cancer mortality rate could rise as a result of delayed screenings and detection brought on by the COVID-19 pandemic.
"The concern is that with COVID causing people to be less inclined to get their screening done, we're going to likely see, and to some extent are already seeing, cancers diagnosed at a later stage," Dr. Ronald Hale, the medical director for radiation oncology at Kettering Health Network, told Insider.
"But survival rates decrease as stage increases, and ultimately these factors will lead likely to an increase in mortality," Hale said.
Recent research supports those concerns. One study that looked at cancer diagnoses in the US before and during the pandemic found there had been a significant decline in identified patients for six common cancer types.
"While residents have taken to social distancing, cancer does not pause," the paper said, noting other research that suggested an additional 33,890 cancer deaths could occur in the US as a result of the pandemic.
Another study conducted in the UK estimated there would be "substantial increases in the number of avoidable cancer deaths" as a result of delayed diagnoses due to the pandemic. That study looked at breast, colorectal, lung, and esophageal cancer.
Experts told Insider that while many people have taken health advice about the pandemic seriously by minimizing their exposure to others, it could be riskier to skip a preventative screening.
'It can mean the difference between surviving it or not'
Preventative screenings are used to detect cancer in people before they may be experiencing symptoms. For some cancers, doctors have highly effective tools to catch the disease early.
Breast cancer can be detected in mammograms, colorectal cancer can be discovered through colonoscopies or other noninvasive means, and lung cancer can be found with CT scans, to name a few.
"Our ultimate goal is to find cancers as early as possible," Dr. Meghan Musser, a radiologist for Kettering, told Insider. "Well before a patient or a physician would be able to find that cancer."
Preventative screenings are recommended annually for some cancers. Mayo Clinic recommends women over 40 get a mammogram done once per year. The Centers for Disease Control and Prevention recommends adults aged 50 to 75 undergo screening for colorectal cancer regularly.
Screening recommendations also depend on other factors, such as family history or anything that can make a person high-risk.
Musser said even before the pandemic, she would see patients who had not had a mammogram in a year or more who, in that time, had developed a sizable cancer that, if detected earlier, could've been more easily treated.
Hale said early diagnosis can make a huge difference, rejecting the misconception that if you have cancer it doesn't matter much when it's detected.
"It can mean the difference between chemotherapy or no chemotherapy, about having a small, simple surgery or a big, involved surgery," Hale said, referring to early detection.
"Ultimately, it can mean the difference between surviving it or not," he said.
Pandemic delays
Last spring, in the early days of the pandemic, many cancer screenings were put on hold due to state and city mandates suspending procedures or activities deemed to be "elective." At the time, hospitals were scrambling to make room for coronavirus patients while states were trying to quell community spread.
Sally Grady, director of Kettering's breast evaluation centers, said they were forced to cancel preventative screenings for about six weeks due to orders by Ohio Gov. Mike DeWine.
Grady, who oversees 13 centers that typically perform 65,000 mammograms each year, saw substantial declines, despite actively trying to reschedule as many screenings as possible.
"Some patients said 'I'm really going to wait until Covid is over before I want to come in,' and some wanted to wait very many months past what their annual screening date was," Grady told Insider.
She said they were able to successfully reschedule many of those patients, but over the year found "our diagnostic mammograms and our biopsies actually increased." Meaning, there were more people already exhibiting symptoms of breast cancer, or cancers that were further along.
"And I think some of that was because patients waited," Grady said. She also serves as an adviser to Volpara Health Technologies, a provider of breast imaging analytics that focuses on preventing advanced-stage cancer.
Even as clinics were able to reopen and resume preventative screenings, some patients have continued to avoid medical settings throughout the pandemic, due to a fear of contracting the virus. But, the experts said, the risk involved with getting a screening done is relatively low.
Safer to have a screening than to not
Grady said her clinics try hard to assure patients of the many measures they're taking to prevent coronavirus transmission, including mask mandates for patients, staff wearing masks and face shields, enhanced cleaning procedures, temperature checks, and physical distancing.
She noted that some of the patients who are hesitant to come in for screenings are still going to the grocery store, going out to dinner, or gathering in groups.
"We are probably cleaning better than any of those places are and taking more precautions than what people do in their daily lives," Grady said.
While many preventative screenings can be done in clinics that are not treating COVID-19 patients, even at hospitals, patients with coronavirus are typically isolated and treated on completely separate floors.
Grady also said some screenings, like mammograms, only last 15 minutes, so patients can quickly be in and out.
Patients who are worried about getting infected with COVID-19 can also call their clinics in advance and ask what measures are being taken to prevent transmission.
All the experts emphasized that because of the precautions medical centers are taking, and the risks involved with delaying a screening, it is safer for patients to have their recommended screenings done than to not.
"There's so much fear and anxiety about the unknown with the pandemic, that oftentimes we can put these screening exams on the back burner and think, 'Well maybe next year I'll do it,'" Musser said. "But it's exceptionally important that you don't skip these years because it really could alter your life."
"Screening mammograms save lives."