September 28, 2021 · Jyoti Patel, MD, FASCO
Now 19 months into the COVID-19 pandemic, the general public and health care systems continue to adapt to developing science and increased understanding of the risk, prevention, and treatment of COVID-19. Early in 2020, when cases of COVID-19 started to increase, public health officials released guidance to help individuals reduce their exposure to the virus. As a result, in-person hospital appointments and procedures were sharply reduced, including cancer screening.
Cancer screening aims to find cancer before symptoms appear while the tumor is still small and confined, which is when the chance of cure is the highest. Different groups, including the American Society of Clinical Oncology (ASCO) and the United States Preventive Services Task Force, or USPSTF, offer recommendations for screening for different types of cancer, including breast cancer, cervical cancer, colorectal cancer, and lung cancer, depending on a person’s age and risk factors. In addition to these cancers that can be detected by screening, some cancers are found during routine medical appointments when a health care provider notices an abnormal lump or skin lesion during a physical exam or when routine blood tests find an abnormality.
Although screening rates for many cancers have started to rebound after the first wave of COVID-19, they are still lower than levels in 2019. The National Cancer Institute predicts that there will be at least 10,000 excess deaths from breast and colorectal cancers over the next 10 years in the United States as a direct result of people not getting regular mammograms and colonoscopies. These deaths don’t include the effects that interruptions in cancer treatment or decreases in preventive measures, such as getting the human papillomavirus (HPV) vaccine, have had, so there may be even more excess deaths as a result of this pandemic.
Yet despite these sobering facts, there have been new, innovative ways to continue providing screening during the pandemic. For example, the use of tele-visit appointments enabled some people to get advice about ways to reduce their cancer risk and to develop plans for rescheduling exams. The pandemic also provided opportunities to promote home-based tests, such as the fecal immunochemical test (FIT) for colon cancer. Meanwhile, some health care systems are offering single-day appointments for breast cancer screening that include same-day counseling, mammography, physical examination, and recommended diagnostic tests.
The collateral damage from the pandemic has affected us all in many ways. It’s important for us to prioritize the interventions, such as cancer screening, that we know work in taking care of our health and well-being over the long term. Now is the time for all of us to get back to cancer screening. So make a note to call your doctor to make sure you are up to date on your cancer screenings!