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Cancer Screenings Dip During COVID, Raising Fears of Spike in Serious Cases

March 04, 2021

Hartford HealthCare screened 25 percent fewer women for breast cancer in 2020, another likely consequence of the COVID-19 pandemic.

Although the pandemic closed the system’s screening facilities for two months between March and June 2020, Dr. Diana James, section chief for breast imaging, Hartford Hospital/Jefferson Radiology, said that only led to part of the decrease.

“We also track breast cancer detection rates, which are the number of cancers diagnosed per 1,000 women screened. That rate dropped from 4.8 to 2.6 in 2020 at Hartford Hospital, which is substantially lower than 2019,” she said. “Overall, the effect of the pandemic on screening for breast cancer is concerning to say the least.”

The same can be said for all cancer screenings, both at the Hartford HealthCare Cancer Institute and nationwide. Concern prompted President Joe Biden to urge Americans to schedule any screenings or treatments they might have missed during the pandemic as he proclaimed March National Colorectal Cancer Awareness Month.

Experts with the National Cancer Institute predict there will be about 10,000 more deaths in the United States from breast and colorectal cancer alone in the next decade, directly stemming from pandemic-related delays in cancer screening and treatment.

“Cancer screenings save lives by diagnosing the disease at its earliest stages when it is more easily and effectively treated,” said Dr. Pallvi Popli, a medical oncologist with the Cancer Institute. “Delay in diagnosis will likely lead to cancer presentations at more advanced stages, from curable to becoming non-curable, which will result in poorer clinical outcomes and decreased life expectancy.”

Dr. Vaibhav Mehendiratta of Connecticut GI, a HHC partner organization, examined second-quarter 2020 statistics for colorectal cancer screenings in their practice and noted a 61 percent drop.

Although many facilities reopened for screening in early summer 2020, people have continued to delay screenings because they are afraid going into medical facilities will expose them to COVID-19. Recently published research revealed stark trends.

The situation has worsened such that the American Cancer Society and National Comprehensive Cancer Network issued a joint letter to the public urging people to schedule any screenings they might have missed during the pandemic. The rates of people newly diagnosed with cervical, colorectal, breast, prostate and lung cancers, the organizations noted, have dropped significantly in the past year with no evidence that the rate of cancer occurrence realized similar decreases. If the decrease in identifying new cancers is not corrected, Dr. Popli said, it will undoubtedly increase cancer mortality in the long run.

“These distressing trends tell us that many cancers are going undiagnosed and untreated in the wake of COVID-19,” the letter said, urging people to “Re-engage in cancer screening and care – (your) lives may depend on it.”

A fact sheet the organizations created noted that:

  • More than one-third of adults failed to receive recommended cancer screening during the pandemic.
  • Diagnoses for six major types of cancer dropped by nearly 50 percent.
  • Routine appointments were missed by 43 percent of patients, with 22 million screenings cancelled or missed just between March and June 2020.

Cancer Institute providers are particularly concerned about minority and rural populations that are already disproportionately affected by existing disparities in cancer care, screening and survival.

“Patients’ own fear has led them to avoid hospital visits that are considered non-emergent, even when services resumed,” said Dr. Alvaro Menendez, a Cancer Institute medical oncologist. “I do think there are some local, regional and ethnic/cultural differences regarding perception of COVID-19. A lot of underrepresented populations are refusing to get the vaccine.”

Dr. Menendez and colleagues are researching the reasons for such disparities in care and perception among Hispanics and other underrepresented populations.

Cancer does not stop for the pandemic, Dr. Popli said, adding that cancer screening and care is safe at all Hartford HealthCare facilities.

“Safety precautions – including wearing gloves, gowns, masks and shields — are being implemented continually to decrease risk to patients,” she said.

Also, the Cancer Institute mobile mammography van has resumed visits around the state. Women interested in scheduling an appointment can call 860.972.1141. The coach is thoroughly cleaned after each patient and appropriate social distancing is maintained.