Cancer screening tests and new cancer diagnoses decreased from 2018 to 2020 in the United States, due to the COVID-19 pandemic, according to a recent study published in the American Cancer Society Journals. The authors associated the decline with pandemic-related restrictions, such as pausing elective procedures and other clinical screening methods.
“Health systems across the United States have suffered a major disruption in cancer care from COVID-19,” the researchers wrote. “Although the extent and impact of the pandemic on immediate treatment of known cancers is predictable and has been reported on, we found a major reduction in diagnostic procedures that are used to identify new cancers and a consequent reduction in diagnosis of new cancers.”
In order to determine the impact that the COVID-19 pandemic had on people living with cancer, the authors reviewed data from the Veterans Health Administration (VA) health care system. Overall, the study included people with lung, prostate, bladder, and colorectal cancers.
As the COVID-19 pandemic began to take hold in March 2020, elective clinical tests and procedures were suspended nationwide, affecting many people living with cancer. These restrictions were also placed on screening methods used to detect cancer, such as computed tomography (CT) scans for lung cancer, colonoscopies for colon cancer, and cystoscopies for bladder cancer.
Low-dose CT (LDCT) scans are recommended by the Centers for Disease Control and Prevention (CDC) for people who are at an increased risk of lung cancer. These screening tests can help identify early cases of lung cancer that might otherwise not be found until they have progressed to an advanced stage. CT scans are also used to monitor a person’s progress in cancer treatment.
These restrictions limited access to care, potentially leading to fewer cancer cases being diagnosed and worse outcomes later on. As the pandemic continues, new outbreaks and changing restrictions continue to limit access to screening tests and other health care resources.
Using data from the VA health care system, the authors found that there were 4.1 million cancer-related encounters between Jan. 1, 2018 and Dec. 31, 2020. Cancer-related encounters include diagnostic testing, procedures, and diagnoses. Overall, lung cancer-related encounters dropped by 10 percent in the spring of 2020 compared to 2018 and 2019.
Additionally, in 2020, chest CT scans used to screen for lung cancer dropped by about 64 percent compared to previous years. While cancer-related encounters rebounded after a few months into the pandemic, monitoring procedures did not. The authors estimate that there were about 62,800 fewer chest CT scans performed compared to previous years.
New lung cancer diagnoses also decreased as a result of lack of screening. Lung cancer diagnoses fell by about 30 percent by May 2020 from the pre-pandemic baselines in 2018 and 2019. The number of lung cancer diagnoses remained low throughout 2020, and the authors estimate that 13 percent fewer lung cancer cases were diagnosed in 2020 compared to earlier years.
While there has been a noticeable decrease in cancer diagnoses and screenings due to the COVID-19 pandemic, the authors are hopeful that these findings can be used to help bring the numbers back up.
“The disruption in non-emergency health care during the peak of the pandemic was intentional and necessary,” said Dr. Brajesh K. Lal of the Veterans Affairs Maryland Health Care System in a press release. “As we enter the recovery phase, we hope that our work will help physicians, hospitals, and health care organizations anticipate the extent to which they have fallen behind in their efforts to diagnose new cancers. It will also help them allocate requisite resources and time to re-engage with patients.”