COVID-19 leaves large cancer screening deficit in USA
medwireNews: Breast, prostate, and colorectal cancer screening rates declined sharply during the initial months of the COVID-19 pandemic in the USA, and while they subsequently recovered, a large deficit remains, study findings indicate.
Ronald Chen (University of Kansas, Kansas City, USA) and co-investigators estimated that the “screening deficit associated with the COVID-19 pandemic across these 3 cancers for the US population was 9.4 million.”
They report in JAMA Oncology that this “may be a temporary delay” but suggest that “public health efforts are needed to address the large cancer screening deficit, including increased use of screening modalities that do not require a procedure.”
Data from the HealthCore Integrated Research Database, which includes approximately 60 million people with Medicare Advantage and commercial health insurance plans, revealed that screening for breast, prostate, and colorectal cancer fell substantially between March and May 2020 compared with the same months in 2019.
The greatest fall occurred in April 2020, when screening rates were 90.8% lower for breast cancer, 63.4% lower for prostate cancer, and 79.3% lower for colorectal cancer when compared with April 2019.
However, by July 2020, screening rates for breast and prostate cancers had almost completely recovered to 2019 levels, whereas the rate for colorectal cancer screening remained 13.1% lower.
The researchers note that although the screening rates generally recovered, the deficit in total screening numbers from January through July 2020 compared with the same period in 2019 was 3.9 million for breast cancer, 1.6 million for prostate cancer, and 3.8 million for colorectal cancer.
Chen and team also analyzed their data by geographic region and socioeconomic status (SES) and found that, for all three cancers, the sharpest declines in screening were recorded in the Northeast USA, while the West had a slower recovery compared with the Midwest and South.
“This corresponds to the differential timing of COVID-19 rates across different regions of the country, with New York and other Northeastern states reporting early and higher surges of COVID-19 cases,” they remark.
Prior to the pandemic, screening rates were greatest in the highest two SES index quartiles but these two groups then experienced the largest declines during the first months of the pandemic, which the investigators say “had the effect of narrowing the gap in screening across the 4 SES quartiles in 2020 compared with 2019.”
In multivariable analyses, increasing age and SES quartile were significantly associated with lower rates of cancer screening in 2020 versus 2019, whereas the use of telehealth was associated with significantly higher screening rates.
The study findings are consistent with those previously reported by medwireNews[SN1] , and Chen and team conclude that they further current knowledge by revealing “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 (ie, prostate-specific antigen testing).”
However, the authors caution that “further study is needed to ascertain the reasons for the different screening deficits.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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