Preventive cancer screenings are nearing or surpassing pre-pandemic norms after years of COVID-related interruptions, according to data from Texas Health Presbyterian Hospital Dallas.
The hospital’s oncology program recorded an 11% increase in breast cancer screenings and an 83% increase in lung cancer screenings between 2020 and 2021, representing a promising shift as health care providers race to make up for procedures that were missed or delayed because of pandemic shutdowns.
A number of factors limited screenings in 2020, including offices being closed for non-essential treatments, staff shortages capping the number of appointments available and patients avoiding visits out of fear of contracting the coronavirus. Some patients also lost their jobs, leading to the loss of health insurance, or they had to juggle appointments while looking after children who would normally be in school.
Since the early days of COVID-19, health professionals have sounded the alarm over the potential consequences of missed health screenings. Diseases like cancer could be caught at later stages, making them more difficult — and more expensive — to manage.
“If we can detect cancer earlier, then people have more options for treatment and their overall survival could also be better,” said Joyce Lee, who works as the nurse manager for the oncology program. “For lung cancer, for example, that could mean the difference between being able to have surgery to remove it versus not being able to do surgery.”
Cancer screening trends nationwide match those seen at Texas Health Presbyterian Hospital Dallas. Breast cancer screenings at the hospital dropped from over 18,000 in 2019 to about 13,600 in 2020 before climbing back to over 15,000 in 2021. Lung cancer screenings dropped from 117 in 2019 to 83 in 2020 before surpassing pre-pandemic rates with 152 screenings in 2021.
Breast cancer screenings have been slower to catch up because mammograms, or breast X-rays, require specialized technicians, Lee said.
The Dallas hospital used targeted social media posts, automated reminders and one-on-one counseling with patients as part of a national Return-to-Screening campaign spearheaded by the American College of Surgeons and the American Cancer Society. It also partnered local nonprofits to provide free screenings to vulnerable patient populations.
Screenings for diseases like breast, lung, colon and cervical cancers, though relatively simple procedures, can be life-saving.
“We have well-known data across multiple cancers where early screening actually prevents cancer-related deaths down the road,” said Dr. Pavan Reddy, director of the Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine in Houston.
Like at Texas Health Presbyterian Hospital Dallas, Reddy said preventive screening rates at the Duncan Comprehensive Cancer Center have returned overall to pre-pandemic norms, although doctors are still fielding some residual catch-up appointments, especially for underserved populations.
It’ll likely be months or years before the health care industry sees the full effects of missed routine care.
A recently published study by health care software research company Epic Research, found no significant increase in cancer diagnoses, including more advanced cancer diagnoses, between 2020 and 2022 when compared to pre-pandemic norms. Though reassuring for now, scientists say cancer severity rates still need to be monitored closely.
“While our data does not show an increase in advanced cancers, it might take years to fully realize the impact of missed screenings, especially for cancers with longer recommended intervals between screenings,” the study’s authors wrote.
Reddy said losses because of delayed care are expected, as are downstream impacts on family members and the health system as they care for sicker patients.
The financial burden of later-stage diseases can also be significant. A 2016 study of breast cancer patients found that insurance companies allowed costs per patient of about $82,000 in the first year of treatment for patients with stage I/II tumors, compared to nearly $135,000 for patients with stage IV tumors.
Future impacts from pandemic interruptions are unavoidable at this point, but that shouldn’t be cause for panic.
“People shouldn’t be getting scared about what the ramifications might be. It’s just important to be informed and to be aggressively on top of screening in general, regardless of the pandemic effect, because it does make a major, major impact,” Reddy said.