Impact of COVID-19 on Cancer Screenings: More Advanced Disease, Says Survey

New cancer patients are arriving for treatment with more advanced disease then before the COVID-19 pandemic, a result of hesitancy on the part of patients to be screening during the pandemic and interruptions in treatment, says a new survey from the American Society for Radiation Oncology (ASTRO).

ASTRO survey polled 509 radiation oncologists across the United States last year and again earlier this year. Nearly two-thirds of the survey’s respondents said that new patients are being diagnosed with more advanced-stage cancers, while existing patients experienced cancer treatment interruptions due to the pandemic.

ASTRO called the survey results the consequence of pandemic-driven drops in cancer screening and diagnostics.

Another three-fourths of those polled said that physicians in their practice are noticing that patients are not getting cancer screenings as much as before the pandemic.

However, the number of patients postponing treatment that was common a year ago has largely subsided, the national survey says, as cancer clinics have put enhanced safety measures in place to protect patients and staff against COVID-19.

Delayed Screenings

The survey highlights that many people canceled or did not make appointments for mammograms and other screenings to detect potential cancers during the pandemic lockdowns last year, says Jordan Winter, MD, Chief of Surgical Oncology at UH Seidman Cancer Center.

“There is recently published data in which cancer patients are presenting at a later stage in the era of COVID-19,” Dr. Winter says. “As a result, cancers are surfacing at a later state, which naturally leads to poor outcomes.”

It’s understandable that some people would rather avoid healthcare facilities until they can get vaccinated. But with most healthcare facilities, including University Hospitals, following strict guidelines for cleaning, social distancing and masking, fears of coming in contact with the coronavirus are unfounded, Dr. Winter says.

A number of studies have shown that the number of patients screened or given a diagnosis of cancer fell during the early months of the pandemic. By mid-June 2020, the rate of screenings for breast, colon and cervical cancers were still 29 percent to 36 percent lower than pre-pandemic levels, says one data analysis. Hundreds of thousands of fewer screenings were performed last year than in 2019, the analysis says.

The consequences for waiting could be serious. Cancer is most treatable, with the best chance for successful treatment, in its early stages, Dr. Winter says.

“The prognosis is worse for later stage cancers,” Dr. Winter says. “The treatment options are more limited.”

Time to Come Back If You’ve Been Postponing

Health care providers want patients to come back and resume screening.

Now that safety measures are in place to protect patients against the spread of COVID-19, there is no reason that cancer screenings can’t take place as recommended by your physician, Dr. Winter says.

“It’s important that people know they can safely return to healthcare environments where we have the appropriate equipment and screening procedures in place,” he says.

While a delay of a few months probably does not have a significant impact on patients, Dr. Winter says, healthcare providers prefer their patients not postpone screening tests.

“Much depends on the biology of the tumors. A few months would have no impact on small, slow-growing tumors. However, sometimes tumors are rapidly growing ones in which timely detection is important,” he says. “We hope we don’t see that, but that is what early detection is aimed at preventing.”

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