CONTACT
Barb Tyler, Office of Communications, (402) 471-3486,
barb.tyler@nebraska.gov
Lincoln – Cancer is a leading cause of death in the United States, with an estimated 606,520 deaths in 2020 alone. However, the rate of cancer-related deaths has been falling over the last two decades with improved research and prevention.
While prevention and cancer screenings are necessary for both personal and population health, disruptions brought on by COVID-19 have significantly interrupted almost all aspects of cancer control and prevention procedures, such as cancer screening services, elective surgeries, and therapeutic routines.
After the US emergency declaration went into effect on March 13, 2020, institutions such as the American Cancer Society (ACS) issued a recommendation that people should pause their cancer screening plans during the COVID-19 outbreak until further notice. This recommendation, along with other factors, such as social isolation, caused drastic disruptions in cancer screening services. Epic Health Research Network estimates that between January 20 and April 21, 2020, screenings for breast, colon, and cervix cancers dropped by 94%, 86%, and 94%, respectively, as a result of the COVID-19 outbreak. The impact of these cancelled or delayed activities is yet to be determined.
Cancer screenings use medical tests to identify precancerous lesions before cancer is formed or to detect cancer before it progresses to more advanced stages. While not curative, cancer screenings have the potential to decrease the burden of cancer. It is important to understand that screening tests look for cancer in people who don't have symptoms. These tests are different from tests a doctor might order for potential symptoms of cancer, such as a lump in the breast or blood in the stool. If these symptoms occur, you should discuss them with your doctor as soon as possible; exams or tests will be needed for evaluation purposes.
According to the Journal of American Medical Association (JAMA), screening is linked to about 20% reduction in breast cancer mortality for women of all ages. Research further shows that if colorectal cancer screening rates in people aged 50-70 years improved to 80%, more than 30% of the deaths resulting from colorectal cancer would be avoided, as well as one third of current costs. For genetically predisposed individuals, benefits of prescribed cancer screening are even greater.
According to the American Association for Cancer Research (AACR), screening for cancer is a proven and recommended approach to prevent deaths from cancer; screening can locate precursor lesions and/or cancer at early stages when it is potentially curable. Racial and ethnic minorities and other medically underserved populations exhibit lower uptake of cancer screening than non-minorities in the United States. The COVID-19 pandemic has curtailed preventive services including cancer screening to preserve personal protective equipment and prevent spread of infection. While there is evidence for a rebound from the pandemic-driven reduction in cancer screening nationally, the return may not be even across all populations. Fear of contracting COVID-19, limited access to safety-net clinics, and personal factors like, financial, employment, and transportation issues are concerns that are intensified in medically underserved communities.
Based on pre-COVID-19 projections, further delays in cancer screenings will cause increased cancer rates overall and will have a variety of impacts across different populations. Knowing the overall benefit of cancer screening versus the risk of acquiring COVID-19, using at-home screening tests, and keeping the delays in screenings to a minimum may help improve access for more people.
The ACS advises to reschedule all missed cancer screenings. Your healthcare provider can help you understand the benefits of being screened now vs the risks of postponing the screening to a later date by taking into account personal and family history, other risk factors, and how long it has been since your last screening test. Although screening recommendations are general recommendations for large groups of people, some cancer screening tests may be ordered based on your individual needs and risks. Your healthcare provider can help you determine what screening schedule and which screening tests are best for you.
Healthcare facilities that provide cancer screening tests use precautions and take measures to ensure that screening tests are performed as safely as possible. It is important to get back on track with regular cancer screenings even if you don't have any symptoms. However, if you do have unusual symptoms, signs of cancer, or family history of cancer, visiting your healthcare provider should be your top priority. It may save your life.