During the rise of the COVID-19 pandemic in 2020, many people minimized the time spent out of their homes, including at physicians’ clinics for appointments. This proved to be detrimental for cancer management. A notable disruption occurred in patients seeking out cancer-based health services, with many cancelling or postponing cancer screening appointments. Clinics also postponed or deferred radiation treatments and elective surgeries. This left patients unable to receive proper healthcare services and resulted in less cancer screenings.
With patients choosing to stay away from hospitals and medical practices to reduce exposure to COVID-19, many cancer screening facilities closed temporarily and faced staffing shortages. This included oncology nurses that play a key role in carrying out routine cancer screenings. According to cancer.gov, “an estimated 9.4 million screening tests that normally would have taken place in the United States in 2020 didn’t happen.” Radiation treatment centers were affected as well: “We were certainly seeing individuals delay coming in for radiation because of concerns related to COVID,” Dr. Karen Winkfield, executive director of the Meharry-Vanderbilt Alliance in Nashville, Tennessee, said.
As a result of the decline in cancer screenings, the American Society for Radiation Oncology (ASTRO) has reported that patients are being diagnosed with more advanced stages of cancer compared to before the pandemic. A survey completed last year by 117 doctors showed that two-thirds of radiation oncologists said that new patients were being diagnosed with more advanced cancers, and that patients had interrupted their radiation treatment because of the pandemic. Among the doctors surveyed, 73% said that patients were not receiving cancer screenings at all. By detecting cancer tumors or lesions through routine screenings before they are fully formed, cancer can be stopped before it reaches an advanced stage. For example, a study by Myers et al shows that cancer screening in women is linked to a 20% reduction in breast cancer mortality.
An initiative led by the American College of Surgeons and the American Cancer Society, called the Return-to-Screening study, was created to help cancer facilities get their screening rates back to pre-pandemic levels. The study took place over a six-month period from June to November of 2021. During the study, 748 cancer facilities worked to implement strategies to increase their number of screenings and add a total of 70,000 additional screenings per month by the end of the study. Strategies included raising public awareness of cancer screening through social media campaigns and giving detailed patient education on screenings through oncology nurses. Other strategies included increasing access to screening for patients by extending facility hours and providing financial support to patients without health insurance. Heidi Nelson, MD, FACS, who led the study, said that many of the facilities “have bounced back to their pre-pandemic levels of screening.”
In September 2021, several facilities that took part in the Return-to-Screening program shared that the study helped boost their screening rates. One facility, Henry Ford Health, saw a 17% increase in mammograms among Black women and a 35% increase among Hispanic women when compared to 2020.