When the COVID-19 pandemic began in 2020, life as we knew it came to an abrupt halt. That included routine healthcare visits, as many providers postponed appointments and cancer screening tests that were deemed “non-essential.”
In the United States alone, an estimated 22 million cancer screening tests were disrupted by COVID-19 from April to June 2020. As a result, about 80,000 patients could be at risk for delayed or missed diagnoses.
The IQVIA Institute for Human Data Science published these estimates as part of its report on shifts in healthcare demand, delivery and care during the COVID-19 era. In this article, we’ll look at how diagnostic procedures for some of the most common cancers are impacted. We’ll also share some tips to help you move forward with your cancer-related care in a timely and safe manner.
DRAMATIC DROP IN DIAGNOSTIC TESTS
The IQVIA report looked at insurance claims for five of the most common cancer screening tests – breast, cervical, colorectal, lung, and prostate – and found a significant reduction across the board as a result of COVID-19.
“Claim codes for diagnostics commonly used to screen and monitor for cancer were generally stable from March 2019 through February 2020,” noted the report’s authors. “However, as the country prepared for COVID by canceling/postponing non-essential visits, procedure codes throughout March declined dramatically, coming to a near stand-still for some tests by the first week in April.”
As you can see in the chart above, colorectal cancer screenings took the biggest hit. In the week ending April 10, 2020, claims filed for colonoscopies dropped by 90%. Mammograms for breast cancer screening saw a similar decline (87%), as did pap smears for cervical cancer screening (83%).
While PSA tests did drop by 60%, some physicians may have opted to continue with scheduled screenings in order to adhere to the patient’s testing plan. This is because the severity of a potential prostate tumor is often measured by how much time it takes for the PSA level to double.
The report’s authors also reasoned that the lower rate of disruption for CT scans (a 39% reduction) could be due to the generally more serious nature of lung cancer. Physicians may have also been trying to rule out COVID-related issues in the lungs for some patients.
RISK OF MISSED CANCER SCREENINGS DURING COVID ERA
Using the screening data from early April, the IQVIA report went on to project how many patients may have missed a diagnostic procedure between April and June 2020, and the risk that would create for potentially delayed or missed diagnoses.
In the chart above, you can see the estimated reduction in the number of tests ranges from 30 to 72 percent, depending on the cancer type. As a result, COVID-19 potentially disrupted more than 22 million cancer screening tests overall during this timeframe. That included an astonishing 13.2 million fewer pap smears and 7.2 million fewer mammograms over the three-month period.
It’s important to note that not all abnormal test results lead to a cancer diagnosis. With the rate of positive cancer diagnosis per test in mind, the report’s authors determined the reduction in screenings could put more than 80,000 patients at risk for a delayed or missed diagnosis. Breast cancer is estimated to be the most impacted (36,000 patients), followed by prostate cancer (22,600) and colorectal cancer (18,800).
A delayed diagnosis could ultimately lead to a more advanced cancer when it is diagnosed. Not only will that have negative impacts on a patient’s prognosis, but it could also have long-term effects on our healthcare system.
“Current excess healthcare capacity to catch-up on missed tests and associated cancer treatments would require providers to shift priorities to make time and space in schedules and facilities,” said the IQVIA report authors. “An immediate return to previous volumes of testing and care will require substantial reallocation of resources and likely last months after social distancing rules are relaxed.”
WHAT YOU CAN DO TO MOVE FORWARD WITH YOUR CARE
Provision is a strong advocate for timely cancer screening and treatment. As such, we have developed a list of guidelines to help you move forward with your care and avoid putting yourself at higher risk.
First and foremost, we encourage you to call your primary care physician and discuss any regularly scheduled procedures like a mammogram, pap smear, colonoscopy or PSA test. Based on your medical history, your provider can help you determine whether it’s appropriate to continue with your cancer screening now or delay it.
If you do receive a cancer diagnosis, it may be appropriate to delay treatment until the COVID risk is lowered. However, some patients may be better off beginning their cancer treatment immediately. As a first step after your diagnosis, we recommend seeking multiple opinions to discuss your specific diagnosis and treatment options.