Throughout the pandemic, health care providers working in the trenches have warned of the ripple effect of COVID surges. When cases jump, hospitals that are overrun with COVID patients must put off lifesaving “elective” procedures, including cancer surgeries and heart valve replacements.
Sobering new research also warns that there has been a substantial decline in new cancer diagnoses — a decline that has extended beyond the earliest stage of the pandemic, when shutdowns were widespread.
The study, published in the journal Cancer, used nationwide data from the Veterans Health Administration from 2018 to 2020. The researchers found that cancer-screening procedures declined dramatically amid the pandemic.
Colonoscopies (which are used to screen for colon cancer) dropped by 45% in 2020, prostate biopsies (used to screen for prostate cancer) dropped by 29%, chest CT scans (used to detect lung cancer) dipped by 10% and cytoscopies (used to look for bladder cancer) dropped by 21%.
New cancer diagnoses also decreased by anywhere from 13% to 23%, depending on the type of cancer.
“I fully anticipate that we’re going to see the consequences of this play out over the next decade,” study researcher Brajesh Kumar Lal, an associate professor of surgery and director of endovascular surgery with The University Of Maryland Medical System, told HuffPost.
Indeed, detecting cancer early — ideally before a person has any symptoms — is often a matter of life or death. Researchers have found, for example, that colonoscopies can slash the risk of death from colon cancer among high-risk patients by more than half. Every month of delay in getting a person cancer treatment can raise the risk of death by 10%.
Studies have sounded alarms over the direct impact of COVID on cancer outcomes around the world.
“A research study from Brazil has shown that short-term decreases in cancer care led to increased cancer-related deaths, with the mortality rate of hospitalized patients with cancer increasing by 14% in 2020 compared to 2019,” said Diane Reidy Lagunes, associated deputy physician-in-chief and a medical oncologist with Memorial Sloan Kettering Cancer Center in New York City. “Similar increases in cancer-related mortality are expected in the U.K. as well, with the UK Lung Cancer Coalition estimating that the delays in lung cancer diagnoses could increase deaths in the five years after diagnosis by about 5%.”
Lal argued that his findings are important to consider now, because they do not simply show that cancer screenings dropped early on the pandemic when the world largely shut down; they suggest they’re persisting.
“We still haven’t recovered,” he said.
“It will be years before we truly quantify the impact COVID has had on cancer care.”
There are, however, relatively straightforward solutions that can help, Lal said, like continuing to leverage telemedicine. Nearly every state has loosened its regulations to allow healthcare providers to offer telemedicine to patients who are unable to come into the office or prefer not to during the pandemic, and Lal believes doctors can use that technology to reach out to patients who have missed routine screenings and “bring them back into the fold.”
Hospitals can also separate COVID patients from non-COVID patients to the extent they’re able as cases surge yet again. “Organize these screening activities in areas of the hospital that don’t have a lot of traffic, or perhaps even outside the main hospital in smaller offices, so patients are not exposed to high-risk conditions,” Lal said.
Of course, bringing the pandemic to an end will also help bring the health care system back to more of a state of equilibrium. And doctors and nurses have been clear that those who are unwilling to get vaccinated are at much greater risk of being hospitalized due to COVID — which strains resources and makes it more difficult for them to do their jobs effectively.
For cancer patients, the potential consequences are profound.
“It will be years before we truly quantify the impact COVID has had on cancer care,” Lagunes said. “We are worried that in the next coming years, we will see an increase in the number of later-stage patients.”
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.