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Delays in Cancer Screening and Care During the Pandemic

Delays in Cancer Screening and Care During the Pandemic

Published on June 15, 2021

What Do Care Delays Mean for Cancer Patients?

This is the fourth in a multipart series exploring important questions about COVID-19 and its unique impact on cancer patients. In this series, Patient Power went to the experts to get the facts about COVID-19 and how it affects prevention, screening, treatment, and research.

For many people with cancer, the pandemic has been doubly difficult. Beyond the isolation, restrictions, and fear of COVID-19, people with cancer have had to make tough decisions about their care. And sometimes those decisions were not in the patient’s control, as hospitals and health systems had to prioritize resources to care for those with COVID-19.

Disruptions in care include postponing cancer screening exams, delays in scheduling follow-up care such as visits with an oncologist or specialist, foregoing scans or other testing, missing primary care visits, or even skipping supplemental services like physical therapy.

What is the effect of these delays, and now that the situation is slowly improving, how can people with cancer best cope? Patient Power spoke with Debra Patt, MD, PhD, MBA, an oncologist and breast cancer specialist in Austin, Texas. She is also Executive Vice President of Texas Oncology and the lead investigator of a recent study in Clinical Cancer Informatics on the impact of COVID-19 on cancer care, focusing on people over 65 years of age.

Impact of COVID-19 on Cancer Care

“During the pandemic there was a very substantial decrease in screening each month for breast, colon, prostate, and lung cancer in Medicare beneficiaries when compared to the prior year. As a result, new cancer diagnoses were down tremendously as well,” Dr. Patt said, summarizing the study. “Unfortunately, the natural rate of cancer didn’t diminish during that time period, so we are concerned that many cancers may have been missed over the last year and a half.”

For people already diagnosed with cancer, delays in biopsies, surgery, chemotherapy, and other follow-up care were also seen.

There are many reasons why people may not have had screening tests or follow-up care done during the pandemic.

“This is a complicated issue. Some people chose not to see the doctor because they were scared, or too busy with other priorities (jobs, kids out of school, family issues), while others wanted to see their doctor but were unable to, because of limited appointments or due to transportation issues during the pandemic,” Dr. Patt said.

When asked about the potential effects for patients who already have cancer and may have had their care disrupted, she said “The natural consequence of that is that people will come in for care with cancers at a more advanced stage.”

Other researchers have looked at the worries people have about disruptions in cancer treatment caused by the COVID-19 pandemic. They found that many people with cancer had anxiety about their level of risk if they contracted COVID-19, so the fear of going for in-person treatment during the pandemic has been substantial. And of course, many people lost jobs and may have also lost (or been unable to afford) health insurance — also disrupting care.

Dr. Patt emphasized that the delays in screening and the disruptions in ongoing cancer care are both worrisome and can result in worse outcomes for cancer patients.

What Can Be Done Now?

Dr. Patt urged people to make healthcare — and particularly cancer screening — a priority. Unfortunately, she believes that it may take years to catch up.

She also has concerns that people may be less healthy in general right now, perhaps because of a more sedentary lifestyle, heightened stress, or weight gain during the pandemic.

Dr. Patt’s parting advice was that it is vital that people prioritize their own healthcare and that of their loved ones. Be sure you and your family are vaccinated and continue to wear a mask if you are around anyone who is not, she advised. This is especially important for people with cancer, as well as those who are older and/or have additional medical conditions such as heart disease, lung disease, kidney disease, or diabetes.

~Susan Yox, RN, EdD

See Our Sources:

American Society of Clinical Oncology. Clinical Cancer Informatics. (2021). “Impact of COVID-19 on Cancer Care: How the Pandemic is Delaying Cancer Diagnosis and Treatment for American Seniors.” https://ascopubs.org/journal/doi/full/10.1200/CCI.20.00134

Journal of Psychosocial Oncology. (2021). “Cancer Survivor Worry About Treatment Disruption and Detrimental Health Outcomes Due to the COVID-19 Pandemic.” https://pubmed.ncbi.nlm.nih.gov/33624572/


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