Cancer screenings decline significantly during pandemic.

Although the American Cancer Society's cancer statistics report for 2020 noted a 29% decline in the cancer death rate from 1991 to 2017 and a 2.2% reduction from 2016 to 2017 —to their knowledge the largest single‐year drop ever recorded—physicians hope a downward trend in screening during the coronavirus disease 2019 (COVID‐19) pandemic will not undo gains.

Findings released in May 2020 by the Epic Health Research Network have indicated an abrupt drop between 86% and 94% in preventive cancer screenings performed nationwide to date in 2020 compared with equivalent weeks from 2017 to 2019. The research assessed screenings for cervical, colon, and breast cancer completed each week from a data set that included 2.7 million patient records from 39 organizations representing 190 hospitals in 23 states. The results demonstrated that cervical cancer screenings declined by 94% whereas colorectal cancer screenings were down 86% compared with the same time period in previous years.

“My fear is that all the good that has happened over the past couple of decades is going to go away and that cancers will be caught later at less treatable stages,” says Electra Paskett, PhD, director of the division of cancer prevention and control in the department of internal medicine at The Ohio State University College of Medicine in Columbus. “I'm very worried about what we'll be seeing over the next couple of years because of people's reluctance to go in for screenings.”

In addition to patients being anxious about seeing their physicians or going to health care facilities amid the pandemic, another complicating factor is the number of unemployed workers who now are uninsured and others who have been furloughed and are worried about affording copays, Dr. Paskett says.

To better understand why people do not get screened for cancer, she and her colleagues are developing a research project, to be funded by the National Cancer Institute, that will survey individuals with and without cancer, as well as adult cancer survivors. Researchers at Ohio State, 1 of the 5 centers involved with the study, plan to survey approximately 10,000 people.

“We want to quantify what people are doing and why,” Dr. Paskett says. “Did they lose their job? Are they a caregiver? Did they stay home to help their children with school? Have they started smoking again? Then we can develop interventions to help people cope and take care of themselves.”

For example, as part of her ongoing efforts to reduce exceptionally high cancer rates in Appalachian Ohio and Kentucky, Dr. Paskett and her colleagues are working to encourage residents to take the home‐based, fecal immunochemical test (FIT) for colorectal cancer. The screening test is an alternative to going to a health care facility for a screening colonoscopy, although that still would be required if FIT results are positive.

“Even before COVID, we were trying to drive people to get the FIT tests, and it was getting good uptake,” Dr. Paskett says. Amid the pandemic, she says, these efforts are more critical than ever.