The dilemma of cancer screening during the pandemic

Everyday life seems to be put on pause. With the country experiencing the highest number of COVID-19 cases since the beginning of the pandemic, many people are limiting their use of health care services.

While this practice has slowed the potential spread of the virus, it may also come at a cost to the population’s long-term health. Cancer screenings are among the most important services that have suffered significant declines in rates of access.

Partly behind the decrease in doctor’s visits is advice from the Centers for Disease Control and Prevention for staying safe during the pandemic, which includes a suggestion that people “reschedul[e] procedures that are not urgently needed.” A large portion of the American public is now faced with weighing the risk of transmission with the benefits of health care access.

As a study published in the Journal of the American Medical Association reports, the COVID-19 pandemic in early 2020 was linked to an average 46.4% decrease in weekly rates of screenings for breast, lung, pancreatic, colorectal, esophageal and gastric cancer.

Screening rates for some of the most severe types of cancer have experienced dramatic declines; research from the Journal of Clinical Oncology reveals an 89.2% decrease in breast cancer screenings and an 84.5% decrease in colorectal cancer screenings.

The stark gap between preventative health care practices before and during the pandemic has troubling implications for long-term health. One predictive study estimates that comorbidity, or underlying health conditions coupled with COVID-19 and other illnesses, and delays in cancer treatment could lead to an excess of 33,890 deaths in the United States. Without following safe preventative measures, people risk living with undiagnosed conditions that could threaten immune responses to COVID-19.

Without following safe preventative measures, people risk living with undiagnosed conditions that could threaten immune responses to COVID-19.

While some people may choose to not go to screenings to protect their health, another portion of the population simply does not have the option to go due to external factors.

First, the availability of cancer screenings is reduced. Hospitals have been forced to discontinue screenings in order to accommodate COVID-19 testing and treatment. Despite the recent reimplementation of these services, screening rates continue to fall, aggravated by lesser demand and, in some cases, diminished supply.

Additionally, pandemic-related job losses have caused over 14 million people to lose coverage from employer-sponsored health insurance, either from unemployment or dependence on someone who is now unemployed. The disparities between health outcomes of the insured and the uninsured have only worsened, exacerbating impacts on minority and low-income communities.

People are being asked to weigh a variety of uncertainties, including the paradoxical risks of contracting COVID-19 by being tested for cancer in a hospital.

The possibility of contracting COVID-19 grows every day, yet the future implications of late-stage cancer detection are just as — if not more —dangerous. People are being asked to weigh a variety of uncertainties, including the paradoxical risks of contracting COVID-19 by being tested for cancer in a hospital.

The lasting impression that the pandemic has left on Americans represents a long-term shift that is likely to impact cancer screening rates for years to come.