ACS is recommending nine steps to improve cancer screening rates
Nine ways providers can improve cancer screening rates
February 23, 2022
by John R. Fischer, Senior Reporter
The American Cancer Society’s National Consortium for Cancer Screening and Care has nine new guidelines to help providers restore cancer screening rates to pre-pandemic levels faster.
Cancer screening rates are still significantly lower than historical baselines two years into the pandemic. Fears of contracting the virus have deterred patients from seeking out care and keeping appointments, along with temporary delays in certain procedures by hospitals early on. One study found that breast and cervical cancer screenings dropped by 87% and 84%, respectively, in April 2020, compared to the previous five-year averages for the month.
And another study last year found that nearly 10 million scheduled cancer screenings did not take place in 2020. The sharpest declines were in breast, prostate and colorectal cancers, which raise the risk of early-stage, curable malignancies progressing to more advanced stages.
“Many health systems have been able to resume cancer screenings to pre-pandemic levels but some have not. There are long-standing issues like structural racism that factor in and also issues like front-line workers and hourly workers, loss of employment and loss of insurance that are impacting both healthy lifestyles, access to care and ultimately delays in cancer diagnosis either through screening or evaluation of new symptoms,” Dr. Laura Makaroff, primary care physician and senior vice president of prevention and early detection, told HCB News.
Made up of leading organizations focused on improving cancer screening and treatment services, the ACS National Consortium laid out its recommended points in its report, Responding to the COVID-19 Pandemic: Improving Cancer Screening and Care in the U.S.
They include:
“Accelerating what works and ensuring all people have equitable access to proven cancer screening strategies is a great first step. This includes expanding the role of patient navigators and community health workers and building linkages with community agencies to help overcome barriers that hinder completion of recommended screening tests,” said Makaroff.
Some initiatives are already helping to increase screening. Last March, the USPSTF lowered the age for current and former smokers to get low-dose CT screenings for lung cancer from 55 to 50. It also redefined the definition of a heavy smoker as someone with a 30 pack-year history (one pack a day for 30 years) to a 20 pack-year history.
The changes are expected to especially be helpful for Black people, who have a higher risk of lung cancer than white people despite smoking fewer cigarettes than white men. They also are seen as potentially lifesaving for women, who also smoke less than white men.
And CMS followed suit just this past month with a similar guideline update.
Additionally, 19 states last year saw upticks in lung cancer screenings. But rates remained unchanged in 25 states and dropped in five others, including some with lower LCS rates prior to the pandemic.
But outside of lung, restoring screening is still a struggle. Whereas breast cancer rates between urban and rural women are similar and stabilizing, colorectal screening among rural women is lagging, with income and insurance being the main culprits.
Cancer screening rates are still significantly lower than historical baselines two years into the pandemic. Fears of contracting the virus have deterred patients from seeking out care and keeping appointments, along with temporary delays in certain procedures by hospitals early on. One study found that breast and cervical cancer screenings dropped by 87% and 84%, respectively, in April 2020, compared to the previous five-year averages for the month.
And another study last year found that nearly 10 million scheduled cancer screenings did not take place in 2020. The sharpest declines were in breast, prostate and colorectal cancers, which raise the risk of early-stage, curable malignancies progressing to more advanced stages.
“Many health systems have been able to resume cancer screenings to pre-pandemic levels but some have not. There are long-standing issues like structural racism that factor in and also issues like front-line workers and hourly workers, loss of employment and loss of insurance that are impacting both healthy lifestyles, access to care and ultimately delays in cancer diagnosis either through screening or evaluation of new symptoms,” Dr. Laura Makaroff, primary care physician and senior vice president of prevention and early detection, told HCB News.
Made up of leading organizations focused on improving cancer screening and treatment services, the ACS National Consortium laid out its recommended points in its report, Responding to the COVID-19 Pandemic: Improving Cancer Screening and Care in the U.S.
They include:
- Engaging in partnerships, coalitions, and roundtables focused on adopting evidence-based cancer screening interventions and policies.
- Coordinating campaigns to promote cancer screening as a public health priority.
- Supporting and expanding proven screening programs to communities that are historically excluded and underserved.
- Adopt improved quality measures, accountability measures and institutional goal-setting for equitable outcomes.
- Accelerate innovations and interventions that better expand equitable access to cancer screening and care.
- Form better trust in public health and health care systems with a forward-looking, whole-person approach.
- Strengthen health system and community preparedness plans for health disruptions by including cancer and other chronic disease care in the plans.
- Strengthen transdisciplinary teamwork in support of healthcare delivery.
- Create better understanding of the outcomes in cancer screening and care by collecting and utilizing demographic and social determinants of health data.
“Accelerating what works and ensuring all people have equitable access to proven cancer screening strategies is a great first step. This includes expanding the role of patient navigators and community health workers and building linkages with community agencies to help overcome barriers that hinder completion of recommended screening tests,” said Makaroff.
Some initiatives are already helping to increase screening. Last March, the USPSTF lowered the age for current and former smokers to get low-dose CT screenings for lung cancer from 55 to 50. It also redefined the definition of a heavy smoker as someone with a 30 pack-year history (one pack a day for 30 years) to a 20 pack-year history.
The changes are expected to especially be helpful for Black people, who have a higher risk of lung cancer than white people despite smoking fewer cigarettes than white men. They also are seen as potentially lifesaving for women, who also smoke less than white men.
And CMS followed suit just this past month with a similar guideline update.
Additionally, 19 states last year saw upticks in lung cancer screenings. But rates remained unchanged in 25 states and dropped in five others, including some with lower LCS rates prior to the pandemic.
But outside of lung, restoring screening is still a struggle. Whereas breast cancer rates between urban and rural women are similar and stabilizing, colorectal screening among rural women is lagging, with income and insurance being the main culprits.