WASHINGTON, Oct. 21, 2020 /PRNewswire/ -- Breast, colon, prostate, and lung cancers did not stop for COVID-19 in 2020, but screenings and treatments did. Dramatically. The result, say doctors, could be a catastrophe in the making.
A new study published online ahead of the November issue of the journal JCO Clinical Cancer Informatics shows a considerable drop in cancer screening, diagnosis, and treatment for American seniors and Medicare beneficiaries this year. Oncologists who were part of the study's research team say they are already starting to see the traumatic results, as cancers are caught at later stages requiring more complex treatments, resulting in higher morbidity, or worse, death.
The study, conducted for the non-profit Community Oncology Alliance (COA) by Avalere Health, examined the billing frequencies from March-July 2020 for common cancer procedures, including screenings, infusion therapies such as chemotherapy, surgeries, and radiation therapy. It found significant reductions in breast (-85%), colon (-75%), prostate (-74%), and lung cancer (-56%) screenings at the first peak of the pandemic in April 2020, compared with April 2019.
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In the early days of the pandemic, shelter-in-place orders and patient concerns about COVID-19 caused a massive drop in common, preventative screenings, such as mammograms and colonoscopies, as well as the cancer therapies and surgical procedures that occur as a result. While this reduction in services was expected as lockdowns took place, several cancer care providers have reported first-hand that they have not seen the complete resumption of services as states have reopened, as reflected in the analysis in the continued reductions in utilization of key cancer services through latter months of 2020.
Lead author, Debra Patt, MD PhD MBA FASCO, executive vice president, policy and strategic initiatives at Texas Oncology, and member of the COA Board of Directors, warned that the worst could be yet to come.
"When cancer becomes more advanced before it is detected it becomes a ticking time bomb. The decrease in screenings, diagnosis, and treatments this year will lead to later stage cancers for patients, increasing morbidity and mortality for years to come. We need to detect cancers and stop them before it is too late. We need to alert all patients that they need to stop medical distancing and get appropriate screening and health care," she said.
A downstream ripple effect throughout the cancer care continuum may also be observed from the drop-off in screenings and diagnoses, reflected in decreases in patient visits, biopsies, and cancer treatments in the months following peak drops in screening. The study shows decreased billing frequencies across a number of services at the height of the shelter-in place-orders, but after a slow rebound, the data highlights additional declines in the month of July. Billings for the top physician-administered chemotherapy drugs were lower in July than they were in April (-31% vs. -26% respectively), which could be attributed to reduced screenings and declines in new patient visits of 30–70% since the beginning of the pandemic.