Big drop for cancer screenings early in COVID pandemic

"Cancer screening remains an important tool to fight cancer incidence and morbidity and mortality caused by these diseases worldwide," says Paolo Boffetta. "And the COVID-19 pandemic has clearly affected public health services, including cancer screening tests, during parts or throughout the entire pandemic." (Credit: Getty Images)

There were significant decreases in the number of screenings for breast, colorectal, and cervical cancers during the early phase of the COVID-19 pandemic, new research shows.

The study in JAMA Oncology includes data included in medical journals worldwide from January 2020 into December 2021. It offers one point of evidence that the global pandemic widely affected cancer screening services.

In 2020, GLOBOCAN estimated that 19.3 million new cancer cases and approximately 10 million cancer deaths occurred—with breast, colorectal, and cervical cancer as the first, third, and seventh most prevalent cancer for incidence worldwide, respectively.

“Cancer screening remains an important tool to fight cancer incidence and morbidity and mortality caused by these diseases worldwide,” says lead author Paolo Boffetta, associate professor in the family, population and preventive medicine department at the Renaissance School of Medicine at Stony Brook University and associate director for population sciences at the Stony Brook Cancer Center.

“And the COVID-19 pandemic has clearly affected public health services, including cancer screening tests, during parts or throughout the entire pandemic.”

Boffetta and colleagues compiled cancer screening data found in PubMed and other medical publishing sources from 19 countries.

They completed a systematic review and meta-analysis to identify published studies that reported data from cancer registries and large series of patients. They then compared the number of screening tests performed before and during the pandemic for all three forms of cancer.

The researchers also divided the data into six time periods (before the pandemic, January to February 2020; March 2020; April 2020; May 2020; and June-October 2020) to assess the change in the number of cancer screening tests performed during the pandemic. The analysis was performed by geographic area, time period, and type of clinical setting.

They reported that during the period of January 2020 to October 2020, there was an overall decrease in screening worldwide of 35.6% for breast cancer, 41.8% for colorectal cancer, and 54.1% for cervical cancer.

The researchers also point out that they identified a U-shaped pattern, which differed by cancer type. By June 2020, most of the decrease in breast and cervical cancer screening was no longer present, while for colorectal cancer the decrease persisted until late 2020.

Additionally, the decrease in breast and cervical cancer screening appeared to be less pronounced in the US than in other countries, but there was no significant difference in colorectal cancer screening decrease between the US and other countries.

While it may be unclear all of the reasons for a global decrease in important cancer screenings during the pandemic, the authors write that based on their research and survey of medical publishing, the main factors that may have caused widespread decreases in breast, colorectal, and cervical cancers are: “stay-at-home orders, people’s fear of the infection and the avoidance of nonurgent medical treatment and care, limited access to in-person medical examinations, and the reorganization of hospital departments.”

Source: Stony Brook University