The danger in postponing cancer screenings during the pandemic

Dr. Pulin Sheth reads a mammogram at Keck Medicine of USC. (Ricardo Carrasco III /

Dr. Pulin Sheth reads a mammogram at Keck Medicine of USC. <span class="copyright">(Ricardo Carrasco III / Keck Medicine of USC)</span>
Dr. Pulin Sheth reads a mammogram at Keck Medicine of USC. (Ricardo Carrasco III / Keck Medicine of USC)

During the COVID-19 pandemic, a distressing downturn has occurred — cancer screenings dramatically decreased across the country. Early detection of cancer can improve the chances of survival. By delaying screening, patients are also delaying treatment and putting their health at risk.

Not surprisingly, with the disruption in routine cancer screenings, new cancer diagnoses have also decreased. Research published in an American Medical Assn. online journal showed that the average weekly number of new diagnoses of six common cancers — breast, colorectal, lung, gastric, pancreatic and esophageal —

fell by more than 45% from March to mid-April compared with the previous two months.

In mid-June, weekly screening volumes for breast, colon and cervical cancer were as much as 36% lower than their pre-COVID-19 levels, according to a July report by the Epic Health Research Network.

While research suggests that screening rates for some cancers may be on the rebound, the hesitancy to undergo cancer screening is extremely concerning from a public health perspective. Many localized cancers are curable with surgery, radiation, chemotherapy, immunotherapy or a combination of these. But patients need to know they need treatment.

According to the director of the National Cancer Institute, we may see as many as 10,000 additional deaths from breast and colorectal cancer alone over the next decade because people failed to get screened and therefore treated for it during the pandemic. Cancer mortality rates have been falling in recent years. COVID-19 could reverse this trend.

When the pandemic first hit the U.S. early this year, patients were asked to stay home and postpone routine medical care. However, most hospitals have resumed routine business and have procedures in place to protect patient safety, including making face coverings mandatory and stationing healthcare personnel at entrances to screen for symptoms of COVID-19.

With such precautions in place, people should feel more comfortable adhering to their recommended cancer-screening schedules. While it is completely understandable that some people may be worried about returning to a healthcare setting, postponing recommended preventive health measures may be far more dangerous.

For certain visits, patients can use telemedicine, which has grown in use during the pandemic, replacing some in-person office visits. However, for cancer screenings that require the use of specialized equipment, such as mammograms or colonoscopies, remote testing obviously is not an option.

Hospitals and clinics nationwide are reinforcing the message that cancer doesn’t stop for the coronavirus, as are organizations such as the American Cancer Society. Keck Medicine of USC is also part of a coalition of six of Los Angeles County’s largest nonprofit health systems that are participating in a public health campaign to urge the public to get the healthcare they need despite their fears of the coronavirus.

At USC Norris Comprehensive Cancer Center, part of Keck Medicine, we are reaching out to our patients, emphasizing the many precautions we’ve put into place to protect their health, such as mask wearing, social distancing and frequent sanitizing of surfaces. In an attempt to ease patients’ minds, we created videos in four languages — English, Spanish, Mandarin and Korean — and had oncologists address concerns that patients may have about cancer screenings or treatments during the pandemic. The videos were emailed to patients and are available on our website.

Our community hospital, USC Verdugo Hills Hospital, is also offering discounted mammograms through October, Breast Cancer Awareness month, which may help those who have lost their jobs — and, as a result, their health insurance — during the pandemic.

In the age of COVID-19, it’s important for people to make, and keep, their cancer screening appointments. The coronavirus is not going away any time soon — and neither is cancer.

Caryn Lerman is director of the USC Norris Comprehensive Cancer Center, part of Keck Medicine of USC. She also is the associate dean for cancer programs at the Keck School of Medicine of USC.

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