"We are certainly worried about the impact of delays in screening and treatment for cancer patients," Dr. Bob Keenan, chief medical officer of the Florida-based Moffitt Cancer Center, wrote in a statement.
Keenan noted the site, like many others, temporarily shuttered routine screening for mammography and colonoscopy for several months last spring. Resumed services by early summer, and protocols to prioritize coronavirus-positive patients depending on how aggressive their tumors were, were intended to tamp down the impact of delays.
"That said, we do have a sense that some patients have presented at a later stage than they might have before COVID," Keenan wrote to Fox News, in part. "We are currently analyzing our findings from this year compared with previous years to see if there are substantial differences."
Separate data drawing on 2.7 million patient records across 23 states indicated an 86-94% plummet in weekly preventative cancer screenings conducted last spring compared to pre-pandemic figures, according to an analysis by EPIC Health Research Network. By June, the number of screenings for breast, colon and cervical cancer improved but remained approximately one-third lower compared to 2017-2019.
An expert with the Dana-Farber Cancer Institute in Boston confirmed that cancer screenings and exams have yet to return to baseline while noting an apparent lack of a rebound to compensate for missed exams.
"This raises concern that we will see an increase in later-stage cancers and in cancer mortality in the future because these cancers will show up eventually, and perhaps at a time when we have missed the opportunity to treat them more easily and to cure them," Dr. Craig Bunnell, chief medical officer at Dana-Farber Cancer Institute, wrote in an emailed statement.
It appears as though serious ramifications from delayed screenings are only beginning to unfold. Dr. Robert McWilliams with the Mayo Clinic Cancer Center reported that providers "are now starting to see the impact of delayed screening," while Dr. Matt Kalaycio, vice-chair of Cleveland Clinic Taussig Cancer Institute, said data has yet to confirm more patients are presenting with late-stage cancers.
Nevertheless, the American Cancer Society told Fox News that providers must not only address the backlog of missed screenings but also prioritize patients vying for appointments, such as those at higher risk for disease who need prompt or more frequent screenings.
"Identification of patients at increased risk of cancer due to genetic, personal, or family history is essential, and these patients should receive priority status when assigning screening appointments," the ACS wrote in an emailed statement.
Patients with previous abnormal tests and those with new or worrying symptoms should also be given higher priority "than asymptomatic average-risk individuals," the society said, also calling for "urgently needed" changes in policy to address an expanding uninsured population as a result of the pandemic.
"The recent coronavirus relief bill and its numerous provisions to expand access to affordable comprehensive health coverage passed by Congress are an important first step to address barriers to coverage," per the statement. "The recent loss of insurance by millions of Americans will lead to immediate challenges with access to care, including cancer screening and cancer care. Despite the challenges of the pandemic, we must provide the public with safe opportunities for cancer screening and care including a deliberate focus on overcoming barriers for populations disproportionately impacted by cancer and COVID-19."