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Monday, September 27, 2021

Reduced cancer screenings due to COVID-19 fears may result in serious health outcomes

Health professionals remind public about the importance of early diagnoses and treatments to mitigate cancer threats

With many people believing that stepping into a hospital will heighten their risk of contracting COVID-19, some may be waiting to get their annual check-ups until the pandemic is over. Predictions by the National Cancer Institute (NCI) illustrate the potential fatal consequences of these delays—10,000 excess deaths could occur in the next 10 years from breast and colorectal cancers alone due to pandemic-related delays in cancer screenings and treatments. In an open letter signed by 76 cancer organizations nationwide, health professionals urged the public to resume regularly scheduled cancer screenings and treatments to reduce further repercussions.

“The fact that so many leading groups were eager to sign our letter shows how important and universal this issue is to the entire oncology community,” said Robert Carlson, CEO of the National Comprehensive Cancer Network (NCCN), via email.

According to statistics provided by the NCCN, one-third of adults in the U.S. failed to receive their recommended cancer screening during the course of the pandemic. Approximately 22 million cancer screenings were canceled or missed between March and June of last year. As the estimated 10,000 excess deaths only account for breast and colorectal cancers, the actual number of deaths may be much higher. 

Carlson explained that once it became clear that reductions in cancer screening and treatment were threatening lives, the NCCN and American Cancer Society (ACS) decided to come together and send a message to the public. Both organizations actively reached out to NCCN Member Institutions, NCI-designated cancer centers and other cancer organizations to spread the word to more patients. One of these organizations was the UC Davis Comprehensive Cancer Center. 

 “With the identification of new variants of COVID, the health care community remains uncertain when the pandemic will end, and further delays in cancer screening may worsen cancer outcomes,” said Richard Bold, physician-in-chief for the UC Davis Comprehensive Cancer Center, via email.

Bold said that cancer screenings try to identify the earliest development of cancer before symptoms, when the chance of spreading to other sites of the body is the lowest and the chance to cure the disease is the highest. 

“For the most part, once a cancer has spread to other sites of the body, it is typically incurable, so the goal of earlier diagnosis is to treat the cancer before any spread to other organs has happened and offer the patient a chance at cure,” Bold said. 

Helen Chew, director of the Clinical Breast Cancer Program at the UC Davis Comprehensive Cancer Center, explained that breast cancer is the most common form of cancer in women by far. She elaborated that 90% of breast cancers are caught in its early stage, when it is only present in the breast and possibly the lymph nodes under the arm. 

If there is a delay in detecting these growths, the cancer could disseminate and become metastatic, meaning that it will spread to a different part of the body. If detected early on, the patient may only need surgery to remove the tumor, whereas more advanced cancers may need chemotherapy, surgery and radiation. With reliable and effective screening methods such as mammograms, Chew expressed that these screenings could save lives.

 “If you have [an] early-stage disease, the goal is to cure,” Chew said. “We’re going to do everything possible to lower the risk that the cancer will ever return in the future. But if you already have the disease escaped, then really, the goal is to control it as much as possible. We know that we can’t generally remove it completely.”

Carlson emphasized that with long delays in cancer screenings and treatments, the risk of leaving a potentially fatal cancer undetected is greater than the risk of experiencing a negative outcome from COVID-19. He stated that there has been nearly zero reported COVID-19 transmissions during cancer treatment at NCCN cancer centers. Although precautions are still necessary during the ongoing pandemic, Carlson hopes that people will continue to address other important health concerns during this time.

Although Chew understands how the uncertainty and confusion surrounding the pandemic a year ago may have warranted an aversion to regularly scheduled visits, she hopes to reassure people that they should not continue to delay seeking treatment. At UC Davis, she is confident in the precautionary measures being taken such as personal protective equipment (PPE), symptoms screening and masking.

“With the rapid availability of healthcare visits by video, patients should discuss cancer screening with their primary care physician,” Bold said. “But the current safety of the healthcare environment makes the risk of catching COVID quite small, and far less significant than the impact of a delay in cancer diagnosis and potential reduction in the chance for cure.”
Written by: Michelle Wong —science@theaggie.org

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