Investigators have found that millions of individuals in the United States continued to miss critical cancer screening tests during the second year of the COVID-19 pandemic, according to a new study published by Star et al in the Journal of Clinical Oncology. Compared with 2019 levels, individuals in 2021 reported receiving 4.4 million fewer cervical cancer screenings, 1.1 million fewer breast cancer screenings, and 700,000 fewer prostate cancer screenings.
Background
"The COVID-19 pandemic continues to have a detrimental effect on important cancer screenings in this country," emphasized lead study author Jessica Star, MA, MPH, an associate scientist II of Risk Factors & Screening Surveillance Research in the Department of Surveillance & Health Equity Science at the American Cancer Society. “It's critical to get [individuals] back into their doctors’ offices to help prevent and catch cancer at its earliest stages when it might be easiest to treat.”
Study Methods and Results
In the new study, the investigators analyzed data from the 2019 and 2021 National Health Interview Survey—and examined information regarding the receipt of screenings for breast cancer among patients aged 50 to 74 years, cervical cancer among patients who haven’t received a hysterectomy aged 21 to 65 years, prostate cancer among patients aged 55 to 69 years, and colorectal cancer among patients aged 50 to 75 years.
The findings showed that between 2019 and 2021, past-year screenings in the United States decreased from 59.9% to 57.1% for breast cancer, 45.3% to 39.0% for cervical cancer, and 39.5% to 36.3% for prostate cancer. Declines in breast, cervical, and prostate cancer screenings were most notable for individuals who identified as non-Hispanic Asian.
Colorectal cancer screening rates remained unchanged because an increase in past-year stool tests (7.0% to 10.3%) offset the decline in colonoscopies (15.5% to 13.8%). The increase in stool tests was most pronounced among individuals who identified as Hispanic and non-Hispanic Black and among individuals with low socioeconomic status—potentially reducing racial and socioeconomic disparities in colorectal cancer screenings. However, the investigators stated that the increase in stool tests may require increased colonoscopy follow-ups for positive tests. They emphasized the importance of home-based testing to maintain screening levels during health-care disruptions.
“We can’t stress enough the importance of returning to screenings,” underscored senior study author Ahmedin Jemal, DVM, PhD, Senior Vice President of the Department of Surveillance & Health Equity Science at the American Cancer Society. “We need to continue health system and national cancer screening campaigns and focus our efforts toward [individuals] of color and lower socioeconomic standing to improve access to life-saving screenings,” he concluded.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
