Investigators have found further evidence to quantify the vast, lingering impact of the global COVID-19 pandemic on timely cancer screening—highlighting the urgent need for health-care providers to address significant delays to cancer screenings in populations most likely to delay testing, according to a new study published by Zhang et al in the Journal of Clinical Oncology.
Background
“These delays to cancer screenings are significant and have persisted into 2023. This deserves immediate, intentional action from the medical community and community health organizations to help get individuals back on track for timely screenings,” underscored senior study author Electra Paskett, PhD, Professor and Associate Director of Population Science and Community Outreach in the Division of Cancer Prevention and Control in the Department of Internal Medicine, as well as Founding Director of the Center for Cancer Health Equity at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. “Data suggest that there will be significant increases in later-stage cancer diagnoses if we do not stem this delay in screenings,” she added.
Study Methods and Results
For this study, investigators conducted a survey among respondents who were within the age range for cancer screenings, asking them about their screening behaviors between June 2020 and November 2020.
The survey respondents were asked if they had scheduled and then postponed a cancer screening test—including a screening mammogram, Papanicolaou (Pap) test, stool blood test, colonoscopy, or human papillomavirus (HPV) test. Statistical assessment tools were used to determine the factors associated with cancer screening delays for each scheduled test.
Among the 7,115 individuals who responded to the survey, 60% of them had a scheduled screening test planned for the June 2020 to November 2020 time frame. Among those who had scheduled a cancer screening test, 11% to 36% of them delayed the test as a result of the COVID-19 pandemic.
Unlike other studies examining general delays in cancer screenings, this study compared the demographic differences between individuals who did and did not plan to obtain any cancer screenings beyond March 2020 and December 2020.
Delays in cancer screenings—especially for Pap smears and HPV tests—among younger individuals, Hispanic women, and women of other ethnicities were of particular concern to the investigators. Specifically, 24% of qualified study participants delayed screening mammograms, 27% delayed Pap tests, and 36% delayed screening colonoscopies.
Investigators noted that identifying the characteristics of individuals who were within the age range of guideline-recommended screenings but did not schedule a test was crucial, because these populations have historically faced barriers to adhering to guideline-recommended cancer screenings—which were exacerbated as a result of the COVID-19 pandemic’s disruption to health-care access.
Conclusions
“Our data reinforce the need for health-care clinics and public health organizations to form partnerships at [the] community level to help address the [lack of health-care access] for these populations, [and] … work to overcome these persistent and layered barriers to care,” stressed Dr. Paskett.
The investigators cited the important role of health education programs to inform individuals of available cancer screening coverage through the Affordable Care Act, as well as free or low-cost screening options for the uninsured or those without physician referrals. They also noted that mobile screening programs can aid in the delivery of cost-effective screenings to underserved populations. They urged health-care providers to consider expanding access to cancer screenings—specifically in low-resource communities—through mobile screening programs.
“Screenings [are] important to help prevent and detect cancer early when it can be successfully treated. Know what tests you need and get those tests. If you don’t know or have barriers to getting screened, talk to your provider and be your own best advocate. Screenings can truly save lives,” concluded Dr. Paskett.
Disclosure: The research in this study was funded by the National Cancer Institute. For full disclosures of the study authors, visit ascopubs.org.
