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New study highlights dramatic impact of COVID-19 pandemic on cancer-screening delays
New data published in the Journal of Clinical Oncology further 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.
"These delays to cancer screening 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 screening," said senior study author Electra Paskett, associate director for population science and community outreach at The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC—James). "Data suggest that there will be significant increases in later-stage cancer diagnoses if we do not stem this delay in screening."
For this study, researchers at Ohio State and Indiana University conducted a survey regarding cancer-screening behaviors between June and November 2020. All study participants were within the age range for cancer screenings and had previously participated in research studies with permission to be recontacted.
Survey respondents were asked if they planned to have and then postponed a scheduled cancer screening test, which included a screening mammogram, 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 planned test.
Of the 7,115 people who responded to the survey, 60% had a scheduled screening test planned for the June-November 2020 time frame. Among those who planned for a cancer screening test, 11%-36% delayed the planned test due to COVID-19, with variation by test.
Unlike other studies that have examined general delays in cancer screening, this study compared the demographic differences between individuals who did and did not plan to obtain any cancer screenings beyond March and December 2020.
Delays in cancer screenings, especially for Pap smears and HPV tests, among younger individuals, Hispanic women, and the women in other race/ethnicity groups were of particular concern to researchers. Of specific note: 24% of qualified study participants delayed screening mammograms, 27% delayed Pap tests and 36% delayed screening colonoscopies.
Researchers note that identifying the characteristics of individuals who were within the age range of guideline-recommended screening but did not schedule one was crucial, because these populations have historically faced barriers to adherence to guideline-recommended cancer screenings. The COVID-19 pandemic disruption presented even more barriers to health care access.
"Our data reinforce the need for health care clinics and public health organizations to form partnerships at a community level to help address the barriers to care for these populations to very intentionally address and work to overcome these persistent and layered barriers to care," said Paskett, who is the Founding Director of the Center for Cancer Health Equity at the OSUCCC-James.
Researchers specifically cite the important role of health-education programs to inform people 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 note the important role mobile screening programs can play in delivering cost-effective screenings to underserved populations. They urge health care providers to consider expanding access to cancer screenings specifically in low-resource communities through mobile screening programs.
"Screening is 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. Screening can truly save lives," said Paskett, co-leader of the OSUCCC-James Cancer Control Program.
Co-authors include Xiaochen Zhang (first author), Mohamed Elsaid, Cecilia DeGraffinreid and Victoria Champion.
More information: Xiaochen Zhang et al, Impact of the COVID-19 Pandemic on Cancer Screening Delays, Journal of Clinical Oncology (2023). DOI: 10.1200/JCO.22.01704