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Another victim of a pandemic?Women’s health

Los Angeles (TNS) – When Stephanie Fajri, 36, had an abnormal Papanicolaou stain 10 years ago, her doctor advised her to come to an annual screening to monitor her health. Did. She was keen to do so on a regular basis until she faced a pandemic.

According to Fajri, the promises scheduled for last summer have been postponed to December. By the time she finally saw her doctor, she had to undergo treatment to develop more abnormal cells and remove them from the cervix.

“Thankfully, I care about my health, but this is how women develop cervical cancer,” she said.

Women throughout Southern California, like Fajri, report that a pandemic delayed appointments, canceled trials, and postponed screening. Some have voluntarily opted out for fear of encountering the virus, while others have their appointments canceled by a healthcare provider who reroutes resources to COVID-19 patients.

However, in the second year of the outbreak, experts have warned about the consequences of prematurely degrading women’s health.

The problem is serious. Cervical cancer screening for 1.5 million women in Kaiser Permanente’s regional network plummeted by 80% during the first stay-at-home order in Southern California, according to a study published by the Federal Centers for Disease Control and Prevention.

Chun Chao, a research scientist at Kaiser Permanente in Southern California, said the findings “have significant public health implications.” “Delays or oversights in cancer screening can increase the risk of cancer at the time of diagnosis and can make the disease more advanced.”

Dr. Maureen Miller, Head of Epidemic Information Services at the CDC and one of the lead authors of the study, said that the change between 2019 and 2020 is “ because the screening rate for cervical cancer is almost the same every year. He said he showed a “substantial difference.”

“We are not only worried about cancer, we are also worried about pre-cancer,” Miller said. “You may have a serious illness in your cervix that you can’t feel in your body … that’s really important.”

Cervical cancer was once one of the most common causes of cancer death in American women. According to the CDC, this rate has dropped significantly with the proliferation of regular screening, and it is now estimated that up to 93% of cervical cancers can be prevented.

“Screening is very important,” said Dr. Ritusarani, OB-GYN at the Ronald Reagan UCLA Medical Center in Los Angeles. “If we don’t catch it now, it may appear at a more advanced stage, which is more difficult to treat, or more aggressive treatment may be needed, and with worse results. “

And it’s not just cervical cancer. Pandemics have lost their way to mammograms, fertility treatments, and even pain prevention procedures, some women said. In April, both the CDC and the Medicare Medicaid Service Center published guidelines in the first wave of the pandemic recommending postponement of selective and non-urgent procedures, including “low-risk cancer” screening.

Heidi Putaraz, 38, of Santa Clarita, said doctors recommended follow-up mammograms and ultrasonography after discovering anomalous tissue spots last fall. She couldn’t find the opening until at least the end of March.

“I know it’s probably nothing, but I’ve lost many relatives, including my mother, to breast cancer, so I’m wondering if this turns out to be the worst scenario.”

Like Papanicolaou stains and HPV tests, mammograms are essential to reduce cancer deaths. A 2020 study published in the journal Lancet Oncology predicts that delays in diagnosis and treatment during the COVID-19 pandemic could increase breast cancer mortality by as much as 9.6% in the UK over a five-year period.

But even before the pandemic, women’s health often took the backseat. Clinical trials have historically been conducted in men, with seat belts, safety devices, and even office air conditioning all designed with the male body in mind. Transgender women in particular have long struggled with barriers to care.

Salani said women’s treatments can be burdened by being regularly classified as “selective,” and hospitals usually classify hospitalizations as “urgent, urgent, or selective.” Said.

Women’s health is “neither urgent nor urgent, but it’s not really an option, it’s how it sounds,” she said. “That’s a disappointing term.”

Its lack of urgency exacerbated the suffering of many women during the pandemic. Maria Vasilchikova, 27, from Inglewood, said she tried to book a doctor’s consultation last spring to address issues related to polycystic ovary syndrome.

She said the pain she experienced was terrible and required to be pulled when driving, sometimes causing vomiting.

After waiting for three months to see her, her doctor had to cancel to accommodate COVID-19 patients at the hospital. Vasilchikova understood the reason for the cancellation — her mother is a nurse in the intensive care unit — but she was disappointed.

“They have greatly set back my progress,” she said, saying that no replacement promise was offered instead. “My ovarian pain symptoms are getting worse and there is no safe way to investigate without going to the clinic.”

CDC’s Miller said some cervical cancer screenings were resumed when the first stay-at-home order in Southern California was lifted in June, but at a rate about 25% lower than usual.

In particular, Miller’s work with Chao was based on data collected by September 2020 — before the catastrophic surge of COVID-19 that arrived around the holidays. Next year’s data, including the region’s latest stay-at-home order, could reduce screening numbers again.

“I don’t think it will be as low as it used to be when we see the next wave of data, but I think it will fall,” said Lisa Richardson, director of cancer prevention and management at the CDC. ..

The next barrier is overcoming anxiety about people seeking health care when they need it. According to recent primary care physician data, the ratio of patients canceling doctors to doctors canceling patients is approximately 50-50.

“The message is to know your own history and talk to your provider about what your needs are,” she said. “If you are at high risk of getting cancer, you shouldn’t postpone it … [pandemic] It’s over, and when this is over you still want to be healthy. “

Still, many women said they were afraid to take care of them during the pandemic, especially for things that didn’t feel like an emergency.

“I don’t want to bring anything back to him because I have a high-risk partner,” said Schirmer’s Monica Gaya, 44, who postponed follow-up after an unusual mammogram last fall. It was. “I feel that going to places where people are prone to illness increases the risk of getting COVID.”

Gaya, who has a family history of cancer, said she was “definitely worried” about abnormal screening, but that it could be difficult to prioritize herself over anything else.

“Women’s care is not a social priority, even if there is no pandemic,” she said. “The pandemic just pushes it further into the back burner.”

Others, such as 29-year-old Raneq Barber, made a similar debate about whether to seek care. Barbers suffer from asthma and high blood pressure. These are two underlying conditions that can increase the risk of severe cases of COVID-19. She chose to postpone the women’s wellness appointment scheduled at the start of the pandemic and thought it would be “a few weeks or a month.”

“It’s been a year and I still can’t stay safe in the clinic,” she said.

In January, more than 75 organizations, including the American Cancer Society and the National Cancer Network, signed a statement supporting the goal of resuming testing and cancer screening during pandemics, and many cancers are diagnosed and treated. He cited a “disastrous tendency” to indicate that it was not done. ..

“We are people across the country to resume regular primary care tests, recommended cancer screening, and evidence-based cancer treatment to mitigate the negative effects of pandemics on the identification and treatment of cancer patients. We strongly encourage you to discuss this with your healthcare provider, “the statement said. ..

Optimistic numbers will continue to improve as hospitals and healthcare facilities regain some sense of balance and people become accustomed to the idea of ​​returning to normal care, Richardson said.

Some women aren’t there yet.

Thirty-year-old Molly Codner has been in need of a medical examination since receiving an abnormal Papanicolaou stain last summer, but like many Southern Californians, last year’s trauma remains heavy on her mind. It’s leaning on. ..

“I know I should have another test right away, but I feel that anxiety about COVID is prioritized over anxiety about cervical cancer,” she said.

..

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