Researchers are studying the effects of a pandemic cancer screening pause |

John Abraham’s colonoscopy was postponed for several months due to a pandemic. When he finally got it, doctors found growth that was too big to safely remove during the scope test. He had to wait a few weeks for the surgery and then a few more weeks to find out that it hadn’t become cancerous yet.

Abraham, a mortgage banker in Peoria, Illinois, absolutely wonders if he could have avoided surgery, “whether he had the original screening or was it different.”

Millions of colonoscopy, mammograms, lung scans, papanicorow trials, and other cancer screenings were interrupted for several months in the United States and elsewhere last spring as COVID-19 overwhelmed medical care. ..

Researchers are now studying the effects, looking at the number of cancers missed and whether tumors found since then are more advanced.

There are already signs of trouble. Researchers at the University of Cincinnati found that when CT scans to check for lung cancer were resumed in June, 29% of patients had suspicious nodules, compared to 8% in the previous year. Did.

Studies suggest that fewer cancers were diagnosed last year, probably due to less screening. Recently, about 75 cancer tissues have sought to safely return to pre-pandemic screening levels as soon as possible.

However, there are reports that tumor development can take years, and even a few months delay in screening for certain types of cancer may not have been as bad as feared. For example, Dutch researchers have found that the expiration of a country’s mammography program does not mean that more cancers will be found later in the day after screening is resumed.

The pandemic has also created several creative solutions, including the widespread use of tests that can be done at home. In Philadelphia, a large church has also partnered with a local doctor to pass a stool test for colon cancer screening using a drive-through influenza vaccination program.

“We are not afraid to try anything related to health and wellness,” said Rev. Leroy Mile of the Enone Tabernacle Baptist Church. “Women advised men to be screened by saying,’I took a mammogram.’ And I say, “My wife, you also have a colon.”

Benefits of screening

Screening tests have different risks and benefits, and health professionals have long debated who should take which test at what frequency. Pandemic revocation can serve as a “natural experiment” to confirm their value in modern times, compared to what is known from studies done long ago.

Differences in mortality may not be seen for years, and early detection is the only factor in survival. Treatment was also important and was hurt by the delay in the pandemic.

Dr. Ned Sharpless, director of the National Cancer Institute, said delayed detection and treatment of breast and colon cancer could lead to over 10,000 deaths over the next decade. I’m estimating. Postponing care was “once cautious” because of the risk of COVID-19 exposure, but too much postponement “can turn one public health crisis into many others,” he said. Is writing in Science magazine.

Based on known breast cancer deaths in the United States over the past few years, about 10% “could have been prevented if women had regular screening,” but 20% to 25% are appropriate. Treatment could prevent it, Dr. Otis said. Brawley is a professor at Johns Hopkins University and a former Chief Medical Officer of the American Cancer Society.

“It doesn’t mean that screening isn’t important, but many people think that cancer screening saves more lives than it really is,” Broley said.

Short-term delays may not significantly impair mortality if screening is resumed as quickly as needed, he said.

Some encouraging news came at a recent meeting of the American Association for Cancer Research from Sabine Siesling, a comprehensive cancer tissue in the Netherlands. The country provides mammograms to women aged 50 to 74 every two years, but stopped in mid-March due to COVID-19. After resuming at the end of summer, she reported that the results “showed no shift” to more advanced tumors.

Researchers at Massachusetts General Hospital and Brigham and Women’s Hospital have analyzed screening tests for lung, cervical, colon, prostate, and breast cancer. Screening declined dramatically from March to June, but cancer or precancerous findings were higher than normal, suggesting an increased risk for those screened. When screening returned to near normal between June and September, the number of cancers that could have been “missed” was lower than expected.

Be creative

When 43-year-old actor Chadwick Boseman died of colon cancer last summer, Miles feared 12,000 members of his Philadelphia church. Blacks were more likely to die of the disease than other groups and had limited access to colonoscopy. Colon endoscopy can find and eliminate growth before it becomes cancer.

Miles, who attracted more than 1,000 members to other health events, called the University of Pennsylvania and said, “If you’re willing to prepare something, you know how to get people to come.” It was.

Dr. Carmenguera realized that home testing could be useful as he has federal grants to increase screening in racially diverse communities. Studies show that these tests for bloody stools can save lives. People put small stool samples in tubes and mail them to the lab, or in this case use the church dropbox. If blood is found, the next step is colonoscopy.

Doctors handed out kits in the parking lot during a drive-through flu shot event in October. Church members had to watch a video about colon cancer in advance and register to confirm their eligibility for screening.

So far, 154 kits have been returned. Stacy Hill was one of 13 people who tested positive. A 48-year-old Philadelphia woman had just lost her job and health insurance. Her colonoscopy, like Abraham, revealed two growths that were caught before she got cancer.

“I was shocked,” Hill said. “I’m a proactive person, so I’m glad I knew it.”

Doctors also helped her register for Medicaid, “now I have medical insurance,” she said.

The church hopes to provide home testing again during this spring’s blood pressure and diabetes screening event.