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Rebound of cancer screening after COVID-related decline

 


Regular screening for breast and colorectal cancers is summer, despite a dramatic decline during the first COVID-19 surge in 2020 and a second pandemic surge. By then, national data showed that it had returned to normal rates.

Weekly screening mammography rates declined 96% from mid-March to April, after which weekly mammography began a rebound that continued until July, when it approached pre-pandemic rates. Similarly, the researchers reported that screening colonoscopy rates fell by 95% and returned to near baseline levels by the end of July. General Internal Medicine Journal..

“These are the first findings to show that healthcare facilities have come up with ways to regain this after the first pandemic restriction, despite real fear of the outcome of cancer screening drop-offs,” said Rand Corporation. Dr. Ryan McBain. Said in a statement in Santa Monica, California. “Our research has shown that healthcare systems have been able to readjust resources and protocols at relatively short intervals to provide these important services.”

Timely recovery of cancer screening rates is encouraging, but healthcare providers need to continue to be concerned about patients who skipped screening during a pandemic, a national health benefit management company that provided data for the study. Dr. Dena M. Bravata of Castlight Health, added. ..

“People who postpone preventive services need to be prioritized for timely screening, especially if they are at high risk of illness,” she said.

The COVID-19 pandemic had an almost immediate effect on cancer screening and diagnosis. A Study of screening trends Six common types of cancer show a nearly 50% reduction in screening rates in the United States from March 1, 2020 to April 18, 2020 compared to January 2019 to February 2020 I did.

Decreased screening rates have fueled concerns that delayed screening will lead to increased diagnosis of more advanced cancers and death from more cancers. Several studies have confirmed concerns.For example, a Spanish survey showed a 38% decrease. Diagnosis of new lung cancer The first six months of 2020 compared to the same period in 2019.

The impact of the pandemic on cancer screening, which requires face-to-face examinations such as mammography and colonoscopy, was of particular concern, McBain and co-authors said. In addition, little was known about the magnitude of the decline in screening rates and the long-term trends in screening.

To address this issue, investigators reviewed data on Castlight Health beneficiaries from January 15, 2020 to July 31, 2020. The team limited the analysis to adults aged 46-64 years, consistent with the non-medical care population for cancer screening. Analysis related to mammography screening included only women. The authors calculated a weekly screening rate per 10,000 eligible beneficiaries.

Prior to the National Emergency Declaration on March 13, 2020, the median weekly rate of mammography examinations was 87.8 / 10,000, but dropped to a minimum of 6.9 / 10,000 in April. After that, the screening rate began to increase steadily, and by the end of July, the median weekly rate had reached 88.2 / 10,000, the researchers reported.

During the same period, weekly colonoscopy screening decreased from 15.1 / 10,000 to 0.9 / 10,000 and then recovered to a weekly median of 12.6 / 10,000 by July 31, 2020.

Multivariate regression analysis confirmed a significant reduction in mammography and colonoscopy. A significant decrease in colonoscopy was observed in high-income counties. Otherwise, the analysis showed no significant demographic changes.

According to Laura Makarov, DO, of the American Cancer Society of Atlanta, the full impact of a pandemic on cancer screening and cancer treatment needs to be determined.

“Similar data showed some recovery in cancer screening rates last summer and fall, but even those recovery reduced cancer screening by about 30% compared to pre-pandemic rates. It shows that she did, “she said. Today’s MedPage on mail. “Also, the impact of late fall and winter surges on cancer screening and diagnostic confusion is not yet fully understood.”

“The COVID-19 pandemic has had many consequences secondary to the disease itself, including reduced access to treatment for other diseases,” Makarov added. “These measures were necessary, but delayed cancer screening, diagnosis, and treatment due to reduced access to health care reduced cancer diagnosis in the short term, followed by late diagnosis and prevention. Deaths from cancer may increase.

“The full impact of the COVID-19 pandemic on cancer prevention and early detection will not be known until population-based national data are available in the coming years,” she said.

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    Charles Bankhead He is a senior editor of oncology and is also responsible for urology, dermatology and ophthalmology. He attended MedPage Today in 2007. To follow

Disclosure

This study was supported by the National Institutes of Health.

McBain reported that there were no conflicts of interest. The co-authors disclosed their relationships with Pfizer, Hilrom Services, Bristol Myers Squibb, Novartis, Amgen, Eli Lilly, Vertex, AstraZeneca, Celgene, Tesaro, Sanofi Aventis, Biogen, Precision Health Economics and Analytical Groups.

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