COVID fallout: A cancer pandemic predicted in the coming years

Due to the COVID-19 pandemic, the number of cancer screenings performed in the U.S. has plummeted.

After decades of progress in detecting, treating, and preventing many types of cancers, this nation could face a “cancer pandemic” in the next ten years as a result of this delay in routine screenings.

Postponed or canceled appointments for cancer screenings will likely result in delayed cancer diagnoses, recurrence of disease, and increases in cancer deaths.

That is why I advise patients to schedule their annual screenings as soon as they can. Hospitals have done everything possible to provide for a safe environment. Rooms are thoroughly cleaned between patients, all visitors and employees have their temperatures taken before entering the building, everyone must wear a mask, and all medical personnel wear appropriate protective gear. We also have teams who move around our facilities, further sanitizing surfaces to ensure patient safety.

There is strong clinical evidence that cancer deaths are directly related to the stage of disease at the time of diagnosis. The National Cancer Institute (NCI) predicts that tens of thousands of excess cancer deaths will occur over the next decade as a result of missed screenings, delays in diagnosis, and reductions in oncology care caused by the COVID-19 pandemic.

This is troubling. At our institution, we’ve spent decades creating programs that allow us to diagnose cancer at its earliest stages, as well as help high-risk patients predict their need for increased monitoring, screening or preventative treatment options. We have powerful drugs to treat cancer, but nothing is more powerful than prevention or early detection.

For example, our unique lung cancer program offers CT-scans to patients who are at high risk of developing the disease. For the last six years, 2.5% of these CT scans revealed undiagnosed, asymptomatic lung cancer. Many of these patients were effectively treated before they even showed signs of illness. These past several months, however, fear of COVID-19 kept patients away – and early detection success stories might become just as elusive.

In my own practice, I regularly saw four to five new melanoma cases per week. At the height of the pandemic, I saw none. I am greatly concerned that allowing skin cancer to advance will cause recurrence rates and mortality rates to skyrocket.

Not all screening declines were due to patient wariness, of course. Some elective procedures, like colonoscopies, had to be put on hold, as they require deep sedation that puts all involved at risk of spreading infection. And at many hospitals, workflows were shifted to accommodate a possible influx of COVID-19 patients, forcing screening appointments to be delayed. But most hospitals, clinics, and medical centers in the region are available for testing once again, and I hope patients avail themselves of lifesaving screenings.

It could take a decade before we completely understand the ripple effects COVID-19 has had on cancer mortality rates. While the predictive models are troubling, patients and their physicians have the power to mitigate the expected damage. COVID-19 has already taken away so much from so many of us. With proper screening, there is still hope that we can regain the progress we have made in beating cancer.

Burton Eisenberg is executive medical director, Hoag Family Cancer Institute, and Grace E. Hoag Executive Medical Director Endowed Chair, Hoag Memorial Hospital Presbyterian, Newport Beach, CA.

Image credit: Shutterstock.com

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