Pandemic Tanked Cancer Screening Rates, But Cancer Diagnoses Didn’t Rise

It’s a well documented fact that cancer screening rates went down during the pandemic, after offices had to defer patient access to preventive screenings to both preserve the medical workforce and keep patients socially distanced. But new data from the Epic Health Research Network gives a glimmer of hope, showing that patients dodged cancer diagnoses and diagnoses of serious illness in the aftermath.

These findings may comfort healthcare experts who worried that the decline in cancer screening rates would result in an upswing of late-stage cancer diagnosis. Cancers that are diagnosed in later stages can be harder to treat and come with poorer prognoses.

Moreover, the study showed that cancers screening rates have rebounded to pre-pandemic levels.

The researchers scanned electronic medical records for almost 375,000 patients from between January of 2018 until December of 2022, identifying not just changes in cancer screening rates but also changes in cancer diagnoses and late-stage cancer diagnoses.

There was that decline in cancer screening rates around March and April of 2020, mostly because healthcare organizations stopped doing the screenings and patients wanted to avoid in-person care in an effort to protect against the novel coronavirus. Cancer diagnosis rates matched that decline; with fewer tests, there were fewer positive results, the researchers reasoned.

But cancer screening rates quickly rebounded in 2021 and managed to stay consistent with pre-pandemic rates. What’s more, the researchers did not identify an influx of cancer diagnoses; although the number of cancer diagnoses did rise around the start of 2021, it was in proportion to the increase in cancer screening rates.

Said otherwise, the lull in cancer screening did not cause an influx of diagnosis down the line.

When looking at advanced-stage cancer diagnosis, the researchers did identify somewhat different trends. Advanced cancer diagnosis saw less of a dip after the COVID-19 National Emergency Declaration than regular cancer diagnosis did. For advanced cervical cancer diagnosis, there was actually no decline at all, even though clinicians were performing fewer screenings.

These figures might suggest that patients still managed to get in for a screening and a diagnosis of a cancer had progressed particularly far. Like the findings about regular cancer diagnosis, these numbers are good news because they suggest the decline in screening did not result in an upswing in cancer diagnoses.

There is room for oversight in their reporting, the researchers acknowledged. Patients may have two approaches to filling their care gaps, they indicated. For example, the recommended mammogram schedule is once every two years. Some women may want to fill a missed mammogram right away; others might wait a few months until they would have been due for their next one, anyways.

There is also still the possibility that there are patients with unscreened and therefore undiagnosed cancer out there.

“Because there are still patients who have not yet caught up on screenings, we might be underreporting the number of cancer cases and advanced/severe cancer cases,” the researchers said.

Even still, some experts might be breathing a sigh of relief knowing that they have managed to fill the care gaps opened during the pandemic, likely with few consequences.

These findings run counter to other reports assessing the link between missed cancer screening and diagnoses. In February 2022, the American Association of Cancer Research (AACR) reported that an estimated 10 million cancer diagnoses were missed during the early months of the pandemic.

AACR added that between March and December 2020, the nation saw an 11 percent increase in patients diagnoses with inoperable or metastatic cancer compared to the same period in 2019. In other words, delays in cancer screening may have led to an increase in late-stage cancer diagnosis, which can be harder to treat and carry a worse outcome for patients.

“The COVID-19 pandemic has highlighted the importance of basic science, cancer prevention, cancer screenings, and addressing cancer disparities,” Margaret Foti, PhD, MD (hc), chief executive officer of AACR, said in the 2022 press release.

“To restore the momentum against cancer, we urge Congress to continue its long-standing commitment to supporting cancer research,” Foti continued. “Robust, sustained, and predictable annual funding increases for NIH and NCI will propel future scientific advances, maximize returns from prior investments in cancer research, drive economic prosperity, and support new lifesaving cures for patients with cancer.”