Preventive Care Takes a Hit, Cancer Screenings Drop 80% Amid Pandemic

The COVID-19 pandemic caused a significant decrease in preventive care access, with the impact on cancer screening being especially notable as millions of patients missed their care, according to a study led by researchers at the American Cancer Society (ACS).

In the survey of nearly 480,000 people, researchers found that the number of women in the United States who had a breast cancer screening decreased by 2.13 million (6 percent) in 2020 compared to 2018.

In addition, cervical cancer screening prevalence decreased by 11 percent between 2018 and 2020, representing 4.47 fewer million women screened. These drops were greater among Hispanic patients and patients with lower educational attainment.

From 2018 to 2020, colorectal cancer screenings dropped by 16 percent for men and women. However, researchers found that the drops in colorectal cancer detection were offset by a 7 percent increase in stool testing use.

This offset shows how at-home testing can maintain screening rates during major healthcare disruptions, the researchers stated.

“COVID-19 pandemic had an immediate impact in March and April of 2020, as screenings initially dropped by close to 80 percent,” said Ahmedin Jemal, MD, the senior vice president of Surveillance & Health Equity Science at the American Cancer Society and senior author of the study.

“Many people caught up on screenings later in 2020, but overall, the COVID-19 pandemic kept screenings down over the course of the entire year. As we move forward, it’s crucial to get people back into their doctor’s offices to get screened.”

Despite the uptake of preventive care, studies have shown that rates of cancer screening remain low after two years of the pandemic. Patients are still citing the desire to reduce potential exposure to COVID-19 as the primary reason for limiting their access to healthcare.

“Regular screening for cancer can help save lives. This important study is further evidence of how critical it is to get people back on track with their regular screening tests following COVID-19,” William Dahut, chief scientific officer at the American Cancer Society, said in the press release.

“Screening is safe, effective, and accessible. Facilities that offer screening services have COVID-19 safety precautions in place,” Dahut added. “Many states have low or reduced-cost screening programs to help ensure that everyone has access, even people who don’t have insurance or a primary care doctor.”

Even though screenings were low overall, traditionally marginalized groups experience further barriers and even lower rates.

For example, Asian/Pacific Islander women had a 27 percent drop in past-year breast cancer screening, the largest drop compared to other races.

The disparities extended to cervical cancer screenings, with Hispanic women experiencing a 17 percent drop in the last year.

Breast cancer screening among those who did not graduate high school decreased by 11 percent compared to 6.1 percent for college graduates. In addition, they experienced a drop of 17.7 percent for cervical cancer screening compared to 9.5 percent for college graduates.

“The impact of these drops on stage at diagnosis and survival is not yet known, but it is something we need to monitor closely,” said Jemal. “It is imperative that we understand the impact of lower screening rates on cancer outcomes among people of color and people of lower socioeconomic standing and also work to improve access to healthcare and cancer screenings for everyone.”