Restrictions in access to care during the COVID-19 pandemic caused disruptions in the treatment of cancer and other conditions. A new study now indicates that the pandemic also likely caused new cancer diagnoses to be delayed, a situation that could lead to worse prognoses for patients. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
For the study, a team led by Brajesh K. Lal, MD, of the Veterans Affairs (VA) Maryland Health Care System and the University of Maryland School of Medicine, examined data from more than 9 million US veterans at 1,244 VA medical facilities. From 2018 through 2020, there were 3.9 million procedures used to diagnose cancer and 251,647 new cancers diagnosed. The researchers found that procedures to diagnose cancer were used less frequently in 2020. There were also fewer new diagnoses of cancer in 2020. These deficits varied by geographic location and by cancer type.
Colonoscopies (to detect colorectal cancer) in 2020 decreased by 45% compared with annual averages in 2018 through 2019, whereas prostate biopsies (to detect prostate cancer), chest computed tomography scans (to detect lung cancer), and cystoscopies (to detect bladder cancer) decreased by 29%, 10%, and 21%, respectively. Colonoscopies had the largest deficits across the country: in 29% of states, fewer than half of colonoscopies were performed in 2020 compared with earlier years.
New cancer diagnoses in 2020 decreased by 13% to 23%, depending on the cancer type.
The investigators created a chart that institutions, health systems, and states can use to determine the time and resources needed to increase diagnostic procedures in order to recover from the backlog created by the pandemic.
The disruption in non-emergency health care during the peak of the pandemic was intentional and necessary. As we enter the recovery phase, we hope that our work will help physicians, hospitals, and health care organizations anticipate the extent to which they have fallen behind in their efforts to diagnose new cancers. It will also help them allocate requisite resources and time to re-engage with patients."
Dr. Brajesh K. Lal, MD, VA Maryland Health Care System and University of Maryland School of Medicine
Englum, B.R., et al. (2021) Impact of the COVID-19 pandemic on diagnosis of new cancers: A national multicenter study of the Veterans Affairs Healthcare System. Cancer. doi.org/10.1002/cncr.34011.