COVID-Delayed Screenings Increase Late-Stage Breast Cancer Diagnoses

The National Cancer Institute, in June 2020, expressed fears that declines in cancer screenings and delays in treatment due to the COVID-19 pandemic could contribute to an increase in rates of advanced cancer diagnoses and deaths through 2030.

A recent study was led by Jade Zifei Zhou, MD, Ph.D., a hematology/oncology fellow at Moores Cancer Center in La Jolla, California, affiliated with the University of California, San Diego. Zhou and his team looked at the patients presenting at Moores Cancer Center with either Stage I or Stage IV cancer — either newly diagnosed or for a second opinion — for the years of 2019 and 2020.

There were almost 500 patients who fit into their profile category; almost 90% were women. The results are compelling, prompting Dr. Jade Zhou and her colleagues to write, “There is increasing concern regarding the effect of the COVID-19 pandemic on cancer mortality, as the evidence suggests that the number of patients presenting at late, incurable stages is increasing.”

Breast Cancer

	Stage 1	Stage IV
2019	63%	1.9%
2020	51.9%	6.2%
January – March 2021	41.9%	8.0%

 

A similar trend was seen for colon cancer, but the number of patients was too low to be statistically meaningful.

Colon Cancer

	Stage 1	Stage IV
2019	17.8%	6.7%
2020	14.6%	19.5%

 

The President’s Cancer Panel released a report on February 3, 2022, stating, “Gaps in cancer screening uptake — both before and during the pandemic — mean that too many Americans are enduring aggressive treatment for or dying from cancers that could have been prevented or detected at earlier stages.” The panel also wrote, “These gaps exacerbate the already heavy burden of cancer experienced by many communities of color, socially and economically disadvantaged populations, and families with hereditary cancers.”

The President’s Cancer Panel stressed the need for more robust screening programs, particularly for breast and lung cancer. CMS announced on February 10, 2022, their decision to expand coverage for Low Dose CT lung cancer screening — lowering the screening age to 50 and lowering the smoking history of a minimum of 20 pack years.

While the researchers were unable to gauge causality, the research team believes that the evidence is compelling and urges patients who have delayed screenings because of COVID concerns to resume recommended cancer screenings.