The United States could be on the verge of a surge in cancer deaths in the coming years after preventive testing and early diagnoses plummeted during the pandemic.
Experts worry that a drop in diagnostic testing in 2020 likely resulted in countless missed opportunities to treat cancers early, which would have increased a person’s chances of survival, potentially leading to an increase in deaths from cancer in the coming years.
The National Cancer Institute, a government agency, collected far fewer reports of breast, lung, colorectal, thyroid, prostate and pancreatic cancer than would normally be expected between March and May 2020 due to disruptions in health care.
The declines in diagnoses were greatest for breast, lung and colorectal cancers in women, types typically diagnosed through screening measures that were missed by millions of Americans.
Government cancer experts now fear that it will take years for Americans to resume preventive health care.
In the graphs above, researchers have plotted the observed cancer case count in 2020 against the projected case count for 2020, or an observed-to-expected (O/E) ratio. For all cancer types included in the study, April 2020 was the month with the lowest proportion
The number of cases of thyroid and pancreatic cancer in men was in line with expectations. In women with thyroid cancer, there were significantly fewer cases than expected
When the first Covid outbreak gripped the country in early 2020, the vast majority of Americans were encouraged to quarantine at home in an effort to protect themselves from infection.
At the same time, health systems reduced many of their elective care services to free up resources to deal with the influx of new Covid patients.
Almost 10 million cancer screening appointments were missed between January and July 2020 alone. The mountain of failed tests translated into an 11 percent increase in the number of patients diagnosed with cancer that had already spread to other parts of the body that year.
Dr. Monica Bertagnolli, director of the National Cancer Institute, said, “These missed opportunities for early cancer detection are alarming, particularly for those vulnerable populations who continue to face significant barriers to accessing cancer care.”
“This report highlights the urgency of helping all Americans get back on track with their cancer care so we can avoid unnecessary deaths and complications from cancer.”
The NCI led the largest study to date using data from central government cancer registries to measure the impact of Covid.
Researchers from NCI, along with those from the Centers for Disease Control and Prevention, the National Institutes of Health, the American Cancer Society, and the North American Association of Central Cancer Registries, came together to analyze data from cancer cases spanning from 2015 to 2020.
They also estimated the expected number of new cancer diagnoses in 2020 based on data from previous years. But the actual numbers in 2020 showed that there were fewer newly diagnosed cases of breast, lung, colorectal, thyroid, prostate and pancreatic cancer than expected.
Researchers projected that 7,147 cases of localized colorectal cancer would have been diagnosed in 2020. In reality, only 5,983 were.
There were also 4,000 fewer localized breast cancer diagnoses, as well as 1,267 fewer localized lung cancer cases and 3,447 fewer localized prostate cancer diagnoses.
There were also 470 fewer than expected cases of thyroid cancer and 115 fewer cases of pancreatic cancer.
The study authors said: “Therefore, the survival benefits of early detection may be limited for a large segment of cancer patients.”
Their findings, which were published in the American Cancer Society’s journal Cancer, align with previous studies on the impact of Covid on disease detection and prevention.
A study published last month in the journal Lancet Oncology found that rates of new cancer patients fell by about 15 percent in 2020 compared to 2019, the equivalent of about 125,000 fewer diagnoses.
The largest decline in diagnoses was among cancers in stage 1, or the earliest phase of the disease. If they are not detected, there is a risk that the cancer will spread when it is detected, making it much more difficult to treat.
Dr. Karen E. Knudsen, CEO of the American Cancer Society, said, “We are deeply concerned about the implications of delayed diagnosis, which is typically associated with more aggressive disease and worse outcomes.”
“It is imperative to ensure that we regain lost ground in early cancer detection, thereby maximizing opportunities for effective treatment and survival.”