Researchers study impact of pandemic cancer screening pause

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Researchers study impact of pandemic cancer screening pause



John Abraham’s colonoscopy has been postponed for several months due to the pandemic. When he finally got it, doctors found a growth too large to be safely removed during the scope scan.

John Abraham’s colonoscopy has been postponed for several months due to the pandemic. When he finally got it, doctors found a growth too large to be safely removed during the scope scan. He had to wait several weeks for the surgery and then several more to learn that she had not yet become cancerous.
“I absolutely wonder if I had been screened when I needed to, if it would have been any different” and the surgery could have been avoided, said Abraham, a mortgage banker in Peoria, Ill..

Millions of colonoscopies, mammograms, lung scans, Pap tests and other cancer screenings were put on hold for several months last spring in the United States and elsewhere as COVID-19 overwhelmed medical care.

The researchers are now studying the impact, looking to see how many cancers have been missed and if the tumors found since then are more advanced.

Already, there are indications of problems. Researchers at the University of Cincinnati found that when CT scans for lung cancer resumed in June, 29% of patients had suspicious nodules compared to 8% in previous years.

Numerous studies suggest that fewer cancers were diagnosed in the last year, possibly due to less screening. About 75 cancer organizations have recently called for a return to pre-pandemic screening levels as soon as possible.

But tumors take years to develop, and some reports suggest that a delay of a few months in being screened for certain types of cancer may not have been as bad as feared. For example, researchers in the Netherlands found that an interruption of the mammography program there did not lead to the detection of more cancers at a late stage after resuming screening.

The pandemic has also spawned creative solutions, such as a wider use of tests that can be done at home. In Philadelphia, a large church partnered with local doctors and used its driving flu vaccine program to also distribute stool tests for colon cancer screening.

“We are not afraid to try anything when it comes to health and wellness,” said Reverend Leroy Miles of the Enon Tabernacle Baptist Church. “The women encouraged the men to get tested by saying, ‘I had my mammogram.’ And I say, ‘ma’am, you also have a settler.’ ”

THE PROPERTIES OF THE SELECTION

Screening tests differ in their risks and benefits, and health experts have long debated who should get them and how often. The end of the pandemic can serve as a “natural experiment” to see their value in modern times compared to what is known from studies done long ago.

Any difference in deaths may not be seen for years, and early detection is only a factor in survival. Treatment is also important and it has also been affected by delays due to the pandemic.

Dr. Ned Sharpless, director of the US National Cancer Institute, estimates that there could be nearly 10,000 more deaths over the next decade due to delayed detection and treatment of breast and colon cancers. The postponement of care “was cautious at one point” because of the risks of exposure to COVID-19, but too long postponement “can turn one public health crisis into several others,” he wrote in the statement. Science journal.

Based on what is known of breast cancer deaths in recent years in the United States, about 10% “could have been prevented if women were screened routinely,” but 20% to 25% could have been prevented. be prevented with proper treatment, said Dr. Otis Brawley, professor at Johns Hopkins University and former chief medical officer of the American Cancer Society.

“That’s not to say screening isn’t important, but a lot of people think screening for cancer saves more lives than it actually does,” Brawley said.

Short-term delay may not do much harm to mortality if screening resumes quickly, as it should, he said.

Some reassuring news came at a recent American Association for Cancer Research conference led by Sabine Siesling of the Netherlands Comprehensive Cancer Organization. This country offers women aged 50 to 74 a mammogram every two years but stopped in mid-March because of COVID-19. After her recovery at the end of the summer, the results “showed no change” to more advanced tumors, she reported.

Researchers from Massachusetts General and Brigham and Women’s Hospital analyzed their tests for cancer of the lung, cervix, colon, prostate and breast. Screening dropped dramatically from March to June, but the portion that found cancer or precancer was higher than usual, suggesting those who were screened were at higher risk. When screening returned to near-normal levels from June through September, the number of potentially “missed” cancers was lower than expected.

TO BE CREATIVE

When actor Chadwick Boseman, 43, died of colon cancer last summer, Miles feared for the 12,000 members of his Philadelphia church. Blacks are more likely to die from the disease than other groups, and access to colonoscopies is limited, which can detect and remove growths before they turn cancerous.

Miles, who has drawn over 1,000 church members to other health events, called the University of Pennsylvania and said, “We know how to get people to come if you are ready and able to set up. Something.”

Dr. Carmen Guerra received a federal grant to increase screening in racially diverse communities and found that home testing could help. Studies show that these tests, which look for blood in the stool, help save lives. People put a small stool sample in a tube and mail it to a lab, or in this case, use a drop box at the church. If blood is found, the next step is colonoscopy.

Doctors handed out kits in the parking lot during a driving flu shot in October. Church members were to watch a colon cancer video in advance and register to make sure they were qualified for screening.

To date, 154 kits have been returned. Stacy Hill was one of 13 who tested positive. The 48-year-old Philadelphia woman had just lost her job and health insurance. His colonoscopy revealed two growths that, like Abraham’s, were caught before they became cancerous.

“I was shocked,” Hill said. “I’m a proactive type person, so I was happy to know that.”

Doctors also helped her to register at Medicaid, “So now I have medical insurance” and can continue to get cancer screenings, she said.

The church hopes to offer home testing again during blood pressure and diabetes screening events this spring.

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The Associated Press’s Department of Health and Science receives support from the Department of Science Education at the Howard Hughes Medical Institute. The AP is solely responsible for all content.

Marilynn Marchione, The Associated Press

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