BACKGROUND AND PURPOSE:

• Cancer screenings declined after the start of the pandemic, with unclear consequences for cancer diagnoses
• Oakes et al. (JAMA Oncology, 2022) examined patterns in breast, cervical, and colorectal cancer screening and diagnosis before and after the pandemic

METHODS:

• Cross-sectional study
• Data
  • All-payer claims and encounters database across 50 states and DC, analyzing calendar year quarterly medical claims from January 2017 to December 2021
• Population
  • Patients 21 to 85 years
  • For breast and cervical cancer, only women were included
• Primary outcome
  • Quarterly number of individuals who received screening for breast, cervical or colorectal cancer

RESULTS:

• 306 million unique individuals
  • Mean age 51.5 (SD, 17.2) years | 54.6% female

Breast Cancer

• Median quarterly rate of prepandemic screening
  • Median 8216 (IQR, 8116 to 8407) per 100,000 beneficiaries
• Screening declined 40% in Q2 of 2020
  • Median 4951 per 100,000 beneficiaries
• Screening rebounded to prepandemic levels by Q3 and Q4 of 2020
• Screening declined in 2021
  • Median 7374 (IQR, 7127 to 7577) per 100,000 beneficiaries

Cervical Cancer

• Median quarterly rate of prepandemic screening
  • Median 5602 (IQR, 5462 to 5851) per 100,000 beneficiaries
• Screening declined 36% in Q2 of 2020
  • Median 3563 per 100,000 beneficiaries
• By Q3 of 2020, cervical cancer screening rebounded toward the prepandemic median
• Screening declined starting in Q4 of 2020 through 2021
  • Median 4246 per 100,000 beneficiaries

Colorectal Cancer

• Median quarterly rate of prepandemic screening
  • 3162 (IQR, 3126 to 3202) per 100,000 beneficiaries
• Screening declined 45% in Q2 of 2020
  • Median 1746 per 100,000 beneficiaries
• From Q3 of 2020 to Q4 of 2021, quarterly colorectal cancer screening remained at 82% to 90% of the prepandemic median

CONCLUSION:

• Screening for breast, cervical and colorectal cancer remain below prepandemic levels
• The authors state

The pattern we found suggests a substantial proportion of forgone care through 2021

To mitigate long-term consequences, multiple stakeholders will need to consider novel strategies and dedicate appropriate resources to increase guideline-concordant cancer screening 

Learn More – Primary Sources:

Rates of Routine Cancer Screening and Diagnosis Before vs After the COVID-19 Pandemic

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