The researchers also looked at these encounters by cancer type. Patient encounters decreased across all cancer types, although they observed a greater decrease related to melanoma (-51.8%), breast cancer (-47.7%), and prostate cancer (-49.1%) than lung cancer (-39.1%), colorectal cancer (-39.9%), and hematological cancers (-39.1%).
Additionally, McNair and colleagues also found that mammograms declined 89.2% in April 2020 compared with April 2019 and colorectal cancer screenings declined by 84.5% during the same period. The researchers plan to track screenings in the coming months as virus mitigation efforts are eased to help predict how many patients are continuing to delay cancer screenings due to the pandemic.
"The most significant finding in our study was the considerable drop in cancer screenings. The fact that this trend was so drastic nationwide is telling of the widespread effect of the pandemic and mitigation efforts - even in regions that had not seen a significant impact from the virus at the time," McNair said.
SKCC is participating in several key initiatives designed to help elucidate how COVID-19 affects cancer patients and clinical care, including the COVID-19 and Cancer Consortium (CCC19) and the American Society of Clinical Oncology (ASCO) Survey on COVID-19 in Oncology Registry. CCC19 is an international registry database that is tracking outcomes among cancer patients who have also been diagnosed with COVID-19. The ASCO Registry is collecting baseline and longitudinal data from oncology practices across the United States to examine the how the virus is affecting cancer care delivery and patient outcomes.
These registries are important in order to understand both short- and long-term impacts of the trends seen here, according to McNair.
The researchers will continue to look at trends throughout the summer and into the fall, especially as states are more drastically affected. It will be important to understand trends in cancer diagnoses to determine if delays in screening are resulting in an increased number of patients presenting with later-stage disease, McNair said.
"These findings are truly striking, as modeling from the National Cancer Institute has predicted thousands of expected increases in cancer death as a result of deferred breast and colorectal screening alone," said Karen E. Knudsen, MBA, PhD, Executive Vice President of Oncology Services, Jefferson Health, and Enterprise Director of the Sidney Kimmel Cancer Center. "This report is a nationwide call to arms, underscoring the urgent need to resume cancer screening and early detection."
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