Delayed diagnoses and missed screenings due to the coronavirus pandemic will likely result in increased cancer deaths, medical experts told the Daily Caller News Foundation.
“We have not yet seen the real impact of COVID-19 on cancer diagnosis and deaths,” warned Dr. Julie Gralow, executive vice president and chief medical officer of the American Society of Clinical Oncology. “Screening for cancer (mainly breast, cervical, and colon) clearly dropped dramatically early in the pandemic, which will likely contribute to a later stage at diagnosis due to the delay/omission of screening that will be seen in the future.”
Lawmakers, health officials, and the Centers for Disease Control and Prevention (CDC) called on health care providers to cancel non-essential or routine appointments, surgeries, and procedures to preserve personal protective equipment and prevent the risk of spreading the coronavirus.
Some patients began cancelling appointments themselves at the start of the pandemic in March 2020, and hospitals in coronavirus hot spot locations quickly filled with COVID-19 patients.
Gralow told the DCNF that she expects that interruptions and alterations in treatment, missed or delayed screenings, delayed diagnoses, and loss of health insurance due to unemployment will result in increased cancer deaths over the long term.
Dr. Roy Herbst, Chief of Medical Oncology at Yale Cancer Center, told the DCNF that he has been seeing patients come into the hospital with more advanced stages of cancer.
“During COVID a lot of elective procedures had to be postponed because there were so many patients in the hospital with COVID,” he said. “At a place like Yale, New Haven, we had to reorganize some of our space so there are fewer procedures being done.”
Yale New Haven Hospital is “back to normal now” and never been busier, Herbst said, but he noted that “we’re seeing patients coming in with somewhat more advanced cancers, whether it be a colon, head, neck, lung, because they’ve gone a little bit longer with symptoms because there was a period when people weren’t able to go in for their exams or for their procedures and for their x-rays and evaluations.”
“So that is something that we’re cognizant of and we’re certainly managing as best we can try to make up for the backlog,” the Yale Cancer Center chief of medical oncology said.
The National Cancer Institute has estimated that there will be a 1% increase in deaths from breast and colorectal cancer over the next 10 years, Gralow noted to the DCNF — about 10,000 excess deaths due to the pandemic. These figures are “conservative,” Norman E. Sharpless, director of the National Cancer Institute, warned in an editorial on the topic.
“The number of excess deaths per year would peak in the next year or two,” Sharpless wrote. “This analysis is conservative, as it does not consider other cancer types, it does not account for the additional nonlethal morbidity from upstaging, and it assumes a moderate disruption in care that completely resolves after 6 months.”
“It also does not account for regional variations in the response to the pandemic, and these effects may be less severe in parts of the country with shorter or less severe lockdowns,” Sharpless said.
A March 2021 survey of radiation oncologists also found that patients are presenting more advanced stage cancer.
Dr. Herbst stressed the importance of early diagnosis, noting that the later the diagnosis, the more chance the cancer has to grow. He suggested the best way to take care of lung cancer and bring down death rates is prevention, noting that current or former smokers who come in and get a chest scan are significantly more likely to be successful at preventing lung cancer.
Join @theNCI and @CDC_Cancer on Monday, April 26 at 4:00 p.m. ET for an exciting, cross-platform social media event on Cancer Prevention and Screening, with a focus on #CervicalCancer. Stay tuned for more info. https://t.co/mrwYA0TaJa #NothingWillStopUs #CancerScreening pic.twitter.com/Sxr03bXKYd
— NCI Cancer Control (@NCICancerCtrl) April 22, 2021
“I’ve seen those numbers going down,” Herbst said, referring to the number of cancer screenings. “And that worries me because that means we’ll detect fewer cancers, before their cancer, or at a stage where they can just be cut out and cured.”
Gralow noted that “it takes a year or two to get reliable numbers of diagnoses and deaths across the whole country,” so experts must rely on “estimates and small studies at this point” to figure out whether there have been decreases in new cancer diagnoses reported in 2020.
“It will take us a little longer to have solid data on the rates in 2021, but many centers are reporting that they are back up to (or close to) their pre-COVID appointment rates for mammograms and colonoscopies,” she said.
Both Sharpless and NIH officials have urged a return to screening, expressing serious concerns about the impact of drops in these screenings.
“That delayed care that decreased diagnosis — we do believe will translate into excess mortality over the next decade,” Sharpless said in February.
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