Covid-19 Outbreaks Led to Dangerous Delay in Cancer Diagnoses

‘Cancer doesn’t take a pause,’ but amid the pandemic, many Americans avoided oncology screenings and other potentially lifesaving procedures

By Anna Wilde Mathews and Mike Cherney of The WSJ. Excerpts:

"A decline in mammograms and other screening procedures after the coronavirus pandemic struck is leading to missed and delayed cancer diagnoses, according to data from insurance claims, lab orders, Medicare billings and oncology-practice records, an emerging pattern that is alarming oncologists.

Hundreds of thousands of cancer screenings were deferred after worries about Covid-19 shut down much of the U.S. health-care system starting this spring. Because many cancers can advance rapidly, months without detection could mean fewer treatment options and worse outcomes, including more deaths.

“There’s really almost no way that doesn’t turn into increased mortality,” with the full effects likely to play out over a decade, said Norman E. “Ned” Sharpless, director of the National Cancer Institute. Missed screenings and other pandemic-related impacts on care could result in about 10,000 additional deaths from breast and colon cancer alone over the next 10 years, the NCI projected earlier this year. Dr. Sharpless said the estimate now appears low.

Cancer-care provider 21st Century Oncology, which has 300 locations around the U.S., said about 18% of its newly diagnosed breast-cancer patients this year through August had an advanced stage of the disease, compared with 12% in all of 2019. From 2015 to 2019, the share of its breast-cancer cases detected at an advanced stage was between 11% and 12.5%. The provider has also seen a higher proportion of its lung-cancer patients arriving with a more advanced stage of the disease this year."

"Data from lab giant Quest Diagnostics Inc. shows that freshly-detected cases of several types of cancer dropped sharply this spring. The mean weekly number of newly diagnosed breast cancer patients fell by nearly 52% for March and early April, compared with figures before the pandemic. This missing cohort means there are likely many patients with undiagnosed cases"

"Researchers didn’t see the above-normal totals that would be expected if all of those who missed procedures this spring returned for them later in the year and no one else skipped their screenings"

"New-patient oncology visits were down between 29% and 70% in the months between March and July, compared with the same months a year earlier. Biopsies for breast, lung and colon cancer fell between 11% and 79% over the same span"