Study Suggests the COVID-19 Pandemic Led to Millions of Decreased Cancer Screenings

Assessing the impact of the COVID-19 pandemic upon cancer screenings in the United States, researchers from the American Cancer Society (ACS) recently reported decreases of 2.13 million breast cancer screenings and 4.47 million cervical cancer screenings in 2020 in comparison to statistics from 2018.

The statistics reflect relative percentage decreases of 6 percent for breast cancer screenings and 11 percent for cervical cancer screenings, according to the national survey study, which was published in JAMA Network Open.

The researchers also found that Asian/Pacific Islander women had an approximately 27 relative percent decrease in breast cancer screening between 2018 (63.9 percent) and 2020 (46.6 percent). Hispanic women had relative percentage decreases of 10 percent (59.5 percent to 53.2 percent) for breast cancer screening and 17 percent (57.1 percent to 47.4 percent) for cervical cancer screening between 2018 and 2020, according to the study.

The study authors also noted cancer screening disparities along socioeconomic lines. In 2020, people without a high school diploma had lower breast cancer (50.3 percent) and cervical cancer screening rates (43.6 percent) in comparison to those with college degrees (62.2 percent and 55.7 percent respectively). The researchers also noted lower relative percentage declines in in breast cancer and cervical cancer screenings for those with college degrees (6.1 percent and 9.5 percent respectively in comparison to those who did not graduate from high school (11 percent and 17.7 percent respectively)

“It is imperative that we understand the impact of lower screening rates on cancer outcomes among people of color and people of lower economic standing and also work to improve access to health care and cancer screenings for everyone,” noted the study’s senior author Ahmedin Jemal, DVM, Ph.D, senior vice president of the Surveillance and Health Equity Science Department of the American Cancer Society.

The study survey included 479,248 people in the breast cancer screening analysis, 301,453 people in the cervical cancer screening analysis and 854,210 people in the colorectal cancer screening cohort, according to the study. For those between the ages of 50 to 75 who responded to the survey in 2020, 67.3 percent were White, 12.6 percent were Hispanic, and 11.4 percent were Black. The study authors also noted that 29.9 percent of the respondents had college degrees.

The comparison between 2018 and 2020 cancer screening rates also revealed a relative percentage decrease of 16 percent for colorectal cancer screening (CRC) but researchers noted an offsetting 7 percent increase in stool-based CRC testing.

In regard to study limitations, the authors noted the patient-reported data is subject to recall biases. They also acknowledged possible underestimation of cancer screening prevalence due to the use of population-based weights to account for non-response in the study. Citing analysis from U.S. Census surveys, Jemal and colleagues noted the greater potential for non-response to surveys for those with lower income in 2020 and emphasized the necessity to improve data collection in higher-risk populations.