Background
Cancer-related deaths are expected to increase over the next decade due to cancer screening shortfalls associated with the coronavirus disease 2019 (COVID-19) pandemic. Although national deficits have been quantified, there has not been a widely available structured response to identify and address local deficits.
The goals of this report are to share preliminary data on monthly screening gaps for breast, colorectal, lung, and cervical cancer in various settings and to provide online materials from a national quality improvement (QI) study to help other institutions to address local screening deficits. .
Methods
This prospective national QI study of return to screening enrolled 748 accredited cancer programs in the United States from April to June 2021. Pre-pandemic and pandemic local monthly screening volumes (MTVs) were used to calculate percent change relative on MTV to describe the monthly selection gap.
Results
Most facilities reported monthly screening deficiencies (colorectal cancer, 80.6% [n = 104/129]; cervical cancer, 69.0% [n = 20/29]; breast cancer, 55.3% [n = 241/436]; lung cancer, 44.6% [n = 98/220]).
Overall, the median relative percent change in MTV ranged from –17.7% for colorectal cancer (interquartile range [IQR], –33.6% to –2.8%), –6.8% for cervical cancer (IQR, –29.4% to 1.7%), –1.6% for breast cancer (IQR, –9.6% to 7.0%), and 1.2% for breast cancer lung (IQR, –16.9% to 19.0%).
No geographical differences were observed. There were statistically significant differences in the percentage change in MTV between types of colorectal cancer screening institutions (P = 0.02).
Conclusion
Cancer screening still needs urgent attention, and screening resources available online can help facilities close critical gaps and address missed screenings in 2020.
Highlights Ask: How can the effects of the coronavirus disease 2019 pandemic on cancer screening be mitigated? Findings: When national resources were provided, including methods to estimate local screening gaps, 748 cancer programs were quickly enrolled in a national return to screening study, with the majority identifying local screening gaps, particularly in colorectal cancer. With these results, 814 quality improvement projects were initiated with the potential to add 70,000 screening tests in 2021. Meaning: Cancer screening still needs urgent attention, and online resources can help close critical screening gaps. |
Comments
Study identifies and addresses cancer screening gaps in US due to COVID-19 pandemic
Drops in colorectal cancer screening rates require urgent attention
Cancer deaths are expected to increase over the next decade as a result of screening shortfalls due to the COVID-19 pandemic. New research published in CANCER , a peer-reviewed journal of the American Cancer Society, reveals the extent of screening gaps in breast, colorectal, lung, and cervical cancers in the United States and outlines efforts that clinics are doing to address missed screenings.
The study, which was initiated by the American College of Surgeons of Cancer Programs and the American Cancer Society, enrolled 748 accredited cancer programs in the United States from April 2021 to June 2021.
Most facilities reported monthly screening shortfalls: percentages reporting shortfalls for colorectal, cervical, breast, and lung cancer screening were 80.6%, 69.0%, 55.3% and 44.6%, respectively. No geographic differences were observed based on the location of cancer programs in the United States.
Using these results, participating accredited oncology programs initiated a total of 814 quality improvement projects to address various barriers to screening. The effects of these interventions on screening rates are being evaluated through 2021, but the estimated number of potential additional monthly screenings if all participating centers meet their goals is 57,141 for breast cancer, 6,079 for colorectal cancer , 4280 for cervical cancer and 1744 for lung cancer.
"From a people’s health perspective, we are hopeful that this collaborative effort between the Cancer Programs of the American College of Surgeons and the American Cancer Society has saved many patients from unnecessary suffering and death from cancer," said corresponding author Heidi Nelson, MD, FACS, Medical Director of Cancer Programs at the American College of Surgeons. “From the perspective of what this means about our programs, we now know that we can turn to our accredited programs in times of crisis to help address large-scale cancer issues. Knowing how enthusiastic these accredited programs are to work collaboratively on national-level problems, we hope to launch one or two quality improvement projects each year in the future.”
The study is especially timely given that the American Cancer Society’s National Cancer Detection and Care Consortium recently announced nine consensus recommendations to accelerate recovery from the pandemic and improve the nation’s ability to provide cancer screening and care. quality for everyone.
March is Colorectal Cancer Awareness Month . The American Cancer Society recommends colorectal screening starting at age 45 for people at average risk for the disease.
