Dive Brief:

• A survey of radiation oncologists conducted this winter has found an increase in new patients with advanced-stage cancers coming into clinics for treatment, compared to before the pandemic.
• Nearly three-quarters of physicians responding in the American Society for Radiation Oncology survey also said they noticed their patients had missed cancer screening tests due to the pandemic.
• The ASTRO findings echo results of a recent poll from the Association for Molecular Pathology that showed 85% of clinical laboratories reported molecular testing for cancer declined during April to June.

Dive Insight:

The industry groups' research adds to evidence bearing out health officials' fears that many people skipped getting cancer screenings in 2020 as they avoided going to the doctor to minimize the risk of COVID-19 infection, and healthcare providers focused on their pandemic response efforts.

In a blog post last week, the CDC's Division of Cancer Prevention and Control urged Americans to schedule their regular screenings, emphasizing the improved odds of treatment success when breast, cervical and colorectal cancers are found early. The agency advised asking the doctor specifically about at-home stool tests for colon cancer and lung cancer screening for high-risk individuals.

Electronic health records data from the Epic Health Research Network, drawn from 2.7 million patients across 190 hospitals in 23 states, in May showed a sharp drop of between 86% and 94% in preventive cancer screenings performed in the U.S. The study compared screenings for cervical, colon and breast cancer in 2020 to the average numbers completed during equivalent weeks from 2017 through 2019. By mid-June, volumes for those tests remained 29% to 36% below pre-pandemic levels.

A CDC report published in January examining the electronic health records of about 1.5 million women in the Kaiser Permanente Southern California network found cervical cancer screening rates fell by about 80% during the state's stay-at-home order, compared with a 2019 baseline, but returned to near normal after the order was lifted.

In a separate study of data from the Kaiser Permanente system, presented at the 2020 San Antonio Breast Cancer Symposium, women who saw their doctors during California's shelter-in-place period between March and May of last year presented with more advanced and aggressive disease than those examined in the same months of 2019.

Two-thirds (66%) of the 117 medical directors of radiation oncology practices nationwide who completed the ASTRO survey in January and February indicated new patients were presenting with more advanced-stage cancers, while 73% said physicians in their practices noticed patients were not receiving cancer screenings. Existing patients experienced an interruption in their radiation treatment due to the pandemic, according to 66% of the respondents.

Radiation oncologists at community-based private practices were more likely to report seeing advanced-stage cancers among their patients, compared to those at university-affiliated clinics. Patient volume dropped at 73% of the clinics due to COVID-19, and visits were down 21% on average. Most practices (72%) reduced staff at some point because of the pandemic.

The Association for Molecular Pathology survey, conducted in September and October, included feedback from 163 U.S. and internationally based academic medical centers, commercial reference laboratories and community hospitals. After the 85% drop in cancer screenings in the second quarter, the survey found 23% of respondents reported a slight decline in testing volumes and 15% saw a moderate decrease, compared to 2019. By the third quarter, 15% of labs had slightly higher volumes than 2019 and 11% reported a moderate increase.