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Cancer Screening, Diagnoses Down During Early Pandemic

FRIDAY, Jan. 22, 2021 -- There was a significant decrease in the number of patients undergoing screening tests for cancer and in the number of resulting diagnoses of cancerous and precancerous lesions during the first peak of the COVID-19 pandemic, according to a research letter published online Jan. 14 in JAMA Oncology.

Ziad Bakouny, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues assessed the number of patients undergoing cancer screening tests (low-dose computed tomography [CT], Papanicolaou [Pap] test, colonoscopy, prostate-specific antigen screening, or mammography) and the number of ensuing cancer diagnoses during the COVID-19 pandemic. The analysis included a comparison between the first peak of the pandemic (March 2 to June 2, 2020) and three control periods (Dec. 1, 2019, to March 2, 2020; March 2 to June 2, 2019; and June 3 to Sept. 3, 2020).

The researchers found that 15,453 patients underwent screening during March 2 to June 2, 2020, resulting in 1,985 ensuing diagnoses. Percentage decreases in screening were observed across all screening tests compared with all three control periods (range: –60 to –82 percent). Corresponding percentage decreases in diagnoses resulting from the cancer screening tests were also observed (range: –19 to –78 percent). Except for low-dose CT scans, the percentage of positivity of screening tests appeared to be higher during the initial pandemic period versus the control periods. It was estimated that 1,438 cancerous and precancerous lesion diagnoses (1,985 versus an anticipated 3,423 diagnoses) were "missed" during the initial pandemic period.

"The percentage of screening tests leading to a diagnosis of a cancerous or precancerous lesion was higher during the primary pandemic period, which may reflect the prioritization of high-risk patients for cancer screening during the pandemic," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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