Cancer screenings and other preventive care declined in Massachusetts during the first year of the COVID pandemic, raising concerns that cancers and other conditions may be going undetected until they’re more advanced and harder to treat.
An analysis from the nonprofit group Massachusetts Health Quality Partners found that tests such as colonoscopies and mammograms dropped in 2020, compared with 2018. The group said 35,000 fewer people were screened for colon cancer, 4,500 fewer women were screened for breast cancer, and 11,700 fewer women were screened for cervical cancer.
In addition, thousands of people with diabetes also missed blood tests and eye exams that can help control their chronic condition.
Massachusetts Health Quality Partners analyzed data for hundreds of thousands of people in the state covered by five commercial health plans. The data do not reflect low-income residents with Medicaid coverage or seniors on Medicare, but they provide a comprehensive look at the impact of the early part of the pandemic on preventive care.
Barbra Rabson, president of Massachusetts Health Quality Partners, called the numbers alarming and said they confirm what health care providers already feared.
“Cancer screenings are going down,” she said. “The number of people that are getting screened is really significantly lower than it should be, and so we want to draw attention to that.”
The drop-off in preventive care began at the start of the pandemic when clinics and hospitals halted most non-urgent medical care, so they could respond to COVID. But when regular medical visits resumed, many patients were reluctant to come back because of fears about COVID. Doctors say they’re concerned that some patients are only now returning to appointments — after more than two years of the pandemic.
Dr. Julita Mir is chief medical officer of Community Care Collaborative, a group of community health centers, and treats patients at DotHouse Health in Dorchester. She saw an elderly patient last week who had avoided the doctor’s office for two and a half years and finally returned with a “laundry list” of things he needed addressed, she said.
Mir said doctors are trying to keep up with the demand from patients who now need care, but staffing shortages are making this more challenging. She said patients who missed their screenings should be able to find appointments now — though they may have to wait longer or travel farther than they want.
“We probably will take the rest of this year, if COVID permits, to catch up on that backlog,” she said. “But it’s hard to predict.”
Dr. Barbara Spivak, an internist who leads the Mount Auburn Cambridge Independent Practice Association, said cancer screenings are critical for identifying early-stage issues, such as polyps that can be removed before cancer develops.
“The goal is to prevent,” she said.
Spivak said she’s equally concerned that people with diabetes and high blood pressure may be getting sicker because they have missed their regular appointments.
“That has other consequences for their kidneys, vascular disease. For diabetics, it could affect their eyes,” she said.
“It isn’t just cancer screening that we worry about, it’s making sure people who have chronic illnesses are appropriately followed,” she said.