The COVID-19 pandemic has decreased the use of ordinary health care such as routine medical exams, leading to cancers being diagnosed at later stages, researchers from UC San Diego reported Feb. 15.
Researchers at Moores Cancer Center at UCSD Health surveyed and compared early- and late-stage breast and colorectal cancer diagnoses in patients in pre-pandemic 2019 and in 2020, the first full year of the ongoing health crisis. The findings were published in JAMA Network Open.
Though the total numbers of diagnoses were roughly similar in 2019 and 2020, there were significant differences in the percentages of Stage 1 diagnoses of breast cancer compared with Stage 4 diagnoses. The difficulty of treatment or cure increases with each higher stage number.
In 2019, for example, 63.9 percent of diagnosed patients had Stage 1 of the disease, compared with 51.3 percent in 2020. Conversely, 1.9 percent of patients were diagnosed with Stage 4 breast cancer in 2019, compared with 6.2 percent in 2020.
“Concerns and consequences caused by the pandemic have prompted at least some patients to delay routine health care, such as screenings or doctor visits, that might have revealed early-stage diagnoses.”
Dr. Jade Zifei Zhou
Similar trends were seen among colorectal cancer patients, though somewhat less than with breast cancer patients.
“For breast cancer at least, these data demonstrate a continuing trend,” said study first author Dr. Jade Zifei Zhou, a clinical fellow in hematology and oncology at the UCSD School of Medicine. “They suggest that concerns and consequences caused by the pandemic have prompted at least some patients to delay routine health care, such as screenings or doctor visits, that might have revealed early-stage diagnoses.”
Researchers acknowledged several limitations to the study, including reflecting data from a single center and not assessing disease causality. Second, the number of patients with colorectal cancer was relatively small. Also, the study included people seeking second opinions, who may or may not have undergone previous treatment.
“Cancer screening is crucial to the early detection of cancer, particularly in colorectal and breast cancers, where many early-stage cancers can be treated and cured,” said senior author Dr. Kathryn Ann Gold, a medical oncologist at Moores Cancer Center and a professor in the UCSD School of Medicine.
“There is increasing concern that one effect of the pandemic is the growing number of patients who are being diagnosed for the first time with late, incurable stages,” Gold said. “Patients who have delayed preventive care during the pandemic should be encouraged to discuss age-appropriate cancer screening with their primary care providers as soon as possible.” ◆