Cancer Screening During the COVID-19 Pandemic: A Systematic Review and Meta-analysis

Mayo, MacKenzie; Potugari, Bindu; Bzeih, Rami; Scheidel, Caleb; Carrera, Carolyn Anne; Shellenberger, Richard A.

doi:10.1016/j.mayocpiqo.2021.10.003

Cited by 78 publications

(77 citation statements)

References 27 publications

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“…4 Due to CDC recommendations to postpone non-urgent medical care along with general public hesitation to enter medical settings, there has been a precipitous drop in cancer screenings throughout the pandemic. 3 , 5 …”

Section: Introductionmentioning

confidence: 99%

“…7 A recent meta-analysis reported significant decreases in both breast and colon cancer screening compared with pre-pandemic levels. 5 The late detection of these aggressive malignancies may result in worse prognoses and sub-optimal treatment options. 4 For example, if detection of colorectal cancer is delayed, cancer may spread and severely limit treatment options and negatively impact patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies investigating the impact of the COVID-19 pandemic on cancer screening, diagnoses, and mortality have been limited in either their scope or population scale. 5 , 8 , 9 For example, a recent meta-analysis investigating changes in cancer screening revealed lower rates compared to the pre-pandemic reference year but were limited to small patient registries used to collect the original data. 5 Similarly, other studies investigating new diagnoses or mortality during the pandemic were limited to available EMR records from individual health networks or analyzed trends in only one type of cancer.…”

Section: Introductionmentioning

confidence: 99%

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Trends of Cancer Screenings, Diagnoses, and Mortalities During the COVID-19 Pandemic: Implications and Future Recommendations

Concepcion

Yeager

Alfaro

et al. 2022

The American Surgeon™

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Introduction The impact of the COVID-19 pandemic on cancer screenings and care has yet to be determined. This study aims to investigate the screening, diagnosis, and mortality rates of the top five leading causes of cancer mortality in the United States from 2019 to 2021 to determine the potential impact of the COVID-19 pandemic on cancer care. Methods A retrospective cohort study investigating the impact of the COVID-19 pandemic on screening, diagnoses, and mortality rates of the top five leading causes of cancer death (lung/bronchus, colon/rectum, pancreas, breast, and prostate), as determined by the National Institute of Health (NIH) utilizing The United States Healthcare Cost Institute and American Cancer Society databases from 2019 to 2021. Results Screenings decreased by 24.98% for colorectal cancer and 16.01% for breast cancer from 2019 to 2020. Compared to 2019, there was a .29% increase in lung/bronchus, 19.72% increase in colorectal, 1.46% increase in pancreatic, 2.89% increase in breast, and 144.50% increase in prostate cancer diagnoses in 2020 (all P < .01). There was an increase in the total number of deaths from colorectal, pancreatic, breast, and prostate cancers from 2019 to 2021. Conclusion There was a decrease in the screening rates for breast and colorectal cancer, along with an increase in the estimated incidence and mortality rate among the five leading causes of cancer deaths from 2019 to 2021. The findings suggest that the COVID-19 pandemic is associated with impaired cancer screening, diagnosis, and care, and further emphasizes the need for proactive screening and follow-up to prevent subsequent cancer morbidity and mortality.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trends of Cancer Screenings, Diagnoses, and Mortalities During the COVID-19 Pandemic: Implications and Future Recommendations

Concepcion

Yeager

Alfaro

et al. 2022

The American Surgeon™

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“…Cancer patients are susceptible to SARS-CoV-2 infection due to biological status, comorbidities, cancer type, and therapeutic management. COVID-19 has made additional impacts on cancer care, including cancer-screening programs and the initiation of treatment [ 13 , 29 ]. Additionally, SARS-CoV-2 infection can also impair an unknown proportion of fertility in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…During the COVID-19 pandemic, cancer-screening programs were deferred, which would mean that incipient cancers were undiagnosed, leading to an increase in cancer morbidity and mortality in the coming years [ 29 , 30 , 31 ]. Further assessment is needed to evaluate the consequences of providing less or delayed treatment initiation, particularly for newly diagnosed cancers [ 26 ].…”

Section: Cancer Patients and Covid-19mentioning

confidence: 99%

Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields

Varlas

Borş

Pop

et al. 2022

JCM

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Background: COVID-19 infection has dominated our lives and left its mark on it. The impact on fertility is major, and the long-term consequences may be disastrous. When we talk about oncofertility, we are talking about those patients worried about the delay in receiving medical services (possible cancelation of surgery, decreased availability of medical services, reorientation of medical resources) due to COVID-19. Finally, patients’ worsening biological and reproductive statuses, associated with high levels of anxiety and depression, are closely related to social restrictions, economic impact, reorientation of medical resources, health policies, and fears of SARS-CoV-2 infection. Aim: We reviewed the current literature on fertility during the COVID-19 pandemic and its effect on cancer patients. Specifically, how cancer treatment can affect fertility, the options to maintain fertility potential, and the recovery options available after treatment are increasingly common concerns among cancer patients. Methods: A systematic literature search was conducted using two main central databases (PubMed®/MEDLINE, and Web of Science) to identify relevant studies using keywords SARS-CoV-2, COVID-19, oncofertility, young cancer patient, cryopreservation, assisted reproductive techniques (ART), psychosocial, telemedicine. Results: In the present study, 45 papers were included, centered on the six main topics related to COVID-19. Conclusions: Fertility preservation (FP) should not be discontinued, but instead practiced with adjustments to prevent SARS-CoV-2 transmission. The increased risk of SARS-CoV-2 infection in cancer patients requires screening for COVID-19 before FP procedures, among both patients and medical staff in FP clinics, to prevent infection that would rapidly worsen the condition and lead to severe complications.

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Cancer Screening Disparities Before and After the COVID-19 Pandemic

Lofters,

Wu,

Frymire

et al. 2023

JAMA Netw Open

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ImportanceBreast, cervical, and colorectal cancer–screening disparities existed prior to the COVID-19 pandemic, and it is unclear whether those have changed since the pandemic.ObjectiveTo assess whether changes in screening from before the pandemic to after the pandemic varied for immigrants and for people with limited income.Design, Setting, and ParticipantsThis population-based, cross-sectional study, using data from March 31, 2019, and March 31, 2022, included adults in Ontario, Canada, the country’s most populous province, with more than 14 million people, almost 30% of whom are immigrants. At both dates, the screening-eligible population for each cancer type was assessed.ExposuresNeighborhood income quintile, immigrant status, and primary care model type.Main Outcomes and MeasuresFor each cancer screening type, the main outcome was whether the screening-eligible population was up to date on screening (a binary outcome) on March 31, 2019, and March 31, 2022. Up to date on screening was defined as having had a mammogram in the previous 2 years, a Papanicolaou test in the previous 3 years, and a fecal test in the previous 2 years or a flexible sigmoidoscopy or colonoscopy in the previous 10 years.ResultsThe overall cohort on March 31, 2019, included 1 666 943 women (100%) eligible for breast screening (mean [SD] age, 59.9 [5.1] years), 3 918 225 women (100%) eligible for cervical screening (mean [SD] age, 45.5 [13.2] years), and 3 886 345 people eligible for colorectal screening (51.4% female; mean [SD] age, 61.8 [6.4] years). The proportion of people up to date on screening in Ontario decreased for breast, cervical, and colorectal cancers, with the largest decrease for breast screening (from 61.1% before the pandemic to 51.7% [difference, −9.4 percentage points]) and the smallest decrease for colorectal screening (from 65.9% to 62.0% [difference, −3.9 percentage points]). Preexisting disparities in screening for people living in low-income neighborhoods and for immigrants widened for breast screening and colorectal screening. For breast screening, compared with income quintile 5 (highest), the β estimate for income quintile 1 (lowest) was −1.16 (95% CI, −1.56 to −0.77); for immigrant vs nonimmigrant, the β estimate was −1.51 (95% CI, −1.84 to −1.18). For colorectal screening, compared with income quintile 5, the β estimate for quntile 1 was −1.29 (95% CI, 16 −1.53 to −1.06); for immigrant vs nonimmigrant, the β estimate was −1.41 (95% CI, −1.61 to −1.21). The lowest screening rates both before and after the COVID-19 pandemic were for people who had no identifiable family physician (eg, moving from 11.3% in 2019 to 9.6% in 2022 up to date for breast cancer). In addition, patients of interprofessional, team-based primary care models had significantly smaller reductions in β estimates for breast (2.14 [95% CI, 1.79 to 2.49]), cervical (1.72 [95% CI, 1.46 to 1.98]), and colorectal (2.15 [95% CI, 1.95 to 2.36]) postpandemic screening and higher uptake of screening in general compared with patients of other primary care models.Conclusions and RelevanceIn this cross-sectional study in Ontario that included 2 time points, widening disparities before compared with after the COVID-19 pandemic were found for breast cancer and colorectal cancer screening based on income and immigrant status, but smaller declines in disparities were found among patients of interprofessional, team-based primary care models than among their counterparts. Policy makers should investigate the value of prioritizing and investing in improving access to team-based primary care for people who are immigrants and/or with limited income.

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Cancer Screening During the COVID-19 Pandemic: A Systematic Review and Meta-analysis

Cited by 78 publications

References 27 publications

Trends of Cancer Screenings, Diagnoses, and Mortalities During the COVID-19 Pandemic: Implications and Future Recommendations

Trends of Cancer Screenings, Diagnoses, and Mortalities During the COVID-19 Pandemic: Implications and Future Recommendations

Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields

Cancer Screening Disparities Before and After the COVID-19 Pandemic

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