Abstract

The USPSTF and ACS recommend screening for breast, cervical, colorectal, and lung cancers. Rates of cancer screening, diagnosis, and treatment decreased significantly in the US and other developed nations during the height of the COVID-19 pandemic and lockdown (April 2020) and have since recovered, although not to baseline levels in many cases. For breast cancer, the USPSTF recommends biennial screening with mammography for women aged 50–74, while the ACS recommends annual screening for women aged 45–54, who may transition to biennial after 55. Minority and rural populations have lower rates of screening and lower utilization of DBT, which offers superior sensitivity and specificity. Among 20 US health networks in April 2020, mammography rates were down 89.2% and new breast cancer diagnoses down by 50.5%. For cervical cancer, the USPSTF recommends cervical cytology every three years for women 21–65, or cytology+hrHPV co-testing every five years for women aged 30–65. Cervical cancer screening rates declined by 87% in April 2020 and recovered to a 40% decline by June 2020, with American Indians and Asians most severely affected. For colorectal cancer (CRC), the USPSTF and ACS recommend screening for ages 45–75, recently lowered from a starting age of 50. Most commonly-used modalities include annual FIT testing, FIT+DNA testing every three years, and colonoscopy every ten years, with shorter repeat if polyps are found. In the US, CRC screenings were down by 79–84.5% in April 2020 across several retrospective studies. Patient encounters for CRC were down by 39.9%, and a UK-based model predicted that 5-year-survival would decrease by 6.4%. The USPSTF recommends screening low dose CT scans (LDCTs) for ages 50–80 with a >20 pack-year smoking history who have smoked within the past 15 years. In April 2020, screening LDCTs fell by 72–78% at one US institution and lung cancer diagnoses were down 39.1%.

Highlights

  • Cancer screening in the US is an integral part of primary care and secondary prevention estimated to save hundreds of thousands of lives

  • Breast [1], cervical, colorectal [2], and lung cancer [3] each have evidence-based screening modalities that are recommended by the US Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) for patients of certain ages and risks, while prostate cancer screening currently holds an equivocal recommendation [4]

  • In a study of 20 US institutions published in JCO Clinical Cancer Informatics, colorectal cancer (CRC) screening rates decreased by roughly 38.4% in March 2020 and 84.5% in April 2020 as compared to the same intervals in 2019

Read more

Summary

Introduction

Cancer screening in the US is an integral part of primary care and secondary prevention estimated to save hundreds of thousands of lives. Breast [1], cervical, colorectal [2], and lung cancer [3] each have evidence-based screening modalities that are recommended by the US Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) for patients of certain ages and risks, while prostate cancer screening currently holds an equivocal recommendation [4]. While screening and diagnosis rates are recovering, these missed opportunities for secondary prevention are projected to depress survival statistics for certain tumors for years to come [6], especially among vulnerable populations like Black, Hispanic, and rural Americans who have lower historic screening rates [7]. 2 of 10 2 of 10 populations like Black, Hispanic, and rural Americans who have lower historic screening rTathees p[7u]r.pTohsee pouf rthpiossaerotifcltehis taorteicxlaemisinteo tehxealmatienset trheceolmatmesetnrdecaotimonmseannddatieocnhsnoalnodgiteeschfo-r ncoalnocgeiersscfroerencaingce, rdesmcroeegnrainpgh,icddemispoagriatpiehsiicndsicsrpeaerniitniegs riantessc,raenednitnhge reastteims, aatned itmhepaecstio-f mCaOteVdIDim-1p9aoctnosfcCreOenViInDg-,1d9iaognnsocsriese, nainndg,mdoiartganliotysis(F, aignudrem1o)r. 22. .BBrereaaststCCaanncecerr Breast cancer (BC) is the most common neoplasm (besides skin cancer) and the second leadBinregacsatucsaenocefrca(BnCce)risdethatehmamosot ncgomwmomonenneinopthlaesUmS([b8e]s.ides skin cancer) and the second leading cause of cancer death among women in the US [8]

Current Breast Cancer Screening
Impact of COVID-19 on Breast Cancer Screening
Current Colorectal Cancer Screening Recommendations
Impact of COVID-19 on Colorectal Cancer Screening
Current Lung Cancer Screening Recommendations
Impact of COVID-19 on Lung Cancer Screening
Other Cancers
Limitations
Findings
Conclusions
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call