As the COVID-19 pandemic took hold in the United States in February and March 2020, observed rates of both lung and breast cancer screenings among Medicare enrollees were 24% and 17%, respectively, below expected rates, rising to -14% and -4% from March 2021 to February 2022, shows a study published late last week in JAMA Network Open.
University of Texas Medical Branch researchers measured observed rates of low-dose computed tomography (LDCT) and mammography from January 2017 to April 2022 and compared them to expected rates for March 2020 to April 2022 (pandemic) using data from January 2016 to February 2020 (prepandemic).
The authors noted that all cancer-screening rates, including mammography, colonoscopy, and LDCT, dropped precipitously early in the pandemic as many healthcare facilities dealt with surges of COVID-19 patients, and patients in general avoided elective visits because of infection fears. As a result, some cancers weren't caught in the early stages, when treatment is often more successful.
Participants in the new study included national yearly samples of more than 3.7 million Medicare fee-for-service enrollees among men and women 55 to 79 years for LDCT and 1.6 million women aged 50 to 74 for mammography.
Targeted actions needed to boost screening
From January 2017 to February 2020, monthly mammography rates were stable, while LDCT rates rose from about 500 per million per month in early 2017 to 1,100 by January 2020. But from March 2020 to February 2020 and March 2021 to February 2022, observed LDCT rates were 24% and 14% below expected rates, and mammography rates were 17% and 4% below expected.
Interference with cancer screening by periodic surges in COVID-19 infections is a continuing problem.
Low income and historically marginalized races were tied to decreased prepandemic cancer screening rates and impaired recovery after the initial surge, which the authors said necessitates more targeted health-related initiatives, including vaccination and initial at-home cancer screening.
"Interference with cancer screening by periodic surges in COVID-19 infections is a continuing problem," the researchers wrote. "Successful interventions to improve screening rates should address pandemic-specific reasons for low screening participation."