Keep Screening A Priority
- A new study shows the rates of cancer screening and cancer diagnoses in the U.S. are still down. Fewer people are getting mammograms and colonoscopies.
- Researchers believe this is due to the lingering effect of the pandemic. even with a rebound in the number of people going back to the doctor, some people are still fearful of going to the doctor.
- Experts stress that medical care can be obtained safely with proper vaccination, masking, hand washing, and careful attention to the known COVID-19 protocols
A new study published in the respected JAMA ONCOLOGY medical journal found screenings for certain cancer types have not returned to the pre-pandemic levels, which is concerning, especially for those at a higher risk of developing such cancers. The researchers looked only at ovarian, colon, and breast cancer, which misses a huge category of cancers, namely lung.Read More
The study found, after analyzing calendar year quarterly medical claims from January 2017 to December 2021, in 2020 the average rate of screening for breast cancer fell 40%, cervical cancer screening went down 36%, and colorectal screening went down 45%.
The cancer prevalence rates, or rate of cancer diagnoses they found were consistent with the reductions in screenings. Prevalence rates declined by 6.0% to 7.1% between 2019 and 2020 and an additional 4.8% to 6.1% between 2020 and 2021, according to the study.
Dr. Otis Brawley, a medical oncologist and epidemiologist at John Hopkins University, previously told SurvivorNet there will be a “clearing of the prevalences.”
“What we’ve seen in the past is when we have a long period of time where there’s not a screening test or screening being done and then all of the sudden you start doing that screening again, we’re going to have what’s called the clearing out of the prevalences,” said Dr. Brawley. “We’re going to have an increase in the number of breast cancers in the first couple of months after we start mammography screening again…I’m fairly comfortable that that’s going to happen in colorectal cancer and it’s also going to happen in breast cancer. Prostate cancer is a little bit harder to predict. Lung cancer where we have screening going on now is also a little harder to predict.”
Brawley predicts this will occur in colorectal cancer and breast cancer screening.
“Prostate cancer is a little bit harder to predict. Lung cancer where we have screening going on now is also a little harder to predict,” he said.
Staying Safe At The Doctors
While the coronavirus is still very much around there are safe ways to go to the doctors. Here are some tips that you can follow to help ensure safety:
- Try to book appointments early in the morning to avoid crowds, as many people will be working. Not only will it be less crowded but the wait may be shorter.
- Protect yourself and others by wearing a mask and gloves to your screening appointment.
- Wash your hands when you enter and leave the hospital and use hand sanitizer while at your visit.
- Practice social distancing and stay six feet away from other patients.
- If you have any risk factors, request priority scheduling when you call to make your appointment.
- Make sure to speak up when booking appointments, especially if you are told that there will be delays.
- If you have any worrisome symptoms — don’t wait and call your doctor today.
- Keep track of your cancer screening history and make sure you are up-to-date.
One other protection is getting the Covid vaccine if you haven’t or a booster if you’re due for one.
Some treatments for cancer, such as chemotherapy, blunt the immune system, meaning a person with cancer could be more likely to contract Covid-19. People battling cancer should get the Covid-19 vaccine too if they’re eligible and able.
Dr. Vincent Rajkumar, a doctor from the Mayo Clinic, spoke previously about the importance of getting vaccinated if you have cancer. He also assures people of vaccine safety, saying, “It is very safe and there is no increased risk to you just because you have cancer.”
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“As long as you are feeling well, just go ahead with the vaccine whenever it’s offered to you. Sometimes even on the same day if you are going to the clinic to get a small dose of chemotherapy and they’re giving the vaccine, just get it, there’s really no major problem,” Dr. Rajkumar said. “The only people for whom we are saying to delay by a month or two are patients who have had a stem cell transplant because we have wiped out (the patients’ immune system). And so you want to wait until some of the recovery happens so when you give the vaccine, they have an immune response.”
Many lung cancers are found incidentally on tests done for other reasons. Right now, screening is recommended for people who meet all of the following criteria:
- You are or were a heavy smoker (who smoked a minimum of 20 pack years)
- You currently smoke or quit within the last 15 years
- You are between 50 and 80 years old
Talk to your doctor about getting a low-dose CT scan (LDCT) if you are at high risk because you were or are a heavy smoker and you’re between the ages of 50 and 80. Unlike diagnostic CT scans, LDCT scans use a smaller amount of radiation. Also get evaluated if you have symptoms like a cough that doesn’t go away or chest pain.
Women between the ages of 45 and 54 should have annual mammograms done. But there is some disagreement among doctors as to whether mammograms are beneficial for women between the ages of 40 and 45. This is an option you should, of course, discuss with your own doctor.
If you’re older than 55, you can choose to continue your annual mammograms or opt to have one every two years, says Dr. Connie Lehman, Chief of the Breast Imaging Clinic at Massachusetts General Hospital and professor of Radiology at Harvard Medical School.
And if you fit into the high-risk category, meaning you have a first-degree relative who has had breast cancer, have the BRCA1 or BRCA2 gene mutation, or had radiation to the chest area when you were young, Dr. Lehman says you should start yearly mammogram screening as early as age 30.
For prostate cancer, screening saves lives, family history can matter a lot, but you should also understand that leading doctors in the field debate when men actually need screening.
“It’s estimated that five to ten percent of prostate cancer can run in families,” says Dr. James Brooks, Chief of Urologic Oncology at Stanford Medicine.
If you have a close relative who has had prostate cancer, such as a brother or father, the risk you will develop prostate cancer in your lifetime is almost double. Men with a family history tend to get prostate cancer at a younger age, so Dr. Brooks recommends getting screened–in some cases as early as age 45–by having a PSA test, or protein-specific antigen, which is a simple blood test.
When it comes to colon cancer prevention, screening is extremely important. In fact, according to colorectal surgeon Dr. Heather Yeo, most colon cancers can actually be prevented if people are regularly screened.
The best and most complete way of screening is a colonoscopy every 10 years. In general, you should get your first colonoscopy at age 45 but the guidelines differ depending on your risk category.
If you have a close relative who had colon cancer, a rule of thumb is to get screened 10 years prior to their age of diagnosis to make sure any growths or cancers are caught early. If you have several family members who had colon cancer, or family members who got it at a young age (less than 50 years old), it may be necessary to undergo genetic screening. And if you have a lot of polyps on your colonoscopy or if you yourself have had colon cancer previously, you will need a colonoscopy every 3 to 5 years.
One other screening type is genetic testing of your tumor. This is available across the country and available even if you’re not living near an academic hospital.
A piece of your tumor can be sent to a hospital that does the sequencing, so having access to a genetic test of your cancer is not restricted by where you live. Genetic sequencing is valuable for patients diagnosed with metastatic cancer as it allows oncologists to understand the mutations that may have evolved in the tumor.
Contributing: SurvivorNet Staff