Cancer screenings lag pre-pandemic levels

©angellodeco-stock.adobe.com

Fewer people are getting screened for common cancers compared to pre-pandemic levels, according to results of a new study.

The study of more than 89,000 adults found that cancer screenings continue to trail pre-COVID levels. Other preventive visits have yet to rebound as well. The findings were published February 2 in JAMA Health Forum.

The authors found especially large declines in screenings among Asian, Black and Hispanic adults.

“Given that we found racial and ethnic minority populations received the fewest preventive screenings in 2019, a slower recovery from disruptions in these services during the pandemic may worsen health care disparities in future years,” the authors wrote. “These findings highlight the urgent need for concerted health system, public health, and health policy efforts to increase preventive screenings among eligible U.S. adults.”

Across all racial groups, fewer people were getting screened for breast, colorectal, cervical and prostate cancers, the study says.

Declines vary by racial groups

The authors, from Beth Israel Deaconess Medical Center and Harvard Medical School compared cancer screening levels in 2019 and 2021. While they found a drop in breast cancer screenings among all adults, the largest declines were among Hispanic women, followed by Asian adults.

Fewer women were screened for cervical cancer, with the largest decline coming among Asian adults, according to the study.

In colorectal cancer screenings, researchers found the largest drop was among Black Americans. Asian adults also had a significant decline in screenings. Fewer men were getting screened for prostate cancer in 2021, compared to 2019. The biggest decline in those screenings was seen in Asian adults.

Researchers found sharp drops in cancer screenings early in the pandemic, including a study published in Cancer in March 2022. The declines in screenings prompted some concerns about seeing sicker patients in hospitals and patients showing more advanced cancers that weren’t detected earlier.

Concerns about loss of Medicaid coverage

The authors expressed concern about the prospect of millions of Americans losing Medicaid coverage, now that states have more flexibility to determine eligibility for the program aimed at providing care for those with lower incomes.

Earlier in the pandemic, states were barred from trimming their Medicaid rolls as a condition of getting federal COVID-19 funding, but those restrictions have expired. As a result, more than 16 million Americans have lost Medicaid coverage, according to a KFF analysis.

With Medicaid enrollment down, the study’s authors said it’s possible that fewer people will get screened for cancer or other health issues. “Given that Black and Hispanic adults, as well as some Asian subgroups, are more likely to receive coverage through Medicaid compared with White adults, loss of Medicaid coverage may exacerbate declines in wellness visits and preventive screenings in future years,” the authors wrote.

Researchers also found fewer outpatient wellness visits in 2021 and 2022, compared to 2019, and were also less likely to get preventive screenings for blood pressure, blood glucose levels and cholesterol. Again, Asian Americans had the biggest drops in screenings for risk factors for cardiovascular disease.

Potential factors in declines

The study’s authors say the declines in screenings could be tied to backlogs from earlier in the pandemic, with some patients finding it harder to get appointments. Some may have deferred screenings due to concerns of contracting COVID-19.

They also cited the rise in telehealth use as a possible factor. Whilenoting that telehealth offers increased access and convenience, they said it’s also correlated with declines in preventive care, since virtual visits entail additional laboratory visits for screening tests.

At least in 2021 and 2022, researchers found financial barriers to screenings actually decreased, compared to 2019. But researchers also warned of looming hurdles with fewer Americans being covered by Medicaid.

The study on screenings comes just a few weeks after the American Cancer Society posted new data showing more younger Americans are being diagnosed with cancer.

Health care leaders have hailed some positive steps for cancer screenings. The U.S. Preventive Services Task Force said women should begin getting screened for breast cancer at the age of 40. The Food and Drug Administration has adopted new regulations requiring providers to notify women who get mammograms if they have dense breast tissue, which increases the risk of breast cancer.