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Delayed Cancer Screenings

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On July 17, we published an update to this article that found that the number of cancer screenings has begun to rise, but has not yet reached historical levels.

EHR data show a recent abrupt drop – between 86% and 94% – in preventive cancer screenings performed across the United States, presumably due to access disruptions caused by COVID-19. This study compares the number of screenings for cervical, colon, and breast cancer completed each week in 2020 to the average number of screenings completed during equivalent weeks from 2017–2019. The data set includes 2.7 million patient records from 39 organizations that represent 190 hospitals spanning 23 states.

If the trend continues, the data suggest that many cancer cases could go undiagnosed or be diagnosed at a later stage with a poorer prognosis. Provider organizations that must postpone in-person screenings might wish to explore alternative options to get patients caught up, such as the use of at-home stool-based tests for colon cancer screening or expanding hours for mammography when imaging centers reopen.

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Figure 1. Weekly cancer screening volume vs. time for each type of cancer screening. Colored capsules show the last observed volume.
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2020-07-13_Stacked_Cancer-Screenings_Overlaid-1

An earlier version of Figure 2 accidentally omitted week 1 data for 2019 breast cancer screenings, which caused all subsequent values to be shifted.

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Figure 3. Weekly cancer screening volumes (colored dots) vs. time. Colored line segments indicate fitted estimates from GAM model, combining long term trend, yearly seasonal, and holiday effects; beyond January 19, 2020, they represent forecasts. Lighter colored areas show the uncertainty intervals. Black segments show observed volumes after January 20, 2020.

8 Comments

  1. hi, any interest in publishing these data quickly in a scientific journal with very large readership ? format can be a short paper like a letter

    1. Thank you for your comment. What journals would you recommend?

      Also, researchers and authors are welcome to cite EHRN in their work.

  2. Very interesting topic on the impact of delaying routine screening care during the COVID pandemic.

  3. Great report! A few questions:

    1. Do you have any plans to publish a follow up report to see if screenings stay at this low rate, return to average, or spike above average as states re-open?

    2. Any plans to see if the backlog of screenings leads to increased diagnosis of advanced cancers?

    3. Can you expand to include other commonly screen cancers (e.g. prostate)?

    Looking forward to more of your work.

    1. Great questions. We plan to continue studying screening trends as clinics reopen. We will keep in mind your suggestions about advanced cancer diagnoses and other types of screenings, including prostate.

      1. Hi Ken,

        Is there any interim update for the breast, colon, and cervical cancer screenings?

        Really appreciate the work you and your team do.

  4. This is incredibly valuable–thank you so much! Do you have this data for lung and thyroid cancer as well? Please let me know!

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