Cancer Screening and Detection Remain Below Prepandemic Levels

At the end of 2021, population-based screening and diagnosis remained below prepandemic levels for breast, cervical, and colorectal cancers, according to a research letter published online Nov. 17 in JAMA Oncology.

Allison H. Oakes, Ph.D., from Trilliant Health in Brentwood, Tennessee, and colleagues used the Trilliant Health all-payer claims and encounters database (306 million unique individuals; 2017 through 2021) to examine patterns in breast, cervical, and colorectal cancer screening and diagnosis before and after the pandemic.

The researchers found that for breast cancer, the median quarterly rate of prepandemic screening mammography was 8,216 per 100,000 beneficiaries, which declined to 4,951 in quarter (Q) 2 of 2020 — a 40 percent decrease — but rebounded to prepandemic levels by Q3 and Q4 of 2020 and then declined again to a median rate of 7,374 per 100,000 beneficiaries in 2021. Quarterly deficits ranged from 6 to 17 percent. A similar trend was seen for cervical cancer, with a median quarterly rate of prepandemic screening of 5,602 per 100,000 beneficiaries, which fell to 3,563 in Q2 of 2020 — a 36 percent decline. Cervical cancer screening rebounded toward the prepandemic median by Q3 of 2020, then progressively declined from 4,853 in Q4 of 2020 to 4,246 in Q4 of 2021. Colorectal cancer screening, too, decreased from a prepandemic median of 3,162 per 100,000 beneficiaries to 1,746 in Q2 of 2020 — a 45 percent difference. From Q3 of 2020 to Q4 of 2021, quarterly colorectal cancer screening ranged from 82 to 90 percent of the prepandemic median. Prevalence rates declined by 6.0 to 7.1 percent between 2019 and 2020 and an additional 4.8 to 6.1 percent between 2020 and 2021, consistent with declines in screening.

“The pattern we found suggests a substantial proportion of forgone care through 2021,” the authors write.

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