NEW YORK – A year after COVID-19 pandemic restrictions forced health systems to begin seeing patients virtually, newly identified cancer diagnoses did not normalize to pre-pandemic levels, according to a study from Quest Diagnostics.
The study, published in JAMA Network Open this week, looked at newly identified cancers across eight tumor types: prostate, breast, colorectal, lung, pancreatic, cervical, gastric, and esophageal. The researchers analyzed data from more than 799,000 patients, about 453,000 from before March 2020 and 345,000 from March 2020 through March 2021. They also broke the data into three "pandemic periods."
Pandemic period 1, from March 2020 to May 2020, was when most restrictions were in effect and people were urged to delay medical care while hospitals were overwhelmed with the first wave of COVID-19 patients. During that time, the mean monthly number of new cancer diagnoses fell nearly 30 percent, from 32,407 to 22,748, for the eight cancers combined.
In the second pandemic period, from June 2020 to October 2020, the drop was less significant and nearly at the same level as pre-pandemic diagnoses for all cancers except prostate. During that time, the mean monthly number of patients newly diagnosed with one of the eight cancers was 29,304, a 9.6 percent decrease compared to pre-pandemic levels.
The third period, from November 2020 to March 2021, saw a 19 percent decrease in monthly new diagnoses compared to the pre-pandemic data from January 2019 to February 2020.
While the study did not examine data for patients undergoing genomic profiling or receiving targeted therapy, lead author Harvey Kaufman, senior medical director and head of the Health Trends research program for Quest Diagnostics, noted that those practices may have also been impacted.
"Due to the reduction in new cancer cases identified, some patients will present at more advanced stages and require more aggressive therapies," Kaufman said in an emailed statement. "We strongly suspect that given delays and deferrals in cancer diagnoses, that many other healthcare services were impacted too. Given the gravity of cancer diagnoses, we suspect that personalized care and genomic testing was impacted, but less than other types of testing and healthcare services."
The researchers noted that because diagnoses have not returned to pre-pandemic levels, many patients with cancer are likely undiagnosed, which may lead to more patients with advanced cancer in the future. Kaufman suggested that patients are still concerned about engaging with the healthcare system while the pandemic is ongoing.
"Our findings call for planning to address the consequences of delayed diagnoses, including strengthened clinical telehealth offerings supporting patient-clinician interactions," the researchers wrote.