‘Missing’ cancer cases: New diagnoses dropped more than 14% early in pandemic
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During the first year of the COVID pandemic, as people were stuck at home and were less likely to visit their primary doctors for preventative care, a study found that new cancer diagnoses were 14.4% lower than in past years, a study has found.
Published in JAMA Network, the study was led by Loma Linda University School of Medicine in California, with participation from American College of Surgeons Cancer Programs in Chicago, Yale School of Medicine, the American Cancer Society and others.
Researchers analyzed data from the National Cancer Database (NCDB) and found that around 200,000 people who had cancer did not receive diagnoses or treatment when the pandemic began in 2020.
Diagnoses dipped to the lowest point in April 2020.
They rebounded somewhat by mid-2020 — but there was not a surge of backlogged cases after that point, according to a press release from Loma Linda University Health summarizing the findings.
‘Missing cases’ still haven’t materialized
“Our findings revealed what we all feared — that many cancer cases didn’t come in during the early pandemic and didn’t catch up during that first year, meaning those ‘missing cases’ are out there somewhere,” said Dr. Sharon Lum, chair of the Loma Linda University Health Department of Surgery and the study’s principal investigator, in the press release.
During the first year of the pandemic, as people were confined to their homes and were less likely to visit their primary doctors for preventative care, new cancer diagnoses were 14.4% lower than in past years. (iStock)
“Our concern is that these patients may show up later, potentially at more advanced disease stages,” she added.
The NCBD was created by the American Cancer Society and the American College of Surgeons Commission on Cancer.
It contains over 70% of all U.S. cancer cases and is used by almost 1,500 medical programs in the country, the press release stated.
Around 200,000 people with cancer did not receive diagnoses or treatment when the pandemic began.
NCBD data is typically pretty stable; this is the first time since 1989 that the cases have fluctuated from the regular patterns, Lum noted.
In addition to seeing the total number of cases decrease, the study authors saw fewer numbers of early-stage diagnoses, indicating that people were not learning about their disease as soon as they might have done pre-pandemic.
“Our findings revealed what we all feared — that many cancer cases didn’t come in during the early pandemic and didn’t catch up during that first year, meaning those ‘missing cases’ are out there somewhere,” said the author of a new study. (iStock)
“We are alerting the cancer community to look carefully at their institutional data to see how what happened in 2020 could have affected what their reports looked like,” Lum said in the press release.
“Fear was a factor — even when health facilities were back up and running.”
“Database users should consider what activities took place in their local and institutional environment that first year of the pandemic.”
Fox News Digital reached out to the study researchers at Loma Linda for comment.
Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said the findings reflect what he has seen on the front lines (he was not involved in the study).
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“Fear was a factor — even when health facilities were back up and running, and even after infection protocols were in place,” said Dr. Siegel.
‘Facing a ticking time bomb’
Dr. Michael Zinner, chief executive officer and executive medical director of Miami Cancer Institute, part of Baptist Health in Miami, Florida, was not involved in the study but said he has seen similar patterns at his own medical practice.
“We have seen more advanced cancer cases post-pandemic, rather than pre-pandemic, specifically within colorectal, lung and breast cancer,” he told Fox News Digital in an email.
“Early diagnosis depends on screening — and screening depends on patients being seen.”
Zinner expressed concern about having an excess number of diagnoses in the years following the pandemic, as patients and providers potentially scramble to catch up with the backlog.
“Overall, when we consider delayed screening due the pandemic, I think we are facing a ticking time bomb with a 10-year fuse,” he said.
Delayed screenings and later-stage diagnoses are thought to have contributed to the current cancer drug shortage. (iStock)
“Early diagnosis depends on screening — and screening depends on patients being seen or going to their physicians’ office for their annual checkup,” said Zinner.
“Since all of that was delayed due to the pandemic, the cascade was inevitable.”
Zinner added, “If the pandemic taught us anything, it’s that individuals should prioritize their overall health and ensure they are being proactive,” he added.
The delayed screenings and later-stage diagnoses have been one factor contributing to the current cancer drug shortage, Dr. Siegel noted.
“This is because cancer is being diagnosed at later stages, which means that more aggressive treatments including immunotherapy and chemo are involved,” he explained.
Levels varied by location
The study authors noted that the decreases in cancer cases during the early pandemic weren’t as dramatic in certain locations.
“The differences in expected versus observed cases didn’t happen in the same way across the board for every single cancer site,” Lum said in the press release.
“There were high levels of variation between different diseases and individual cancer sites.”
“The key to beating cancer is, primarily, the ability to catch it early when it is most treatable,” one doctor told Fox News Digital. (Icahn School of Medicine at Mount Sinai/Tisch Cancer Center)
Dr. John J. Montville, executive director of oncology services at Mercy Health — Lourdes Hospital in Paducah, Kentucky, noted that while nationally, many areas saw massive decreases in normal cancer screenings, his facility was one of the exceptions.
Montville was not involved in Loma Linda’s study.
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“For the area we serve in western Kentucky, we actually conducted a study to look at our cancer screening rates during the pandemic via our Cancer Committee and with data from the Commission on Cancer,” he told Fox News Digital.
“The key to beating cancer is, primarily, the ability to catch it early when it is most treatable.”
“We found that our regional decreases in screening were far lower than national averages — so, as such, we are also seeing fewer decreases in new cancer cases diagnosed.”
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Nationally, however, Montville shares the concern about seeing more later-stage cancers being diagnosed due to delayed screenings.
“The key to beating cancer is, primarily, the ability to catch it early when it is most treatable,” he said. “When cases are being caught later on, they will be later stage and more advanced cancers, which have higher mortality [rates] and are harder to treat effectively.
