During the COVID-19 pandemic, physicians warned about the ramifications of delayed or skipped cancer screenings. Now researchers at Baptist Health Miami Cancer Institute have quantified what was once conjecture. There has been a significant increase in the number of cancers diagnosed at a more advanced stage in the months after the pandemic compared to before it.
During and following the pandemic, in-person cancer screenings were either unavailable or had limited appointments, and many patients, out of fear or other problems, postponed their tests. The study, titled “The Impact of COVID-19 on Patients Diagnosed with Melanoma, Breast, and Colorectal Cancer,” was published recently in the American Journal of Surgery.
Geoffrey Young, M.D
“Our initial discussions about what would happen when people couldn’t get colonoscopies or mammograms were all theoretical. We wanted to see if our theories would bear out over an extended time,” says Geoffrey Young, M.D., chief of head and neck surgery at Miami Cancer Institute, and the study’s corresponding and senior author.
Similar studies conducted by other organizations have primarily focused on one specific cancer or cancer screening numbers and diagnoses in the initial months of the pandemic. But the Institute study went further, looking at more than 4,000 patients diagnosed with breast cancer, colorectal cancer or melanoma at Miami Cancer Institute from May of 2018 through January of 2022. This covered the initial outbreak as well as the Delta and Omicron waves.
It revealed a significant jump in stage T2 cases of breast cancer and an increase in stage T4 diagnoses for colorectal cancer. In the 12-month post-pandemic timeframe, melanoma clinical stage T1 increased and colorectal cancer clinical stage N2 increased.
“Early detection is so important,” Dr. Young says. “Early-stage cancer is less likely to spread. As it advances, treatment options may be more limited and the likelihood of it being untreatable is greater.”
Joining Dr. Young in the research was a team of Institute informatics experts and statisticians. In addition, the study was a collaboration with Florida International University’s Herbert Wertheim College of Medicine, where Dr. Young is vice chair of the Department of Surgery. Baptist Health and FIU announced last spring the formation of a comprehensive alliance that will enhance the university’s medical school, provide training for new physicians and other health professionals, and expand clinical research. The first author of the study, Danielle Hanuschak, will graduate from the medical school in 2024.
Dr. Young is hopeful that the findings will help spur other long-term studies and bring about changes to avoid similar problems in the future. He urges physicians to continue exploring opportunities to develop and use alternate screening methods, including less-invasive tests.
“The study reinforces the importance of screening and early detection,” he says. “And it shows that when access to care is limited, whether it be because of a global health crisis, a pandemic or a war in a region, there might not just be an immediate window of repercussion, there might be long-term repercussions.”