As COVID-19 cases continue to climb and the pandemic’s effect on health care becomes more pronounced, a leading cancer expert says the long reach of the virus could add a 1% increase in deaths, roughly 4,500, from colorectal cancer over the next decade—deaths that wouldn’t have occurred if there were no pandemic.
“Fear of contracting the coronavirus in health care settings has dissuaded people from screening, diagnosis, and treatment for non–COVID-19 diseases,” writes Ned Sharpless, Director of the National Cancer Institute, in an editorial published by Science. “The consequences for cancer outcomes … could be substantial.”
Colorectal cancer screenings have dropped by 86% relative to averages prior to January 20, 2020, according to an analysis by Epic Health Research Network. As a result, Americans are at risk of up to 18,000 missed or delayed colorectal cancer diagnoses in the early March to early June timeframe, according to a report by the IQVIA Institute for Human Data Science.
While the prediction shared by Sharpless should be considered initial, it is also conservative. Research shows a longer wait time for treatment leads to an increased risk for disease progression. That’s why access to screening and treatment is critical. The five-year survival rate for colorectal cancer found at the local stage is 90%.
“This prediction is important because it’s a wake-up call—the future doesn’t have to look like this,” said Michael Sapienza, CEO of the Colorectal Cancer Alliance. “There are options for at-home screening, and the hospitals have worked to make it safe for patients and staff alike. We all must get on the bullhorn and shout that screening can’t wait.” [TWEET THIS]
Still, doctors across the country are noticing a drop in cancer diagnoses over the past few months, says Dr. Kimmie Ng of the Dana-Farber Cancer Institute in an article by NBC News.
"That certainly has us worried that there are cancers out there that are being undiagnosed," Ng said in the article. "We are all preparing to see a surge of new patients."
Are hospitals safe?
MD Anderson Cancer Center has one of the largest and densest concentrations of immunocompromised patients in the world. COVID-19 is particularly dangerous for immunocompromised people, such as those with cancer, according to the CDC.
“We consider it our responsibility to protect the health and safety of all of our patients at all times, including during a global pandemic,” wrote the center’s president, Dr. Peter WT Pisters, in The Cancer Letter.
Pisters’ letter takes a deep dive into the precautions the hospital is taking to keep patients safe. Those precautions include:
Placing a perimeter around our clinical care areas to limit access points and we coordinating symptom screening, temperature checks, and masking for all
Reducing onsite employees at the campus from a typical day of 16,500 people to, on average, only 6,500 people
Expanding PPE protocols to ensure everyone is safe and protected.
Implementing a zero-visitor policy with few exceptions, and requiring social distancing measures
Launching a virtual care platform to continue serving patients unable to travel, and tapping into MD Anderson’s national network of hospitals to offer some patients care close to home.
Dr. Jeffery Meyerhardt of the Dana-Farber Cancer Institute said his hospital has implemented similar measures—as many hospitals have across the country. Hospitals communicate with one another constantly to stay up-to-date on best practices, he said.
“The reason we work so hard to make the hospital a safe place is because we want to give the best care to patients, and we need to protect ourselves, too, so can give them that level of care,” Meyerhardt said.
Patients, when they return to the hospital, are finding safe practices and no crowding, said Meyerhardt, who also serves on the Alliance’s Medical and Scientific Advisory Board.
“As we've had patients come back who were initially trying to hold off or delay treatment a little bit, they’ve realized that it was safe to be here, that there were appropriate precautions in place,” he said. “That has helped patients gain confidence once they’re here.”
Advocating for access to screenings
Recently, the Alliance and the National Colorectal Cancer Roundtable—an organization founded by the American Cancer Society and the Centers for Disease Control and Prevention—convened a panel of prevention and screening experts to offer a united response and propose national guidance on improving colorectal cancer screening rates during the COVID-19 era.
By late June, the organizations had created colorectal cancer screening guidance for healthcare organizations, inspiring a united front in advocating for and providing access to life-saving screening tests.
The guidance, “Reigniting Colorectal Cancer Screening as Communities Face and Respond to the COVID-19 Pandemic,” provides an action-oriented playbook enabling advocates to work together in reigniting screening efforts appropriately, safely and equally.
“We can be safe in a pandemic and continue saving lives,” said Michael Sapienza, CEO of the Alliance. “COVID-19 demands that we find new solutions to encourage and make possible CRC screening tests for all communities. We ask that healthcare providers and organizations don’t lose sight of the risk presented by CRC in lieu of COVID-19.”
Individuals should speak with their doctors about the best colorectal cancer prevention plan for them.
For more information about colorectal cancer screening tests, please visit the Alliance’s screening information page.