Reduction in Standard Cancer Screening in 2020 throughout the U.S

Leslie K Dennis; Chiu-Hsieh Hsu; Amanda K Arrington

doi:10.3390/cancers13235918

Reduction in Standard Cancer Screening in 2020 throughout the U.S

Cancers (Basel). 2021 Nov 25;13(23):5918. doi: 10.3390/cancers13235918.

Authors

Leslie K Dennis^{1

2

3}, Chiu-Hsieh Hsu^{1

2}, Amanda K Arrington^{2

4}

Affiliations

¹ Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
² University of Arizona Cancer Center, Tucson, AZ 85724, USA.
³ Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
⁴ Department of Surgery, Houston Methodist Hospital, Houston, TX 77030, USA.

Abstract

Cancer screening is an important way to reduce the burden of cancer. The COVID-19 pandemic created delays in screening with the potential to increase cancer disparities in the United States (U.S.). Data from the 2014-2020 Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed to estimate the percentages of adults who reported cancer screening in the last 12 months consistent with the U.S. Preventive Services Task Force (USPSTF) recommendation for cervical (ages 21-65), breast (ages 50-74), and colorectal cancer (ages 50-75) prior to the pandemic. Cancer screening percentages for 2020 (April-December excluding January-March) were compared to screening percentages for 2014-2019 to begin to look at the impact of the COVID-19 pandemic. Screening percentages for 2020 were decreased from those for 2014-2019 including several underserved racial groups. Decreases in mammography and colonoscopy or sigmoidoscopy were higher among American Indian/Alaskan Natives, Hispanics, and multiracial participants, but decreases in pap test were also highest among Hispanics, Whites, Asians, and African-Americans/Blacks. Decreases in mammograms among women ages 40-49 were also seen. As the 2020 comparison is conservative, the 2021 decreases in cancer screening are expected to be much greater and are likely to increase cancer disparities substantially.

Keywords: COVID-19; cancer screening; colonoscopy; disparities; mammogram; pap test; sigmoidoscopy.