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. 2022 Aug;11(15):2990-2998.
doi: 10.1002/cam4.4655. Epub 2022 Mar 18.

COVID-19 and inequities in colorectal and cervical cancer screening and diagnosis in Washington State

Ofer Amram  1   2   3 , Solmaz Amiri  1   2 , Jeanne Robison  4   5 , Chaya Mangel Pflugeisen  4 , Pablo Monsivais  1   2
Affiliations

COVID-19 and inequities in colorectal and cervical cancer screening and diagnosis in Washington State

Ofer Amram et al. Cancer Med. 2022 Aug.

Abstract

Introduction: Studies have shown that cancer screenings dropped dramatically following the onset of the coronavirus diseases 2019 (COVID-19) pandemic. In this study, we examined differences in rates of cervical and colorectal cancer (CRC) screening and diagnosis indicators before and during the first year of the COVID-19 pandemic.

Methodology: We used retrospective data from a large healthcare system in Washington State. Targeted screening data included completed cancer screenings for both CRC (colonoscopy) and cervical cancer (Papanicolaou test (Pap test)). We analyzed and compared the rate of uptake of colorectal (colonoscopies) and cervical cancer (Pap) screenings done pre-COVID-19 (April 1, 2019-March 31, 2020) and during the pandemic (April 1, 2020-March 31, 2021).

Results: A total of 26,081 (12.7%) patients underwent colonoscopies in the pre-COVID-19 period, compared to only 15,708 (7.4%) patients during the pandemic, showing a 39.8% decrease. A total of 238 patients were referred to medical oncology for CRC compared to only 155 patients during the first year of the pandemic, a reduction of 34%. In the pre-COVID-19 period, 22,395 (10.7%) women were administered PAP tests compared to 20,455 (9.6%) women during the pandemic, for a 7.4% reduction. period 1780 women were referred to colposcopy, compared to only 1680 patients during the pandemic, for a 4.3% reduction.

Conclusion: Interruption in screening and subsequent delay in diagnosis during the pandemic will likely lead to later-stage diagnoses for both CRC and cervical cancer, which is known to result in decreased survival.

Impact: The results emphasize the need to prioritize cancer screening, particularly for those at higher risk.

Keywords: COVID-19; cervical cancer; colorectal cancer.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
Reductions in colonoscopies pre and during COVID‐19 by age (panel a), by rural/urban residence (panel b), by type of insurance coverage (panel c), and by race/ethnicity (panel d). p‐values from Chi‐square tests comparing pre and during COVID‐19 values
FIGURE 2
FIGURE 2
Percentage decrease in colonoscopies and medical oncology referrals pre and during the COVID‐19 periods. Zip code level map highlighting differences in percentage change in colonoscopies pre and during the COVID‐19 periods in WA State
FIGURE 3
FIGURE 3
Reductions in PAP tests pre and during COVID‐19 by age (panel a), by rural/urban residence (panel b), by type of insurance coverage (panel c), and by race/ethnicity (panel d). p‐values from Chi‐square tests comparing pre and during COVID‐19 values
FIGURE 4
FIGURE 4
Percentage reduction in PAP tests and colposcopies pre and during the COVID‐19 periods. Zip code level map highlighting differences in percentage changes in PAP tests pre and during the COVID‐19 periods in WA state
See this image and copyright information in PMC

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