Impact of the COVID-19 Pandemic on Volumes and Disparities in Lung Cancer Screening

Henderson, Louise M.; Benefield, Thad; Bosemani, Thangavijayan; Long, Jason; Rivera, M. Patricia

doi:10.1016/j.chest.2020.12.033

Cited by 18 publications

(24 citation statements)

References 6 publications

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“…Seven papers [33,34,[36][37][38]40,42] reported on "early diagnosis and predisposition exams", namely: screening visit for prostate cancer (US), gBRCA testing (Italy), HPV tests rate, low-dose computed tomography and prostate-specific antigen measurement (all from the US). All these indicators have shown a decreasing trend in the number of diagnostic procedures.…”

Section: Discussionmentioning

confidence: 99%

“…All these indicators have shown a decreasing trend in the number of diagnostic procedures. "Screening detection rates" were reported by 14 indicators from 5 articles [22,36,37,47,48], from the US and Italy. Most of the indicators (n=9, 75%) showed an increase in screening detection rates.…”

Section: Discussionmentioning

confidence: 99%

“…The first stage of the care pathway looks at early detection. Regarding the "number of screening and other early diagnosis procedures", a total of 33 indicators from 13 articles [33][34][35][36][37][38][39][40][41][42][43][44][45] have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Seven papers [33,34,[36][37][38]40,42] reported on "early diagnosis and predisposition exams", namely:…”

Section: Discussionmentioning

confidence: 99%

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Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Carvalho

Fernandes

Lange

et al. 2022

Preprint

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Objectives: Summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020), and to assess changes in the quality of care as assessed via selected indicators. Methods: Scoping review. Indicators and their reported trends were collated following the cancer care pathway. Results: Database searches retrieved 6277 articles, 838 articles met the inclusion criteria, and 135 articles were included after full-text screening, from which 917 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n=30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n=64, 58%) and in the diagnoses (n=130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed an increasing trend (n=8, 89% and n=14, 56%, respectively). Nine indicators (64%) showed stability in cancer stages distribution. A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n=9), and 70% (n=43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79% (n=82) of indicators concerning surgeries, 72% (n=41) of indicators assessing trends in radiotherapy, and 93% (n=40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64% (n=195) of indicators revealed changes in treatment. Ten indicators (83%) signalled a decreasing number of hospital admissions. Conclusion: Health systems struggled to ensure continuity of cancer care. As this pandemic keeps evolving, the trends reported over the first 6 months of 2020 provide an argument to monitor these changes closely. This information needs to be transparent, standardised, and timely, allowing to monitor quality and outcomes of care during crises and inform policy responses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Seven papers [33,34,[36][37][38]40,42] reported on "early diagnosis and predisposition exams", namely:…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Carvalho

Fernandes

Lange

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…2). Because of the delays in cancer screening and care during the pandemic that disproportionately impacted financially disenfranchised communities and communities of color, there is concern that the recent gains achieved in cancer equity might be reversed 41–44 …”

Section: Cancer Disparities and Covid-19mentioning

confidence: 99%

Improving Equity in Cancer Care in the Face of a Public Health Emergency

Winkfield

Winn

2022

Cancer J

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Cancer health disparities have been well documented among different populations in the United States for decades. While the cause of these disparities is multifactorial, the COVID-19 pandemic has highlighted the structural barriers to health and health care and the gaps in public health infrastructure within the United States. The most long-standing inequities are rooted in discriminatory practices, current and historical, which have excluded and disenfranchised many of the most vulnerable populations in the nation. These systemic barriers are themselves a public health crisis, resulting in increased mortality rates in communities of color from both COVID-19 and cancer. While implementing programs to temporarily improve cancer equity locally or regionally is laudable, it is imperative to develop a public health strategy focused on alleviating the root causes of health inequities to improve the health and well-being of every citizen and ensure readiness for the next public health emergency.

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Breast and Lung Cancer Screening Among Medicare Enrollees During the COVID-19 Pandemic

Doan

Goodwin

2023

JAMA Netw Open

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ImportanceSeveral studies reported sharp decreases in screening mammography for breast cancer and low-dose computed tomographic screening for lung cancer in the early months of the COVID-19 pandemic, followed by a return to normal or near-normal levels in the summer of 2020.ObjectiveTo determine the observed vs expected mammography and low-dose computed tomographic scan rates from the beginning of the pandemic through April 2022.Design, Setting, and ParticipantsIn this retrospective cohort study assessing mammography and low-dose computed tomography rates from January 2017 through April 2022, data for January 2016 to February 2020 were used to generate expected rates for the period March 2020 to April 2022. The study included a 20% national sample of Medicare fee-for-service enrollees among women aged 50 to 74 years for mammography, and men and women aged 55 to 79 years for low-dose computed tomographic scan.Main Outcomes and MeasuresReceipt of screening mammography or low-dose computed tomographic scan.ResultsThe yearly cohorts for the mammography rates included more than 1 600 000 women aged 50 to 74 years, and the cohorts for the low-dose computed tomographic scan rates included more than 3 700 000 men and women aged 55 to 79 years. From January 2017 through February 2020, monthly mammography rates were flat, whereas there was a monotonic increase in low-dose computed tomographic scan rates, from approximately 500 per million per month in early 2017 to 1100 per million per month by January 2020. Over the period from March 2020 to April 2022, there were episodic drops in both mammography and low-dose computed tomographic scan rates, coincident with increases in national COVID-19 infection rates. For the periods from March 2020 to February 2020 and March 2021 to February 2022, the observed low-dose computed tomographic scan rates were 24% (95% CI, 23%-24%) and 14% (95% CI, 13%-15%) below expected rates, whereas mammography rates were 17% (95% CI, 17%-18%) and 4% (95% CI, 4%-3%) below expected.Conclusions and RelevanceIn this cohort study, the decreases in cancer screening during the early phases of the COVID-19 pandemic did not resolve after the initial pandemic surges. Successful interventions to improve screening rates should address pandemic-specific reasons for low screening participation.

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Impact of the COVID-19 Pandemic on Volumes and Disparities in Lung Cancer Screening

Cited by 18 publications

References 6 publications

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Improving Equity in Cancer Care in the Face of a Public Health Emergency

Breast and Lung Cancer Screening Among Medicare Enrollees During the COVID-19 Pandemic

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