Understanding COVID-19 impact on cervical, breast, and colorectal cancer screening among federally qualified healthcare centers participating in “Back on track with screening” quality improvement projects

Abstract

The COVID-19 pandemic has contributed to decreases in breast, colorectal, and cervical cancer screenings between 86 and 94% compared to three-year averages. These postponed screenings have created backlogs that systems will need to address as healthcare facilities re-open for preventive care. The American Cancer Society is leading a 17-month intervention with 22 federally qualified health centers (FQHCs) across the United States aimed at reducing cancer incidence and mortality disparities and alleviating additional strain caused by COVID-19. This study describes COVID-related cancer screening service disruptions reported by participating FQHCs. Selected FQHCs experienced service disruptions and/or preventive care cancellations due to COVID-19 that varied in severity and duration. Fifty-nine percent stopped cancer screenings completely. Centers transitioned to telehealth visits or rescheduled for the future, but the impact of these strategies may be limited by continued pandemic-related disruptions and the inability to do most screenings at home; colon cancer screening being the exception. Most centers have resumed in-person screening, but limited in person appointments and high levels of community transmission may reduce FQHC abilities to provide catch-up services. FQHCs provide critical cancer prevention services to vulnerable populations. The delivery of culturally competent, high-quality healthcare can mitigate and potentially reverse racial and ethnic disparities in cancer prevention testing and treatment. Ensuring and expanding access to care as we move out of the pandemic will be critical to preventing excess cancer incidence and mortality in vulnerable populations.

Breast reconstruction during the COVID-19 pandemic: Single institution experience from the pandemic's epicenter in the United States

“… 5 Interestingly, the 11% decline in mammography observed at our institution is less than the near 90% decline observed nationally. 6 …”

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

“…If the 2021 screening rates drop even more than 2020, as they are expected to, screening rates will be below the recommended rates. Then, the likelihood of catching up to baseline screening rates while, at the same time, not increasing stage at diagnosis or disparities, is particularly concerning [ 35 , 36 ].…”

Empowering Patients Through Virtual Care Delivery: Qualitative Study With Micropractice Clinic Patients and Health Care Providers

“…This is consistent with evidence of deferral of primary care in the United States, Canada, and the Netherlands during the COVID-19 pandemic, including concerns about missed referrals and routine care, increasing risk for morbidity and mortality [ 47 , 48 ]. As the acute phase of the COVID-19 pandemic subsides, this issue may resolve; however, health care providers may need to strategize ways to address this issue for future emergencies [ 49 ] and plan for catching up on preventive activities such as immunizations [ 50 , 51 ] and cancer screening [ 52 , 53 ].…”