Experts Discuss COVID-19's Impact on Cancer Screenings

It was just one year ago – March 11, 2020 – that the World Health Organization declared the coronavirus a global pandemic. Since then, nearly every aspect of our lives and routines has been upended by COVID-19. Of special concern for leaders at Baptist Health’s Miami Cancer Institute and Lynn Cancer Institute is the sharp decrease in cancer screenings over the past year, and what that portends for the future.

“In a November 2020 report, The Journal of Clinical Oncology quantified year-over-year decreases in different types of cancer screenings and the data was alarming,” says Michael J. Zinner, M.D., CEO and executive medical director of Miami Cancer Institute. “They found that during the initial surge last April, breast mammograms were down 85 percent from the previous year, while colonoscopies and lung cancer screenings both were down 75 percent.” Prostate cancer screenings decreased by 56 percent during the same time, he adds.

Dr. Zinner worries about what those numbers mean for the millions of patients diagnosed with cancer each year. He believes the sharp decrease in screenings for these common cancers could lead to increased morbidity and mortality for those patients diagnosed with late-stage cancer.

“When we factor this data into our computer modeling and look ahead 10 years, we see potentially 5,000 more deaths from breast cancer and 4,000 more for colon cancer, simply because people decided to forego their regular cancer screenings during the pandemic,” Dr. Zinner says. “We’re looking at a ticking time bomb here – one with a 10-year fuse.”

Is it safe to go to a doctor’s office or hospital for cancer screenings? “Absolutely,” says Dr. Zinner, who notes that patients coming in for screenings won’t be sitting in a big waiting room with lots of other patients. “Considering all of the extensive precautions we take, I think it’s safer to come to Miami Cancer Institute – or any of our facilities at Baptist Health, for that matter – than it is to go to your local grocery store.”

Medical oncologist Louise Morrell, M.D., who serves as medical director of Lynn Cancer Institute at Boca Raton Regional Hospital, also part of Baptist Health, says the dropoff in screenings is a real concern. “We know cancer diagnoses are being missed, simply because of the decrease in screenings over the past year.”

Some patients, she says, are self-driven to keep up with their screenings, while many others depend on their primary care physician to recommend which screenings they need and when. “They’re the ones we worry about because that’s where we’ve seen the biggest drop – in physician-referred screenings,” Dr. Morrell says.

Dr. Morrell uses a familiar analogy to underscore the importance of screenings and early detection in beating cancer.

“If you do get cancer, it’s kind of random when you get it,” Dr. Morrell says. “So it’s a bit like using your seatbelt. It doesn’t matter if you wore it last year. If you were to have an accident, for the seatbelt to work, you’d actually have to be wearing it – not just now but every time you get in the car.”

Similarly, she says, cancer screenings are great for early detection, but they’re only effective if you get them. “Screenings are a valuable tool but they can only offer a snapshot of your health at a certain point in time,” Dr. Morrell says. “That’s why it’s so important to keep up with your recommended screenings.”

According to Dr. Zinner, certain populations are predisposed to getting certain types of cancer during their lifetimes. “Smokers are far more likely to develop lung cancer, and patients who’ve had polyps revealed in a colonoscopy are more likely to develop colon cancer,” Dr. Zinner notes. “There’s often a history involved for patients with breast cancer, and elderly populations are generally more likely to develop any type of cancer, simply by virtue of having lived so long.” These are people who should be especially vigilant when it comes to their regular screenings, he says.

Dr. Zinner expects cancer screenings to increase this year but hopes they’ll return to their pre-pandemic levels. In the meantime, both Miami Cancer Institute and Lynn Cancer Institute are stepping up programs to make cancer screenings more widely available to at-risk populations in South Florida.

“We’re committed to community outreach and are pairing with local organizations to conduct screenings,” Dr. Zinner says. “There are obviously areas of particular need within our community and Miami Cancer Institute has been reaching out to these medically underserved populations with the goal of providing better access to the lifesaving technology and expertise available here.”

At Lynn Cancer Institute in Boca Raton, Dr. Morrell says the cancer center looked at the 8,000-plus patients who had missed their annual mammograms last Spring as the pandemic spread throughout South Florida and across the nation. “We actually used artificial intelligence to identify those patients who, based on their known risk factors, were deemed to be at highest risk for developing breast cancer, and we made a special effort to get them back in for their screenings.”