Q&A: COVID-19 pandemic linked to drop in colorectal cancer screenings
Colorectal cancer screening rates in recent years have significantly decreased in at-risk groups such patients aged 50 to 52 years and patients under 50 years with Crohn’s disease and ulcerative colitis, according to data collected by the Blue Cross Blue Shield Association and reported in The Health of America report, Rise in Chronic Conditions is Putting More Americans at risk for Colorectal Cancer.
COVID-19 has further caused the colorectal cancer screenings to decline.
Healio Gastroenterology spoke with Vincent Nelson, MD, vice president, medical affairs and interim chief medical officer for the Blue Cross Blue Shield Association on how delayed screenings can impact patients and how patients can prioritize preventive care during the pandemic.
Healio: Can you speak about the data from BCBSA?
Nelson: While the rate of colorectal cancer has remained mostly steady, the rising prevalence of risk factors presents some troubling trends. Risk factors like CD, UC, diabetes and diagnosed obesity could lead to a significant increase in future diagnoses of colorectal cancer. Colorectal cancer is predicted to take the lives of more than 53,000 Americans in 2020, most of whom will be over the age of 50 years. That’s why increased screenings can help prevent or detect colorectal cancer at an earlier stage, which in turn can improve the effectiveness of the treatment.
Healio: What is the impact of delayed screenings such as missing precancerous polyps or detecting colorectal cancer at an earlier stage?
Nelson: Preventive care is an essential part of any health routine because it allows medical professionals to identify potential areas of concern before they become problematic. Delaying screenings is worrisome for several reasons, notably because the patient has many more options for care and prevention if they catch the signs of colorectal cancer earlier. People who delay screening until their late 50s or early 60s are at risk for missing these early detection signs that could potentially be lifesaving.
Healio: What could happen if screening rates do not improve, especially during COVID-19?
Nelson: In general, the pandemic has caused many to postpone or avoid preventive screenings and elective procedures. Preventive colorectal cancer screenings have dropped by 86%, which could prevent members from catching smaller, more treatable conditions before they get worse.
Blue Cross Blue Shield Association’s (BCBSA) new health report, revealed that current trends show a rise in risk factors for colorectal cancer for all generations, but especially among millennials and younger adults. Risk factors include CD and UC, types 1 and 2 diabetes, and diagnosed obesity. Many commercially insured Americans, especially those in two at-risk groups (those aged 50-52 and those under 50 years old with CD or UC), are not getting screened regularly for colorectal cancer.
What we are seeing now are the warning signs for potential health concerns in the years to come. This trend among millennials could mean a significant increase in future diagnoses of colorectal cancer.
Healio: How can patients prioritize preventive care during COVID-19?
Nelson: There are many ways to prioritize preventive care during the pandemic; the rise in telehealth and virtual care options being two ways Americans can access preventive care from the safety of their home. These care practices also remove some of the hassle from scheduling appointments and figuring out the logistics for a wellness visit. Additionally, other technology – from mobile apps to wearable devices – can help incorporate health into your daily life so you can identify any abnormalities or changes and contact your medical provider immediately.
An example of this comes from Premera, who has addressed local barriers to care by sending fecal immunochemical test kits to members living in rural communities to connect them with potentially lifesaving lab results.
Healio: How can rescheduling screenings due to COVID-19 impact patients?
Nelson: As health providers across the country mobilized to ensure those on the front lines fighting the virus had adequate space, personal protective equipment and staff, millions of procedures and screenings across the country were delayed. This sets up a potential bottleneck in the future when these procedures are able to resume.