In a study reported in the Journal of Clinical Oncology, Star et al found that cancer screening remained below prepandemic levels in the United States during the second year of the COVID-19 pandemic.
Study Details
Data on past-year receipt of age-eligible screening for breast cancer (women aged 50 to 74 years), cervical cancer (women without a hysterectomy aged 21 to 65 years), prostate cancer (men aged 55 to 69 years), and colorectal cancer (men and women aged 50 to 75 years) were obtained from the 2019 and 2021 National Health Interview Survey.
Key Findings
Between 2019 and 2021, past-year screening decreased from 59.9% to 57.1% (adjusted prevalence ratio [aPR] = 0.94, 95% confidence interval [CI] = 0.91–0.97) for breast cancer, from 45.3% to 39.0% (aPR = 0.85, 95% CI = 0.82–0.89) for cervical cancer, and from 39.5% to 36.3% (aPR = 0.9, 95% CI = 0.84–0.97) for prostate cancer. Declines in screening were largest among Asian individuals, ranging from 25% for breast cancer (from 62.2% to 48.4%; aPR = 0.75, 95% CI = 0.65–0.88) to 50% for prostate cancer (from 36.3% to 17.6%; aPR = 0.5, 95% CI = 0.3–0.83).
Change in past-year colorectal cancer screening prevalence—from 21.1% to 22.2%—was not significant (aPR = 1.04, 95% CI = 0.98–1.09). The stable prevalence reflected a 44% increase in past-year use of home blood stool tests (from 7.0% to 10.3%; aPR = 1.44, 95% CI = 1.31–1.58), offsetting a 12% decrease in colonoscopy screening (from 15.5% to 13.8%; aPR = 0.88, 95% CI = 0.83–0.95). The increase in stool testing was greatest among Black individuals (from 7.1% to 11.9%; aPR = 1.66, 95% CI = 1.25–2.2), Hispanic individuals (from 8.3% to 15.3%; aPR = 1.82, 95% CI = 1.39–2.37), and individuals at or below 100% of the federal poverty level (from 7.0% to 12.1%; aPR = 1.52, 95% CI = 1.15–2.01).
The investigators concluded, “Past-year screening prevalence for breast, cervical, and prostate cancer[s] among age-eligible adults in the United States continued to be lower than prepandemic levels in the second year of the COVID-19 pandemic, reinforcing the importance of return to screening health system outreach and media campaigns. The large increase in stool testing emphasizes the role of home-based screening during health-care system disruptions.”
Ahmedin Jemal, DVM, PhD, of the Surveillance & Health Equity Science Department, American Cancer Society, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
