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Cancer Screening In The Age Of COVID: The Time Is Now!

COVID-19 remains top of mind for many of us.

As the virus lingers on, taking a terrible toll in lives and life-threatening illnesses, our capacity to deal with the reality of  this pandemic gets less and less. That’s why it is so important that we remember to pay attention to the important things in our life, so we can continue to enjoy our lives as best we can today and as we want to do for the future. 

Part of that attention has to be for our health, and cancer detection/prevention needs to be on that list. The reality is that I suspect many of us aren’t giving it the due it deserves.

Two recent incidents in my own family brought that message home for me in a very personal way, and maybe the same has happened to you as well:

Both involved women who are very close to me and my heart. One is a woman who had the diagnosis of DCIS—a noninvasive form of breast cancer—about a year ago. She was due for a followup post-treatment mammogram in May. She called for an appointment, and was told the first available would be in September, which was another six months away from the time she called. Without going into details, let’s just say that a “workaround” was done, and the mammogram was completed in early June. The good news: all was well.

The outcome of the second story was sadly more typical: a young woman whose mother died when this person was in her teens needed a routine screening mammogram. She doesn’t have a known proven genetic risk factor, however the risk of a first degree relative developing breast cancer and dying from it is certainly something she lives with, and so she is religious about getting screened.

She called the center a couple of weeks ago, and was told the first appointment was a bit far away, like in March. That issue hasn’t been resolved, which is why I suspect it is more typical. It is also very troubling. No one should have to wait that long for a mammogram. No one.

I can only imagine how many other folks out there aren’t getting their routine medical care or cancer screening, and I can’t imagine how many more are making the call and getting significant delays. Even under normal circumstances, there are delays—however the current COVID crisis has undoubtedly made the problem worse. After all, as clinics, surgery centers, and hospitals have put precautions in place their ability to see as many patients as they did previously is limited.

Having said that, it’s also important for doctors’ offices to be certain that those patients who need to have their screening prioritized for whatever reason receive priority attention, even if it means extending hours or even–heaven forbid–making weekend hours available. We can’t forget that the COVID precautions do reduce the number of people a doctor’s office can seen in a day, so if we are to make this work all of us have to make some changes, even in “normal business hours.”

When the pandemic first started, the American Cancer Society recommended that routine cancer screenings in adults at average risk be suspended as the disease took hold in large parts of the nation. Expectations at that point were that delays would be about 3 months, and likely not of great consequence.

However, time has marched on—and so has the pandemic. We are now seven months into this disaster, and to make matters worse we are facing a surge in  COVID cases. I suspect people are even more cautious about going to medical facilities in some parts of the country. You don’t have to be a doctor or other health professional to appreciate that the delays are starting to add up and may impact the opportunity to find a cancer early when treatment may be more successful and more tolerable. The impact is real: the director of the National Cancer Institute recently predicted that thousands of lives will be lost over the next 10 years because of delays in cancer screening, detection and treatment.

I can certainly understand why some people may be reluctant to get even routine medical care these days. Patients who get screened are generally older, usually have other medical conditions and are therefore at higher risk of complications if they get ill from a corona virus infection. They are worried about their risk and consequently more cautious than younger folks.

However, as we have now lived with this virus for the past seven months we have a better idea of what we need to do to be cautious and reduce risk as much as possible. Wearing a mask, washing your hands, socially distancing, and avoiding crowds has been repeated again, and again, and again. (I only wish more people would follow those recommendations however will hold that thought for another day.)

And as people have become aware of what they need to do to reduce their personal risk, so have medical facilities. They too have undergone a restructuring of sorts, thinking through their obligations to their patients and their staff—remembering always that prevention from catching the corona virus is a two way street where patients have to wear masks and staff appropriate protective gear. The latter is especially important given the close proximity of patients, staff and clinicians when it comes to rendering medical care such as getting a mammogram, a colonoscopy or cervical cancer screening.

You should also keep in mind that maybe you can make some adjustments to your cancer screening “routine” during these exceptional times: perhaps if you are at average risk you can get a mammogram every two years instead of every year; perhaps for this year you can ask your clinician to arrange for you to have a stool test at home for colorectal cancer and plan on the colonoscopy next year; maybe with the new cervical cancer screening guidelines you don’t have to have that pap smear every year (that hasn’t been the standard for several years, however some women—especially older women—are so used to an annual pap smear that they feel they must get it done, when in reality they don’t).

The reality is that for some of us, we can safely delay screening. However others cannot, and your clinician should be the one to guide you as to what is best for you. (Remember: this advice is for people at average risk; if you are at high risk you should definitely consult your clinician about what you should do for screening.)

It also goes without saying that you are not comfortable with the precautions your clinicians and their staffs are taking, it may mean you need to go elsewhere. There are plenty of places that are just as concerned about transmission of COVID as you are. It is essentially a matter of everyone doing their part to substantially reduce any risk. You may be surprised at the efforts that have been put into giving you a sense of comfort that a medical environment can be a safe place where people take your safety, your concerns and your comfort seriously.

This is the bottom line: This pandemic is not going to go away any time soon. It is going to be with us in some form for a quite a while. This virus is not going to magically disappear. It will be more like going from a shout to a wimper, and getting to that wimper is going to take time.

If we all took precautions the frequency of infections could be dramatically reduced in a short time, however unfortunately right now it doesn’t look like that is going to happen. And an effective vaccine that meets acceptable safety standards is some time away, and even then there will still be risk of spread beyond the moment such vaccines become available.

So take charge of your health. If you have a chronic illness, reach out to the folks who take care of you and get the lab tests and visits you need, whether in person or virtually online. And make certain you keep prevention top of mind, including those tests that can find cancer early.

For gosh sakes, don’t delay cancer screenings any longer. They reduce deaths from cancer, so the life you save may be your own.