Study Shows More Late Stage Breast Cancers Were Diagnosed During COVID-19 Pandemic

The COVID-19 pandemic has led many people to put off regular health screenings. As just one example, the CDC reported 87% fewer breast cancer screenings through its National Breast and Cervical Cancer Early Detection Program in April 2020, compared with the prior five-year average for April. A new study shows that such delays may have had a big impact on how far along cancers progressed before diagnosis.

A team at UC San Diego Health’s Moores Cancer Center examined breast and colorectal cancer figures for 2019 and 2020, comparing the number of early- and late-stage diagnoses within each year to look for impacts from the pandemic. They say that though the number of diagnoses was roughly the same for each type of cancer, 2020 saw a much higher proportion of stage IV versus stage I breast cancer diagnoses. The findings, published in JAMA Network Open, reflect some of the non-COVID health challenges brought by the pandemic.

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Dr. Jade Zifei Zhou, lead author and clinical fellow in hematology and oncology at UC San Diego School of Medicine, explains, “For breast cancer, at least, these data demonstrate a continuing trend. They suggest that concerns and consequences caused by the pandemic have prompted at least some patients to delay routine health care, such as screenings or doctor visits, that might have revealed early stage diagnoses.”

When it comes to early stage diagnoses, the team found that 63.9% of patients diagnosed in 2019 were at stage I of the disease. In 2020, that figure fell to 51.3%. Meanwhile, the percentage of 2019 patients diagnosed at stage IV was 1.9%. That more than tripled in 2020 to 6.2%.

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The time at which a patient is diagnosed can be crucial to their prognosis. According to the American Cancer Society, early stage breast cancer patients have a five-year survival rate of 99%, compared with just 28% for stage IV patients.

The team noted that there are some limitations of their study, including that these figures are from just one cancer center and that some patients involved were seeking second opinions, meaning they could have had treatment before. However, the findings from this study indicate that due to delayed screenings brought on by the pandemic, many patients may have received later diagnoses and their outcomes may suffer as a result.

Dr. Kathryn Ann Gold, senior author and medical oncologist at Moores Cancer Center, says, “Cancer screening is crucial to the early detection of cancer, particularly in colorectal and breast cancers where many early stage cancers can be treated and cured. There is increasing concern that one effect of the pandemic is the growing number of patients who are being diagnosed for the first time with late, incurable stages. Patients who have delayed preventative care during the pandemic should be encouraged to discuss age appropriate cancer screening with their primary care providers as soon as possible.”