As Vaccination Rates Increase, Doctors Remind Patients to Resume Routine Cancer Screenings

With more than a third of Americans now fully vaccinated against COVID-19, the American College of Surgeons (ACS) recently began a nationwide campaign to remind people to resume regular cancer screenings if they missed any such tests during the pandemic.

A March 2021 study by researchers at the RAND Corporation, a national think tank, looked at millions of health insurance claims and found that screenings for breast and colon cancer, two very common cancer screenings, dropped dramatically during the early months of the coronavirus pandemic. While they returned to near-normal levels by the end of July 2020, they still fall short of pre-pandemic levels, especially for colon cancer.

Experts are concerned that people who missed appointments early in the pandemic still have not returned for their screenings and that some people continue to be fearful of receiving in-person health care.

“While it is reassuring to see cancer screening rates begin to return to pre-pandemic levels, we have to ensure that people who deferred preventive services are prioritized to get their screening in a timely manner, especially if they are at higher risk of disease,” Dena M. Bravata, MD, MS, an author of the RAND research and a health policy researcher at Stanford University, tells Verywell.

Ryan McBain, PhD, MPH, a policy researcher in RAND’s Boston office and the lead researcher on the study, tells Verywell the group will be looking at insurance claims in the next few months to see if the drop in tests during the pandemic resulted in an increase in cancer diagnoses.

Timely Cancer Screenings Can Save Your Life

In January 2021, Neil Katz, 62, was anxious about having an in-office skin cancer screening. COVID-19 cases were high in Baltimore, Maryland, where he lives, and he hadn’t yet been vaccinated. But he was even more anxious about an unusual looking spot on his arm.

Katz decided to see a dermatologist in-person, taking all the precautions required by the practice, including waiting in his car rather than the waiting room, having his temperature taken, and not taking his mask off while in the office. “I added some precautions of my own, including wearing two masks and having hand sanitizer wipes waiting for me in the car to fully disinfect my hands after the visit,” Katz tells Verywell. 

The spot on his arm didn’t bother the doctor, but a spot on the side of his head did. A biopsy found melanoma, potentially fatal if not caught soon enough. Katz scheduled a second appointment for surgery in the office to remove the mole.

“Turns out waiting until the pandemic would be over might have made been too late,” Katz says. While the cancer hadn’t spread, the margins of the tumor were narrower than the doctor had hoped for—indicating the potential for spread if not removed—and the doctor began treating Katz with a cream form of chemotherapy. “The prognosis now is a good one, but that might not have been the case if I had waited any longer than I did,” Katz says.

Screening Sites Are Opening Back Up and Expanding Availability

Many people did opt out of regular screenings at physician offices, hospitals, and clinics out of concern they could be exposed to COVID-19, according to the ACS. But even people who were ready to have screenings earlier in the pandemic might have found it hard to schedule an appointment. In the hospital setting, for example, appointments were rescheduled or cancelled as physicians focused on COVID patients. And intermittent overcrowding or lack of personal protective equipment caused delays too.

Now, as hospitals close COVID-19 wards and many doctors return from remote work to more in-office hours, some patients have to be reminded, or gently nudged, to reschedule tests they are due for, experts say.

“Regular cancer screening tests can improve and save your life,” Timothy W. Mullett, MD, FACS, chair of the ACS Commission on Cancer, tells Verywell. “A year into the pandemic, cancer care facilities have assumed best practices in order to resume screenings and surgical care safely…we’re encouraging everyone to talk to their doctor or a healthcare professional about getting back on track with their recommended cancer screening.”

Even if you’re not behind on a screening, but should have one in a month or two, experts suggest scheduling screening tests now. In an advisory updated on April 23, 2021, the American Cancer Society noted that “how quickly you may be able to get screened may vary by community and facility while the pandemic continues.”

Questions to Ask Before Your Screening

To help patients feel safe returning to healthcare facilities for screenings and surgery, the American College of Surgeons created a resource document with questions to ask about how to prepare and what to expect while the COVID-19 is ongoing. Questions include: 

• What COVID-19 protective measures can I expect when I arrive at my appointment?
• Can I wait inside my car when I arrive for the office visit, or do I have to come inside to check in? What safety measures are in place for check-in?
• Can my insurance coverage be confirmed before I check in by telephone or computer? Or do I have to meet with a staff member on-site?
• Will I be with others in a waiting room, or will I be in a room away from other patients the whole time?

You Won’t Need a Vaccine for a Screening—But Expect to be Asked About It

It’s unlikely you will be required to have a COVID-19 vaccine in order to have your screening since the vaccine isn’t required in the U.S., says David Farber, JD, a partner specializing in issues related to the Food and Drug Administration (FDA) at the D.C. law firm of King & Spaulding. However, it is a question that physicians are often asking in order to encourage as many people as possible to get the vaccine. So, you may be asked by someone in the practice, and if you haven’t yet gotten the vaccine and have questions or concerns, this might be an opportunity to share them. 

Will Screenings Go Virtual?

While in-office screening tests remain the gold standard for most types of cancer, researchers say the pandemic has helped them rethink tools for screenings that don’t require an office visit.

“We’ve learned some things during the pandemic that could lead to better screening practices in the future,” Jennifer Haas, MD, an internist at Mass General Brigham Hospital, who studies cancer screening, tells Verwell. “For instance, the pandemic has created an opportunity to promote home-based screening tests, such as the fecal (stool) immunochemical test (FIT) for colorectal cancer.”

With the test, a person collects a stool sample at home using a kit they receive in the mail and sends it to a laboratory for testing. If the test indicates cancer is a possiblility, an in-office colonoscopy will have to be scheduled.

Haas says FIT could be a model for developing other cancer screening tests, and home-based screening tests are being studied for cervical cancer, though the FDA has not approved any.

While staying up to date on cancer screenings is crucial, so is staying up to date, as best you can, on all health issues during the pandemic.

“If you’ve delayed care, now is a great time to see your provider to keep your health on track,” Katherine D. Rose, MD, an internist at Brigham and Women’s Hospital in Boston, Massachusetts, tells Verwell. She says most healthcare practices, including free or reduced fee clinics, are still offering telehealth services. So if you’re concerned about going into an office, you can start with a phone or video visit to review your file—or start a new one—to assess which annual tests you might need. 

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.