Screenings for breast cancer, prostate cancer, and colorectal cancer all dropped sharply during the first few months of the COVID-19 pandemic, resulting in an absolute deficit for 2020 compared with 2019. Screenings did begin to rebound but did so somewhat unevenly, according to a new study published in JAMA Oncology.

The retrospective cohort study examined data on breast, prostate, and colorectal cancer screenings from people insured through Medicare and private insurance that was obtained from the HealthCore Integrated Research Database, which covers 60 million people.

The researchers found that significant declines occurred for all 3 types of cancer screenings between March and May of 2020, compared with the same time period in 2019. Researchers found that the sharpest declines occurred in April, with breast cancer screening rates dropping 90.8% from April 2019. Colorectal cancer screenings and prostate cancer screenings dropped 79.3% and 63.4% respectively.

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The researchers also noted that the screening deficits were larger for breast and colorectal cancers, both of which require a procedure, compared with prostate cancer screening, which requires a blood test. Monthly breast and prostate cancer screening rates completely recovered by July 2020, but colorectal cancer screening still remained 13% below the 2019 rate.  “From a public health perspective, increasing the use of alternatives to colonoscopy for colorectal cancer screening may help mitigate this screening deficit,” they wrote.

The researchers also looked at declines by geography and socioeconomic status. When the researchers looked at screening rates in 4 different regions of the country, they found the sharpest decline in screenings occurred in the Northeast. Meanwhile, screening rates were slower to rebound in the West compared with the South and Midwest. The sharpest declines in screenings among socioeconomic groups occurred in the highest SES index quartile.

The study did not take race or ethnicity into account. Uninsured persons were also not included, so the results may “skew our population-level estimation of cancer screening deficit associated with the COVID-19 pandemic,” the researchers acknowledged.

Ultimately, even with the rebounds, there was an estimated 9.4 million deficit in screenings for these 3 types of cancer that was associated with the COVID-19 pandemic. That breaks down to 3.9 million for breast cancer screening, 3.8 million for colorectal screening, and 1.6 million for prostate screening.

“Public health efforts are needed to address the large cancer screening deficit, including increased use of screening modalities that do not require a procedure,” the researchers concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Chen RC, Haynes K, Du S, Barron J, Katz AJ. Association of cancer screening deficit in the United States with the COVID-19 pandemic. JAMA Oncol. Published online April 29, 2021. doi:10.1001/jamaoncol.2021.0884