Early Detection is Key to Cancer Treatment
Dr Alit Amit-Yousif
Over the past year, we have adjusted our lives repeatedly to keep ourselves and our communities safe during the COVID-19 pandemic. We have postponed weddings, canceled vacations and turned our dining room tables into classrooms for our children. These changes have been difficult, and at times, they may have even seemed dire. Very few of these changes, however, could actually be life-threatening.
With delayed cancer care, that is not the case.
We have long known that early detection leads to better outcomes. When cancer is in an early stage, it is easier to treat. After cancer spreads, treatment can become more invasive and less likely to succeed. Surveillance, Epidemiology, and End Results (SEER) data show that the five-year relative survival rate for patients with localized breast cancer is 99%. The survival rate drops to just 28% in stage IV, when the cancer has spread to other parts of the body.
Luckily, we have the tools to catch cancer before it spreads. We can detect cancer in its early stages through regular cancer screenings such as mammograms, Pap and HPV tests, lung cancer screenings, and colonoscopies. In some cases, we can even detect pre-cancer and monitor for changes.
It seems obvious to say, but for the screenings to work, we have to conduct them. This is where the challenge lies: due to the coronavirus pandemic, screenings for all forms of cancer have decreased across the nation.
In a KFF Health Tracking Poll from May 2020, 48% of Americans reported that they had postponed or skipped medical care due to the pandemic. Another study from The IQVIA Institute for Human Data Science estimates that more than 80,000 breast, cervical, colorectal, lung and prostate cancer diagnoses have been missed. At the Barbara Ann Karmanos Cancer Institute, these trends bear out. Screenings for all cancers were down by 17% in 2020 compared to 2019. About 18,000 fewer mammograms and colonoscopies were conducted in 2020 than in 2019.
These delays could result in a wave of cancer deaths in the coming years if we don’t change the trend. Scheduling a cancer screening for yourself or a loved one starts with a simple phone call. If you have put off a mammogram or other screening during the COVID pandemic, I urge you to follow up and seek care. If you are unsure of what screening you might need, the following can provide an outline. However, every person is unique, and screening needs vary between individuals. Contact your primary care provider to see what screenings you may need. Karmanos oncology navigators are also available to assist at 1-800-KARMANOS.
Mammograms: Karmanos recommends an annual screening mammogram for all women of average risk beginning at age 40. Women with one or more risk factors may need earlier screening and should talk with their family doctor or a cancer specialist to find out more.
Colorectal Cancer Screening: Men and women at average risk should begin screening at age 45 and continue every ten years. Those at increased risk may begin screening sooner and continue with more frequency.
Lung Cancer Screening: Men and women ages 55-80 who are current smokers or who quit no more than 15 years ago, with at least 30-pack-year smoking history should be screened for lung cancer.
Cervical Cancer screening: Women between the ages of 21 and 29 should have a Pap test every three years. Women between the ages of 30 and 65 should have a Pap test and an HPV test every five years or a Pap test alone every three years. Women age 65 and older who have had regular screenings and normal results can cease screening.
Many people have fears about cancer screenings. Some would rather not know about their illness for fear of burdening their families or having to tackle the disease head-on. However, turning a blind eye to cancer will not make it go away. On the contrary, early detection can give you a significant advantage in battling the disease. A screening test can also give you peace of mind if it returns negative results.
Some patients fear that they will be exposed to COVID-19 at an appointment. I can understand this fear since we are all looking very carefully at the places we visit. However, many safety protocols are in place to keep you safe at an appointment. Social distancing, masking and enhanced cleaning procedures are being enforced at every screening facility. As a cancer specialist, I can confidently say that our staff members are well equipped to keep every person who enters our doors safe during their visit. In this field, we accommodate immunocompromised patients every day. We are used to exercising an extreme level of caution to ensure that our patients stay safe and well.
After living in a pandemic for more than a year, there are many places we want to go. I cannot wait to sit down at a restaurant or board a plane to go on vacation. Visiting your doctor might not be the first stop on your list of places you’d like to visit, but a trip to your screening appointment could save your life.
Dr. Alit Amit Yousif is a specialist in Neurological Radiology at Barbara Ann Karmanos Cancer Institute.