Real Burden of Cancer ‘Won’t Go Away’ Because of COVID-19

After the COVID-19 pandemic caused many people to take extreme safety precautions, doctors noticed a decline in routine care appointments and cancer screenings. Now, more than a year into the pandemic, it is crucial that patients resume these screenings to prevent a detectable cancer from progressing, says an expert from the Karmanos Cancer Hospital & Network.

Dr. Justin Klamerus, president of the Karmanos Cancer Hospital & Network in Detroit, spoke with CURE® about COVID-19, cancer screenings, what institutions are doing to ensure patients’ safety and offered some advice to patients who may still be hesitant to return to their health care provider’s office for preventative care.

“It's much safer for you to get into a facility to be to be screened than it is to avoid that screening because of concern of COVID,” said Klamerus.

CURE®: Why do you think people have been delaying cancer screenings during the pandemic?
Klamerus: I think, as I reflect on it, there isn't a part of any of our personal or professional lives, most likely, that haven't been impacted by the virus and not only changing our routines, how we handle our daily lives, how we care for our children, how we care for our loved ones, how we get our groceries, all of those things have been impacted by the coronavirus pandemic. So too, has cancer screening.

And if I think about reasons why patients would be avoiding this, it's sort of the health maintenance, the routine things that we do for our care, sort of get triaged lower in the list of priorities when we're worried about, you know, a global pandemic. So, it's natural for patients to have perhaps avoided routine care. Some routine care services like dental care and others were really discouraged during the height of the pandemic. Now, I'm happy to say it's a much different time and we're ready for all those services for patients.

Have you seen the impact of delayed screenings at your own practice?

We're the largest provider of cancer care in the state of Michigan, we have 15 locations here in Michigan (and) a location we're building in Ohio. With that, we've seen about a 20% decline in the usual utilization rates of screening tests like mammography, colonoscopies for colon cancer, even Pap smears, lung cancer screening, those routine services that become a part of our regular health care, those have been avoided and delayed.

And the impact, then, we worry, is that wherever we're not keeping up with cancer screening, that we're missing the golden opportunity in cancer care and treatment, and that is to find the cancer as early as possible so that it can be cured. Our goal, of course, is hopefully preventing them as first priority, but certainly we know, in most all forms of cancer, the earlier it's detected, the greater the chance of cure.

What impact would you say these delayed screenings will end up having on those advanced cancer diagnoses in the future?

I have no doubt that what we will see, as we begin to track and collect data, is first that the stage of diagnosis becomes higher during this period. I think we'll see potentially cancer death rates rise in this country during this period and perhaps even for the next year or so.

All that's incredibly crucial, because this will be the first year that we actually haven't reversed the trend and survival. Every year for the last decade, the survival or the five-year survival rates of cancer have increased in this country. And I think we may be at a point during COVID and 2020, where we see that go backwards for the first time. So, we've got to reset. Health care is safe, screening is safe, we've got to get patients back.

How is your institution in particular making it safer for patients to kind of return to normalcy and get tested and screened regularly, despite the pandemic still going on?

I think we, like most health care facilities, have focused on firstly making sure that we communicate to our patients that this is a safe environment. What does a safe environment mean? We screen patients, we screen anyone who enters our building, including our own employees, for symptoms. We check for fevers, those are reported and screened for upon entry, for patients the same thing. Of course, as vaccinations become more available, I'm happy to say in most of our facilities, we've got anywhere from 55%-70% of our staff vaccinated, which decreases risk.

And I think it's imperative that people remember that COVID is principally a community acquired infection. It is not an infection people acquire when they come into our facilities.

Despite that, we're of course spending all the time making sure there's proper distancing, that we clean our rooms and sanitize our equipment to protect against the spread of the virus, as all health systems, all healthcare facilities are doing. We've learned a lot in a very short period of time, but I have 100% confidence for patients thinking about cancer screening. It's much safer for you to get into a facility to be to be screened than it is to avoid that screening because of concern of COVID.

What advice would you have for patients who might be afraid still to have those screenings done?

Well, it's understandable, given where we have been for the last year. All the challenges we've seen. But health care is safe, and the real burden of cancer is there and present and won't go away because of the virus. And just know that the greatest chance that we have to reduce the burden of cancer is to detect it early.

Certainly, practicing healthy lifestyle behaviors, avoiding the risk factors that put one at risk for developing cancer. But certainly, we know the story for many cancers, (that) if we can detect it early, we can cure cancer and people can get on to leading on normal and full lives when that occurs.

This interview has been edited for clarity and conciseness.

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