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COVID-19 Impact on Georgia Latest Articles

July 16, 2022

New Cancer Cases on the Rise

New Cancer Cases on the Rise

About 1.9 million new cancer cases will be diagnosed in the United States in 2022 and more than 609,000 people will die from the disease, according to new estimates from the American Cancer Society (ACS). It’s the highest estimate of new diagnoses since 2007, the group points out. Despite two decades of progress, cancer remains the second-leading cause of death in the U.S., second only to heart disease. 

During the pandemic, health experts warned about the domino effect that the COVID pandemic would have on public health, particularly cancer care. The cancellation or postponement of cancer-related appointments and screenings, they suggested, would lead to missed or delayed diagnoses when the disease may be more difficult to treat. 

The ACS report includes cases reported in 2018 and deaths through 2019, so the effects of the pandemic on U.S. cancer rates will continue to unfold.

“It is clear already that the disruption of health services resulted in millions of people who missed or postponed appointments for cancer screening or follow-up of abnormal results or new symptoms, as well as patients already diagnosed who experienced treatment delays and/or modifications,” the authors wrote.  “The consequences of this interruption in care will become evident in our cancer statistics over the next several, years to come.” 

Perfect storm for cancer
Screenings for breast cancer fell by 94 percent between January and April 2020. Colon cancer screenings also dropped by 86 percent and screenings for cervical cancers also feel by 94 percent, according to a May 2020 study published by the Epic Health Research Network. While the number of screenings started to rebound since then, data from a July 2020 update, showed that between March and June 2020, weekly cancer screenings were still 29 percent lower for breast cancer, 35 percent lower for cervical cancer and 36 percent lower for colon cancer than pre-pandemic averages. As a result, there were 285,000 breast, 95,000 colon, and 40,000 cervical exams missed during that time period.

“Three effects of COVID-19 combine[d] to make a perfect storm for delayed diagnosis of cancer which will persist well beyond when the pandemic ends,” says William Cance, MD, ACS chief medical and scientific officer.

First, the shutdown of clinics during the early months of the pandemic created a patient backlog. Screening centers were seeing fewer patients and functioning more slowly because of the requirements for containing the pandemic, Dr. Cance explains.  

Second, the financial fallout of the pandemic triggered mass unemployment. Upwards of 12 million people lost employer-sponsored health insurance, according to estimates by the Economy Policy Institute. As a result, health concerns—including cancer prevention or even treatment—took a back seat to paying the mortgage or putting food on the table.

Third, fear of catching COVID kept people away from doctors’ offices. Outpatient visits dropped nationwide by almost 60 percent in early April 2020, and were still 10 percent below normal in late July 2020, according to analyses by the healthcare technology company Phreesia, Harvard University and the Commonwealth Fund.

New cancer diagnoses dropped steeply when the COVID pandemic began. This could result in more cases being diagnosed at more advanced stages when they’re harder to treat.

An August 2020 study published in JAMA Network Open showed that weekly numbers of new cancer diagnoses fell by 46.4 percent for seven weeks between March and April 2020, compared to pre-COVID levels. The research included 278,778 patients from across the U.S. and looked at six types of cancer: breast, colorectal, lung, pancreatic, gastric, and esophageal.

The most dramatic drop was for breast cancer at 51.8 percent.

Reason for hope: Cancer deaths are declining 
Despite its prediction that new cancer diagnoses will rise, the ACS points out that cancer mortality rates are falling. The largest factor in that new trend? Decreasing tobacco use.

The overall age-adjusted cancer death rate peaked in 1991 at 215 cancer deaths per 100,000 people due to the rampant use of tobacco, which is linked to 20 percent of all cancers and approximately 30 percent of all U.S. cancer deaths, according to ACS. Recent efforts to curb smoking combined with advancements in the early detection and treatment for the four most common types of cancer—lung, colorectal, breast, and prostate—led to a 32 percent drop in cancer deaths in 2019. This represents nearly 3.5 million fewer cancer deaths from 1991 to 2019.

Prevention is key
Significant progress has been made in the detection and treatment of cancer over the past few decades, including more advanced imaging and the development of novel therapeutics to target cancer cells. But prevention is key. It’s important to know your risk.

While anyone and everyone can develop cancer, several factors increase the risk, including, age and lifestyle as well as race and ethnicity. In the U.S., people ages 55 years and older accounted for 80 percent new cancer diagnoses. Certain lifestyle factors and other things people can control may also drive up their chances of developing cancer, such as smoking, obesity, alcohol consumption, and diet. But if you’re young, it doesn’t mean you’re risk-free. Recent years have shown a shift toward earlier age at cancer diagnosis for people born after 1950. So, a young person who is having persistent symptoms—especially if they have a family history of cancer—should get screened, Cance advises.

Black and Hispanic people—groups which often face barriers to care—may also be at increased risk for certain cancers. For example, Black people have a higher overall rate of death from cancers compared to whites. This is largely due to higher rates of death from breast, colorectal, prostate and lung cancer.

There are several ways you can be proactive in order to help reduce your risk for certain forms of cancer, including:

  • Kick bad habits: Not smoking, exercising regularly, limiting your alcohol intake (or not drinking at all) and maintaining a healthy weight could help. For cancer prevention, the ACS recommends cutting back on the amount of red and processed meats you consume, opt for whole grains instead of refined grains and eat at least two and a half cups of fruits and vegetables each day. About 19 percent of all cancer deaths are caused by smoking while 4 percent are linked to alcohol consumption and 2.2 percent are associated with sedentary lifestyles, the ACS reports. Obesity is associated with an increased risk for 13 types of cancer, which accounts for about 40 percent of all cancers diagnosed in the U.S., according to the Centers for Disease Control and Prevention (CDC).
  • Prevent and treat infections: Other cancers caused by viruses, including the human papillomavirus (HPV), hepatitis B virus (HBV), and hepatitis C virus (HCV)—as well as bacteria, including Helicobacter pylori (H. pylori)—could also be prevented through vaccination or by avoiding or treating these infections.
  • Wear sunscreen: It’s estimated that the vast majority of skin cancers are caused by exposure to UV radiation, according to ACS. The most common types of skin cancer are basal cell and squamous cell cancers, which are often found on parts of the body that are most exposed to the sun. While a person’s risk of developing melanoma is associated with genetic and personal characteristics, UV exposure has also been shown to increase risk. ACS estimates that millions of skin cancers diagnosed each year could be prevented if people protected their skin by routinely applying sunscreen and avoiding indoor tanning facilities and other man-made sources of UV rays. For the prevention of skin cancer, the American Academy of Dermatology recommends using broad spectrum sunscreen with a sun protection factor (SPF) of at least 30 and reapplying every two hours or after swimming or sweating.
  • Get screened: Certain cancers may be detected early on when treatments are often more successful. Screening tests are recommended for breast, cervical, colorectal and lung cancers. There are also screening tests available to detect prostate cancer, but the risks and benefits of these tests are less clear. You should weigh the risks and benefits of cancer screenings with your doctor. Together, you can determine when and how often you should be screened for certain forms of cancer based on your values, age, health preferences, and individual risk for the disease. In addition, some doctors perform skin examinations to also screen for skin cancer during routine checkups, but it’s also important to perform regular self-checks, the ACS advises. During a skin self-exam, you should use a full length and hand mirror to look at all sides of your body—front and back as well as both sides with your arms raised. Be sure to check your elbows, forearms, underarms, the palms of your hands, the soles of your feet and the skin between your toes. Ideally, you should perform this skin self-exam once per month and report any worrisome or suspicious changes to your doctor.

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