Delays in cancer screening worry Augusta doctors who want patients to get checked now
While other physician practices saw a big drop in patients, Dr. David Squires said Augusta Oncology Associates and other cancer clinics continued to see their patients and provide care. But he and other physicians worry that a long delay in cancer screenings caused by COVID-19 and continued fear of medical facilities could lead to a delay in new diagnoses and potentially worse outcomes for those patients.
“It makes sense that there is going to be a percentage, maybe five or 10 percent, that will get diagnosed later in their disease than they would have had they been screened on time,” Squires said. “For breast cancer, it could mean the difference between getting chemotherapy and not getting chemotherapy or between the possibility of being cured or not being cured. The same thing with colon cancer. Those particularly, it makes the biggest difference.”
As COVID-19 spread across the country and across Georgia, many hospitals decided to cancel elective procedures, or were mandated by states to stop, in order to limit exposure to staff and help preserve limited supplies of personal protective equipment. That means shutting down many cancer screenings such as colonoscopies or mammograms for much of March and April. The volumes at AU Health System reflect that. Despite restarting screenings in May, the health system 788 fewer mammograms this year compared to 2019 and 461 fewer colonoscopies. While most cancer surgeries continued, some that could be safely delayed, such as those in early-stage, non-aggressive prostate cancers, were rescheduled, said Dr. Rabii Madi, a urologic surgical oncologist at Georgia Caner Center at AU. The clinic also used telemedicine to reach out to its patients, he said.
“That was a great asset to communicate with patients who could not come or had a concern about coming to the clinic,” he said.
Mammograms and colonoscopies are back in full swing at Doctors Hospital of Augusta now after the long delay and are very busy, said Elizabeth Lamb, administrative director of oncology for Doctors.
“However, there were a lot of patients missed in that six-week period we were closed that may not feel the priority right now to get back on that schedule, to reschedule it,” she said. “It would be easy for me to say, I really don’t need my mammogram this year, I’ll just catch up with it next year. Maybe women say about a Pap smear, I’ll just go next year. I’ve already missed my appointment, I’ll just reschedule for next year and get back on track then. But if you delay it for a year or you say, ’I’m just not comfortable going out’ and you delay it for a long period of time, it could impact you.”
For instance, in the more aggressive bladder cancers “there are studies that suggest that if there is a delay of more than three months in terms of treating that cancer that can result in more advanced stage and worse prognosis,” Madi said.
Squires said he has already seen the impact of patients who delayed care or delayed screening even though they had symptoms, in one case putting a patient directly into hospice because the cancer was found too late to treat it.
Those who are at higher risk, who are elderly or are medically fragile, and are fearful about going to a clinic or hospital for screening should reach out to their primary care provider, Lamb said.
“To say, knowing my history, is this worth the risk of me getting out and coming to see you or getting that test or getting the bloodwork?” she said. “They should have that conversation with their physician who can guide them one way or another.”
In fact, now and in the coming summer months may actually be the best time to get screened or to have that annual visit, Squires said.
“This summer is probably going to be the best time to do all of those screening tests,” he said. “Right now, we have a lull (in COVID-19 outbreaks) and school is not in session. We’re not going to have big flare-ups right now. Now is the best time to do it.”
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