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Cosmos Study

Cancer Screenings Are Still Lagging

Abstract: While cancer screenings briefly returned to baseline, we have not fully recovered from the initial drop reported in May 2020.
June 9, 2021
Christopher Mast, MD | Alejandro Muñoz del Río, PhD | Tyler Heist, PhD

In May 2020, we reported a significant drop in the weekly rate of routine cancer screenings. At that time, there was a 94% decrease in breast cancer screenings, an 86% decrease in colon cancer screenings, and a 94% decrease in cervical cancer screenings. In July 2020, our follow-up study showed weekly screening rates for these three cancers were on the rise but had not yet reached pre-pandemic levels, remaining 29%-36% lower than their pre-COVID-19 levels.

Since then, many organizations have reinvigorated their efforts to encourage patients to reschedule missed screenings and to keep existing preventive appointments. Looking at screenings for March 2020 through March 2021, total cancer screenings are still lower than historical baselines. Breast cancer screenings were 13% below historical averages, colon cancer screenings were 25% below, and cervical cancer screenings were 21% below. These rates equate to an estimated 382,000 missed breast cancer screenings, 249,000 missed colon cancer screenings, and 94,000 missed cervical cancer screenings from March 2020 to March 2021. These missed screenings continue to raise concern of an increase in later stage cancer diagnoses with potential poorer prognosis. While our findings suggest the gap is decreasing, continued diligence is needed to make up for the missed screenings.

Figure 1
Breast Cancer Screening Rates
Breast Cancer Screening Rates
Figure 1. Breast cancer screenings from January 2017 through March 2021, compared to the historical average. From March 2020 through March 2021, the total number of breast cancer screenings is down 13% compared to the historical average.
Figure 2
Colon Cancer Screening Rates
Colon Cancer Screening Rates
Figure 2. Colon cancer screenings from January 2017 through March 2021, compared to the historical average. From March 2020 through March 2021, the total number of colon cancer screenings is down 25% compared to the historical average.
Figure 3
Cervical Cancer Screening Rates
Cervical Cancer Screening Rates
Figure 3. Cervical cancer screenings from January 2017 through March 2021, compared to the historical average. From March 2020 through March 2021, the total number of cervical cancer screenings is down 21% compared to the historical average.

These data come from Cosmos, a HIPAA Limited Data Set of more than 107 million patients contributed by Epic customers. This study expanded on the data collected in two previous EHRN studies listed above. This study is based on data from 113 healthcare organizations representing 442 hospitals covering 70 million patients.