Significant decreases in CT imaging for cancer persisted even after the peak of the COVID-19 pandemic in 2020, delaying diagnosis and treatment and raising the possibility of more advanced cancers and poorer outcomes for patients in the future, according to a study being presented at the annual meeting of the Radiological Society of North America (RSNA) and reported in a news release from RSNA.
For the new study, researchers from Massachusetts General Hospital (MGH) and Harvard Medical School in Boston compared cancer-related CT exams during three periods of 2020: the pre-COVID phase (January to mid-March), peak COVID (mid-March to May) and post-COVID peak (May to mid-November). They looked at CT volume and the type of care being delivered through imaging.
As expected, CT volumes dropped significantly during the COVID peak. CT for cancer screening fell a whopping 82%, while CT for initial workup, active cancer and cancer surveillance also saw significant declines. Volumes for cancer screening and initial workup failed to recover in the post-COVID peak period, remaining down 11.7% and 20%, respectively, from their pre-COV2302s.
The persistence of the decline in CTs for cancer screening and initial workup likely means higher numbers of patients with advanced cancers in the future, the researchers said.
CT imaging declines particularly affected the outpatient setting, as utilization shifted away from large academic centers toward community hospitals and emergency departments (EDs). Cancer-related CTs at the ED actually increased in the post-COVID peak period.
“The ED remains a place in the American healthcare system where people can get help, no matter the situation,” said study author Ottavia Zattra, a fourth-year medical student at Harvard Medical School. “From a systems perspective, however, the best care in terms of prevention is administered in the outpatient setting.”
The possibility of being exposed to COVID-19 likely made many cancer patients reluctant to go to large hospitals and primary care centers, the researchers said. As a result, they may have put off a visit until symptoms grew too significant to ignore.