Pandemic worsened gaps in care, led to 30% fewer cancer diagnoses: Alberta doctor

Click to play video: 'Health Matters: Pandemic led to 30% fewer cancer diagnoses in Alberta'
Health Matters: Pandemic led to 30% fewer cancer diagnoses in Alberta
Health Matters December 14: COVID-19 has meant fewer Albertans seeing a doctor, which led to a 30 per cent drop in cancer diagnoses during the spring lockdown. As Su-Ling Goh reports, doctors are worried about more cases going undiagnosed during this second wave. – Dec 14, 2020

The COVID-19 pandemic is having a ripple effect on other parts of the health-care system and an Alberta oncologist is worried an increasing number of cancer patients aren’t being diagnosed early enough — or at all.

“Cancer hasn’t gone away. It’s still a very serious health threat and we need to be able to diagnose and manage it, pandemic or not,” Dr. Douglas Stewart told Global News.

Prior to the pandemic, about 2,000 Albertans were diagnosed with cancer, and approximately 600 died from cancer, each month, according to numbers from Alberta Health Services.

“Even before the COVID-19 pandemic, delays in cancer diagnosis and inadequate supports for patients and family physicians were issues facing Albertans and healthcare providers,” Stewart said.

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“The Cancer Strategic Clinical Network of AHS has initiated work on the creation of a comprehensive provincial cancer diagnosis program, and will soon add diagnosis programs for lymphoma and colorectal cancer to build on those created for lung and breast cancer.

“The pandemic has made these gaps in cancer diagnosis worse and has resulted in a decrease by more than 30 per cent during the first wave in the spring [from the same months last year] with some recovery through the summer and early fall,” Stewart wrote.

“We are seeing a reversal of that recovery through Wave 2 and cancer diagnosis is declining again.

“We find this concerning. Similar decreases in cancer diagnosis have been reported globally, including the USA, Europe and Australia.

“The pandemic has not made cancer go away, but may worsen cancer outcomes.”

Click to play video: 'Alberta woman shares story to offer lesson about breast cancer screening'
Alberta woman shares story to offer lesson about breast cancer screening

“There was a pause in screening programs,” said Stewart, who is an oncologist at the Tom Baker Cancer Centre, a professor of Oncology at the University of Calgary and senior medical director of AHS’ Cancer Strategic Clinical Network.

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“We have screening programs for cervical cancer, breast cancer and colorectal cancer. They were paused in the spring.

“CT scans were really prioritized to urgent need, but the numbers of CT scans [went down], imaging studies dropped, a lot of surgical procedures decreased — by about 60 per cent — biopsies decreased, colonoscopy suites, endoscopy suites, they were paused.”

Even when services picked back up in the summer, cancer diagnosis rates were still lower than they should have been, Stewart said.

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“Being even 10 per cent down means every month, we were accumulating another 200 people that we would’ve expected to be diagnosed with cancer who weren’t,” he said.

“We never dealt with the backlog and the number of undiagnosed cancer patients has steadily been growing during the pandemic.

“We’re in the midst of this huge second wave… We worry everything is going to go back to the way it was in the spring… People aren’t showing up for the screening tests, we worry that people aren’t going to see their doctor when they notice a warning symptom of cancer.”

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Click to play video: 'Health Matters: Missing medical appointments during the pandemic'
Health Matters: Missing medical appointments during the pandemic

Stewart wrote in an op-ed sent to several Alberta newspapers and media outlets Monday, highlighting the importance of timely cancer diagnosis and care.

“Diagnosing cancer later at more advanced stages results in shorter survival, reduced quality of life and more hospitalizations.

Alberta’s chief medical officer of health has spoken about the importance of people maintaining their health and not delaying treatment.

“During this pandemic, it has become clear that Albertans are not seeking medical attention as often as they normally would or should,” Dr. Hinshaw said on Dec. 10.

“This trend is not unique to Alberta. It has been identified across Canada and many other countries. But we need to change that. The health system in Alberta remains a safe place to go. If you need help, it is open and ready to help diagnose and manage illnesses and diseases.”

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“Alberta Health Services and the Alberta Cancer Foundation are reminding Albertans about the importance of listening to their bodies and seeking medical attention if they notice any changes,” she added.

“Please talk with your health care provider so they can investigate any new persistent symptoms if you were experiencing them. This includes things like an unusual or growing lump, significant blood in your stool, urine or phlegm or growth or darkening of a mole. These can all be signs of serious health issues, including cancer.”

Stewart echoed those sentiments, adding that timely cancer diagnoses and treatment is crucial.

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“Cancer is the leading cause of death in Alberta,” he wrote.

“We know that early cancer diagnosis results in less advanced disease, more effective treatment options, better survival and quality of life outcomes. However, diagnosing cancer early is a complex process that requires a person to notice a change in their body that is persistent or worsening and seek medical attention.

“My colleagues are meeting newly diagnosed cancer patients who first noticed symptoms or lumps in April, but did not book an appointment to see their family doctor until later in the summer because they were worried about catching COVID-19 or bothering their doctor with a non-COVID-19 issue, or thought their doctor was not seeing patients in-person,” Stewart continues.

“The public needs to be assured that physician offices and testing facilities are safe places to visit because of strict COVID-19 precautions such as masking, extra cleaning, distancing, and prescreening protocols.

“An important part of taking care of your health during the pandemic is also seeing your doctor and going for tests when needed. As clinicians, we will always be here to help you with serious medical concerns.”


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