Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
Carmen Guerra , Peter Edward Gabriel , Abigail Doucette , Colleen M Grosso , Armenta L. Washington , Emily Verderame , Claudia Melendez , Christina Wooden , Daniel Lee , Linda White Nunes , Christine E Edmonds , Brian S. Englander , Roderick Brathwaite , Michael Noji , Erin E. Hollander , Jaia Wingard , Farouk Dako , Corrine Rhodes , Shivan Mehta , Robert H. Vonderheide
Background: The COVID-19 pandemic caused major disruptions in cancer screenings. The delays in screenings were expected to be more pronounced in racial minorities due to their pre-existing barriers to accessing cancer screenings and care. Starting in 2020, to mitigate those expected declines in cancer screenings among Black individuals, the Abramson Cancer Center (ACC) and Penn Medicine decentralized cancer screenings using mailed and drive-through Fecal Immunochemical Testing, mobile mammography, community PSA blood testing and lung cancer risk assessments. Methods: The ACC catchment area comprises more than 7 million individuals who reside primarily in 12 counties across the three states (PA, NJ, DE) surrounding Philadelphia. We used the ACC cancer registry to review the number of analytic cases for cancer diagnoses for which screening is available during the three years before and two years since the pandemic began. We compared the proportion of cancer cases diagnosed in Black patients seeking treatment at the ACC throughout all five years. Results: A total of 16.5% of the individuals diagnosed and treated for cancer from 2017-2021 at ACC were Black. In 2020, there was a decline in the number of analytic cases of breast, cervical, colorectal, lung and prostate cancer at the ACC, but by 2021, the number these cancer cases returned to pre-pandemic levels. Compared to pre-pandemic years, the proportion of Black patients with these cancers was unchanged in 2020 for all cancers except for cervical and colorectal cancer which increased by almost 2%. Conclusions: During the pandemic, there was a temporary decline in the number of ACC patients diagnosed with cancers for which a screening test is available, suggesting a correlation with the disruptions in cancer screenings caused by the pandemic. The declines in cancers diagnosed did not disproportionately impact Black individuals with the exception of cervical and colorectal cancer where there was a slight increase. Limitations include the small number of cervical cancer analytic cases which may prevent reliable estimates. Decentralization of cancer screenings for Black communities during the pandemic may have mitigated potential delays to accessing timely cancer screenings.
2017 | 2018 | 2019 | 2020 | 2021 | ||
---|---|---|---|---|---|---|
Total Patients | Breast | 1,222 | 1,519 | 1,512 | 1,444 | 1,789 |
Cervix | 40 | 39 | 42 | 32 | 49 | |
Colon/Rectum | 407 | 453 | 475 | 313 | 445 | |
Lung | 888 | 966 | 978 | 587 | 889 | |
Prostate | 856 | 1,016 | 1,085 | 739 | 878 | |
% Black | Breast | 22.7% | 19.8% | 21.3% | 21.3% | 21.5% |
Cervix | 30.0% | 41.0% | 26.2% | 28.1% | 30.6% | |
Colon/Rectum | 20.9% | 21.4% | 21.3% | 23.6% | 20.2% | |
Lung | 22.6% | 19.8% | 23.0% | 22.3% | 22.7% | |
Prostate | 21.1% | 24.9% | 28.8% | 28.1% | 27.0% |
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