Because of COVID-19, about 40% of adults are canceling or postponing their regular medical appointments, according to the Centers for Disease Control. And for diseases like breast and colon cancer, which rely on regular screenings, experts say delays could mean an additional 10,000 deaths.
Philadelphia resident Tomika Bryant is a breast cancer survivor who’s postponing her second mammogram because of coronavirus. Seven years ago, she was diagnosed with triple negative breast cancer, an aggressive form of the disease. She had a double mastectomy and underwent chemotherapy.
Afterward, she still developed fat deposits in her chest, so her oncologist recommended she undergo screenings. However, due to COVID-19, she’s delaying that second mammogram.
“I said, ‘I can't go.’ And it wasn't about me. It was more that I was just afraid of what I was going to bring home to my family. It was so new, no one knew what was going on,” Bryant says.
She says her next appointment is being pushed to next year, her health center has reduced the number of appointments, and those already scheduled are higher up on a list. It’s been nearly a year from when she was supposed to get a mammogram in the first place. In the meantime, Bryant is conducting her own breast exams and logging anything she feels is unusual.
Dr. Pauline Yi, an internist at UCLA Health, says Bryant’s experience is typical during COVID. That’s because at the start of the pandemic, many health care providers recommended delaying routine appointments because personal protective equipment (PPE) were in short supply. She says many of her patients’ routine mammograms and colonoscopies are delayed three to four months due to backlogs from February and March.
Yi notes that for healthy people, delayed routine screenings might be okay. But she warns that other patients with a history of cancer or have other red flags, it’s important to make it to a screening.
Patients being proactive
Yi notes that some doctors are not aware of a backlog, so patients should contact their physicians directly to discuss the situation.
“You really need to reach out to the doctor to talk to them, because based on the history and medical medical conditions or the complaints … that's the only way you'll be able to expedite a sooner screening,” Yi says.
Due to her mammogram delay, Bryant reached out to her doctor and explained the situation. Her doctor asked about her at-home breast exams and whether anything was alarming.
“I told her that nothing had changed. But I am very much aware that if I feel like there is something that is life-pressing, I will either call her or reach out, go to the emergency room or something to that effect,” Bryant says.
The risk of COVID at the doctor’s office
Many medical facilities have enacted strict COVID-19 screening protocols to keep patients safe. Yi says that includes temperature checks, questionnaires, and vigorous cleanings.
At UCLA Health, Yi says rooms are cleaned after each patient’s visit, and doctors are fully gowned in PPE. Staff members isolate patients if they suspect they might have COVID. In those rooms, protocols are more rigid, and only doctors are allowed inside.
Health screening recommendations amid COVID
Due to screening delays, Yi says individuals should discuss their medical histories with their physicians to figure out the next best steps. Mammograms and pap smears depend on results of previous screenings, so reaching out to a doctor can help gauge when the next appointments can be scheduled.
She says in general, each patient should get a mammogram every one to two years and a pap smear every three to five years — both based on previous screenings.
Yi says individuals should not skip their regular preventative care treatments. If they feel uncomfortable with an in-person visit, she recommends telehealth appointments. But she also recognizes that some patients require in-person tests or bloodwork to be done.
“We do know the second wave is here, and so we want to make sure our patients are at the best health that they can be.”