Cancer Screening in the COVID-19 Era

As oncology professionals, we’re aware of the significant impact the COVID-19 pandemic has had on cancer screening rates. At the start of the pandemic, many components of healthcare delivery were shifted to telemedicine, accommodating patients’ increased fear of infection relieving the burden placed on hospitals and health systems. While these changes were necessary, it is estimated that 9.4 million Americans’ cancer screenings that would have taken place in 2020 were delayed. Additionally, a National Cancer Institute data model estimates that the pandemic would cause an additional one percent increase in breast and colorectal cancer-related deaths by 2030; a number equivalent to 10,000 extra deaths.

At Mercy Medical Center-Cedar Rapids, Hall-Perrine Cancer Center in Iowa, cancer center leadership and staff took note of the significant impact the pandemic had on our routine screening rates. In spring 2020, colonoscopies and mammograms dropped by 97 percent and 91 percent, respectively. Due to public perceptions about safety, patients were slow to return to normal screening patterns. And concerned about these trends, hospital leadership formed a group to identify and tackle patient barriers to these services. A multidisciplinary group—made up of primary and specialty care leadership as well as IT (Information Technology), Quality, Billing, and Marketing department staff—launched a quality improvement project to increase our colorectal screening rates.

Bulk Ordering

Our facility then launched its bulk ordering project to contact patients who delayed their cancer screening due to the pandemic or who haven’t yet scheduled their screenings for other reasons. Through reporting in our electronic health record, patients who had not completed a colonoscopy in the last 10 years were contacted by our gastrointestinal (GI) team. It was through these efforts that 25 percent of patients completed their overdue colonoscopies, and positive pathology was noted in 47 percent of these exams.

Project Expansion

After the success of this initiative, we launched bulk ordering for both mammography and lung cancer screening efforts. Of the overdue mammograms, we saw a 13 percent compliance rate with one confirmed malignancy. In building on this momentum, we further built our lung screening program. The lung initiative at Hall-Perrine Cancer Center started in January 2022. Since, we’ve had a participation rate of 15 percent and raised the number of completed CT lung cancer screenings in our facility by 43 percent.

Because of our multidisciplinary team-based approach, we have improved communication across the health system, and we continue to make incremental progress around cancer screening. Cancer center staff continue to analyze the project’s findings and build best practices for improving cancer screening rates in our community. Additionally, we hold quarterly cancer screening events in partnership with our local free clinics in order to reach underserved populations in need of cancer screening services. Looking to the future, we plan to launch bulk ordering for prostate-specific antigen screening and annual wellness visits through continued work with our primary care network.

Through current practices and future plans, Hall-Perrine Cancer Center staff will continue to try to reach as many patients in our community as possible to provide high-quality care.