The COVID-19 pandemic last year had a dramatic impact on cancer screenings that has “altered what we have done in healthcare for decades,” stresses Michael J. Zinner, M.D., CEO and executive medical director of Miami Cancer Institute .
Screenings for breast cancer, colorectal cancer, lung cancer and prostate cancer were down as much as 85 percent, compared to the year before. “When we model that out … when we look to the decade ahead, that translates into 4,000 additional deaths from breast cancer, 5,000 additional deaths from lung cancer and prostate cancer,” Dr. Zinner says. “What I’m saying is … this is a ticking time bomb with a 10-year fuse that we need to fix immediately.”
That blunt assessment was part of a news conference held yesterday  in front of Miami Cancer Institute  to alert the community about the vital importance of keeping up with cancer screenings. On the panel, Dr. Zinner was joined by Jane Mendez, M.D.,  chief of breast surgery at the Institute, and Mark Dylewski, M.D. , the Institute’s chief of general thoracic surgery. The Institute’s experts were joined by Morgen Chesonis-Gonzalez, a clinical art therapist for Miami-Dade County public schools, and a breast cancer survivor who recounted how she was diagnosed with stage-two breast cancer after a mammogram nearly a year ago.
“It was during the mammogram that they found I did have breast cancer after not having any cancer the year before,” explains Ms. Chesonis-Gonzalez. “So, it was quite startling and frightening… but I did follow through and I felt very safe at Miami Cancer Institute with my team of doctors … The type of cancer that I had was already a stage-two that had metastasized … so they started treatment right away.”
Dr. Zinner adds that it is quite safe to tend to your screenings with COVID-19 protocols still in place.
“In fact … last year and currently, it’s safer to come to one of our facilities than it is to go to your grocery store,” said Dr. Zinner. “So, I strongly encourage you to go ahead and catch up on your screenings.”
The COVID-19 pandemic has caused too many people to skip their vital cancer screenings, according to a recent study. Screenings for breast cancer, colorectal cancer and prostate cancer declined sharply from March to May 2020, compared to the same time span in 2019, according to findings from a study that was published in JAMA Oncology . The declines were striking: breast cancer screenings down 91 percent; colorectal cancer screenings down 79 percent; and prostate screenings down 63 percent.
The study’s co-authors were blunt in their conclusion: “Delays in cancer screenings owing to COVID-19 are suspected to lead to additional excess deaths that are directly attributable to the pandemic.”
Breast Cancer Screenings
“There is no doubt that early detection makes a difference when it comes to breast cancer,” said Dr. Mendez. “The pandemic certainly made it very difficult for women to get a screening. But centers are open now and it is safe to do so.”
Dr. Mendez strongly emphasized that early detection saves lives. “We know that when breast cancer is detected early, we have a 98.5 percent survival nowadays, given all the technology and all the advances that we have available for breast cancer,” said Dr. Mendez. “So, the message out there is — do not delay getting your screening studies performed, particularly mammograms, because we know that they save lives and improve prognosis though early detection.
“And it’s safe at all our imaging centers at Baptist Health and they can offer mammograms that are easily accessible. So do not delay getting your mammograms.”
Lung Cancer Screenings
Dr. Dylewski emphasized that even certain nonsmokers need to get lung screenings. “Many individuals out in the community may not be aware that 17 percent of our patients that we operate on for lung cancer are non- smokers. Not all smokers get lung cancer, and not all non-smokers don’t get lung cancer.”
But it’s very difficult to screen those patients who are non-smokers, he pointed out. “When you’re a smoker, it’s very easy to identify your risk factor, which is smoking — one of the worst things that you can do for your health all across the board.” It causes coronary artery disease … cancers in the bladder, the uterus, the lungs, and the head and neck region. So, it’s very important to realize that if you’re a smoker, you’re at risk.
If you smoked more than 30 years, you were at heightened risk, and it’s important to get screened primarily with a low dose CT scan. “If you have a family history, you’re also at heightened risk for developing lung cancer. And we screen most patients between the ages of 55 and 80. If you’re a smoker, talk to your primary care physician about a regular screening program.”
Dr. Dylewski adds that the Institute is seeing a rise in incidents of adenocarcinoma, lung cancer not related to smoking, in women. “It accounts for most of those individuals — that 17 percent that I mentioned — that are non-smokers that we operate on. And it’s very difficult to identify their risk factors. What we know until this point is that it tends to run in family members. So, if you have a previous family member — a mother, grandmother, sister, brother –, who had lung cancer, I think it’s important to demand a screening for yourself if you’re between 50 and 70.”
List of Recommended Screenings
Here are the recommended cancer screenings based on age and gender. Consult with your primary care physician if you any questions regarding cancer screenings and your level of risk.
Colorectal Cancer Screening: Average risk individual should begin screening at age 45, with follow-up on findings. Those at an increased risk, including African Americans or those who have a family history of colon cancer, should start screening earlier and be tested more often.
Mammogram: Recommended annual screening starting at age 40. Begin earlier if there is a family history of breast cancer.
Pap & HPV Test: Women ages 21-29 should get a Pap smear every three years. Women ages 30-65 should have an HPV test every five years, a Pap test every three years or a combination of every five years. Women over age 65 who have had regular cervical cancer testing in the past 10 years with normal results may forgo testing.
Lung Cancer Screening: For those 55-80 years old, screening is recommended for current smokers and those with heavy smoking history.
Prostate Exam: Men ages 55-69 should have a conversation with their doctor about the risks and benefits of prostate cancer screening. Begin earlier if you are African American/black or have a family history of prostate cancer.
Mole & Skin Checks: According to American Cancer Society, exams by your doctors and checking your own skin frequently can help find many skin cancers early, when they are easier to treat. Regular skin exams are especially important for people who are at a higher risk for skin cancer. Talk to your doctor about how often you should have your skin examined.