Researchers from Massachusetts General Hospital (MGH) and Harvard Medical School in Boston compared cancer-related CT exams during three periods of 2020: the pre-COVID phase (January to mid-March), peak COVID (mid-March to May) and post-COVID peak (May to mid-November). They looked at CT volume and the type of care being delivered through imaging, according to their report.
As expected, CT volumes dropped significantly during the COVID peak. CT for cancer screening fell a whopping 82%, while CT for initial workup, active cancer and cancer surveillance also saw significant declines. Volumes for cancer screening and initial workup failed to recover in the post-COVID peak period, remaining down 11.7% and 20%, respectively, from their pre-COV2302s.
The persistence of the decline in CTs for cancer screening and initial workup likely means higher numbers of patients with advanced cancers in the future.
CT imaging declines particularly affected the outpatient setting, as utilization shifted away from large academic centers toward community hospitals and the Emergency Department (ED). Cancer-related CTs at the ED actually increased in the post-COVID peak period.
The possibility of being exposed to COVID-19 likely made many cancer patients reluctant to go to large hospitals and primary care centers, the researchers said. As a result, they may have put off a visit until symptoms grew too significant to ignore.
The study findings underscore the vulnerable position of cancer patients in the pandemic.
The imaging utilization trends support the diversion of more resources to community centers to take care of patients who might be avoiding large academic hospitals. The trends also highlight the importance of a robust ED imaging service with overnight coverage in both academic medical centers and private practices.
The researchers hope to do a follow-up study to track CT imaging volumes through 2021. They also want to look at the role that factors like race, language and income have played in access to cancer imaging during the pandemic.