Are people avoiding preventive care testing? Or are they waiting for life to return more to normal since so many clinics and medical practices have been closed? Whatever the reason, healthcare practitioners who are already straining to meet COVID-19 demands and keeping patients safe, have been performing fewer preventive care tests.
A new report from the Health Care Cost Institute (HCCI) found that on average, preventive care testing has gone down across the United States. The HCCI is a nonprofit that gathers data on health care claims, the paperwork that is sent to insurance companies, explaining what was done and how much it cost.
The HCCI used numbers from 18 states and compared month-to-month data from 2019 and the first half of 2020. They looked at claims made to health insurance companies to see what procedures were being done. This has not been the only report looking at care delays but the HCCI researchers felt that previous work was “limited in scale and scope.” Their report used data from 50 million claims between 2019 and 2020.
The researchers saw little to no change in some procedures. For example, the number of childbirths did not go down significantly in 2020. For expectant families, the baby will be born, pandemic or not.
Only screenings for prostate cancer have returned to pre-pandemic levels. These tests were down about 70% in April and May 2020 as compared to those months in 2019, but by June and July 2020, they are being performed at almost the same rate as last year. Conversely, colonoscopies saw the biggest drop of all the procedures studied, falling nearly 90% in April and May of this year relative to 2019. Even in June and July around 30% fewer colonoscopies were done this year, compared to last.
Overall, fewer preventative screenings are being done this year compared to last year.
Preventive tests for women took a significant drop. In April 2020, about 80% fewer Pap smears and mammograms were done compared to 2019. By June, only 30% fewer tests were being done, but still not as many as last year. Pap smears are used to examine the cells of the cervix to screen for cancer. Mammograms check breast tissue, also for cancer. Not all procedures saw the same drop – diagnostic mammograms, used when doctors suspect a possible case of breast cancer, did go down, but only by about 40%. Likewise, IUD insertions, a type of long-lasting birth control, went down, but not as dramatically as routine mammograms or Pap smears.
Children’s vaccinations also took a tumble. Typically, children are vaccinated against infections like measles, chickenpox, and human papillomavirus (HPV). The MMR vaccine against measles, mumps and rubella, dropped by 70% and was still 30% below 2019 levels at the beginning of the summer. On average, all vaccines were down about 60% in April and May and still haven’t returned to pre-COVID-19 levels. The meningococcal vaccines, against meningitis and other serious infections, dropped almost 80%, polio vaccines about 70%, and HPV vaccines were down close to 80%.
Only time will tell if levels of care will return to normal, and what the drop in care will mean. What will happen when unvaccinated children eventually all return to in-person school? Will there be more colon cancer due to missed colonoscopies? What about breast cancer and cervical cancer?
Regular screenings exist to catch conditions like cancer, when they are more easily treatable. Despite the pandemic, the need for screenings has not gone away. Although in response to COVID-19, many things have been paused, the progression of a metastasizing cancer or chronic condition cannot be halted without medical intervention. For patients who have delayed care, or are concerned, doctor’s offices are reopening and healthcare providers are prepared to meet patient’s non-COVID health needs. Checking in with a healthcare provider, be it a family physician, a clinic, or a hospital, might be a good idea.
Services are still available. The Centers for Disease Control and Prevention suggests using telehealth when possible, but in-person visits can be done safely. If you think you have COVID-19, the CDC site says, notify the doctor or health care provider before your visit and follow the instructions.