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Decline in cancer screening during pandemic could result in spike in cases - medical experts

Medical experts concerned about decline in cancer screenings in South Africa. File image.

Medical experts concerned about decline in cancer screenings in South Africa. File image.

Published Aug 21, 2021


Johannesburg - The novel coronavirus and subsequent lockdown could potentially result in a cancerous ticking timebomb which could soon explode.

Health experts and insiders have warned there had been a significant decrease in cancer screenings for both men and women across the country since the arrival of Covid-19 in March last year.

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There has also been a decline in oncology registrations as people fear contracting the virus from hospitals and clinics and other medical centres.

“The 13% drop in registrations, while it may reflect a reduction in screenings, also reflects a decrease in cancer diagnosis mainly achieved through elective surgical procedures that were deprioritised during the pandemic,” Noluthando Nematswerani, head of Discovery Health’s Centre for Clinical Excellence said.

He said the medical aid scheme witnessed a 17% decrease in mammography visits per 1000 lives in 2020 when compared with the previous years.

There was also an 18% decrease in pap smear visits per 1000 lives in 2020 and in April 2020, during level 5 lockdown, the colorectal registrations were down 40% from the previous year.

Nematswerani’s comments coincide with a recent study conducted by insurer 1st for Women whose findings revealed just 22% of the survey’s participants had been for a pap smear to screen for ovarian or cervical cancer during the pandemic and just 14% had been for a mammogram to screen for breast cancer.

“The survey showed many women have not had their annual cancer screenings over the last 18 months, due to the lockdowns and fear of contracting the Covid-19 virus as well as financial pressure,” Seugnette van Wyngaard, head of 1st for Women Insurance, believes.

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She said cancer screenings were vital in order to increase the chances of survival from the deadly diseases.

“Early detection of cancer is key for quick treatment and a better chance of recovery.”

Van Wyngaard also noted findings from the American Cancer Society which found early-stage breast cancer had a five-year survival rate of 99%.

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Later-stage cancer had a survival rate of 27% and more than 75% of women who had breast cancer had no family history of cancer.

“Input from the experts on what screenings entail, and how pap smears and mammograms could very well save your life through early detection and prompt treatment,” Van Wyngaard said.

Van Wyngaard said in terms of pap smears, screening tests can help identify signs of developing cancer before symptoms appear.

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“For example, when you have a pap smear, your gynaecologist may tell you you have been identified with pre-cancerous cells,” she said.

Meanwhile, Dr Liat Malek, a specialist radiologist at the Breast Wellness Centre in Johannesburg, said there had been a drastic decline of routine screening mammograms reported around the world.

“The result has been that this year we have been diagnosing more late stage cancers or advanced stages of the disease.”

Regular mammograms allow doctors to discover subtle changes in the breast by comparing results to previous years. Picture: REUTERS Kim Kyung-Hoon

Malek said a screening mammogram was the routine examination of the breasts in women who had no signs or symptoms of a cancer, using low dose X-ray imaging.

“This is the most effective way of diagnosing early breast cancers and therefore reducing breast cancer deaths, with effective and less aggressive treatment,” she said.

The specialist radiologist said regular screening mammograms allowed doctors to discover subtle changes in the breast by comparing to the previous years.

“These subtle changes to the breast pattern may be the first sign of a cancer developing and helps catch the cancer early before it is even symptomatic.”

Despite the decline in screenings for several types of cancer, Discovery Health have insisted their medical centres have remained open for cancer patients during the lockdown and that they have complied with all Covid-19 protocols at these sites such as mask-wearing, sanitising and hand washing as well as social distancing.

“The experience with members actively receiving treatment for their cancer, chemotherapy and/or radiation treatment, was quite different.”

“Oncology units executed the necessary steps and precautions so members continued to access treatment throughout the pandemic.”

Staff at Chris Hani Baragwanath Academic Hospital (CHBAH) in Johannesburg have also insisted they have done all they could to provide cancer screenings and treatment during the lockdown.

“All non-essential surgical procedures had to be cancelled, but we continued to do all necessary essential cancer surgery at CHBAH through a vetting committee which includes the clinicians and management,” the hospital said.

They said there had been no delay and backlog for cancer surgeries.

The hospital also said while they did not have the numbers of cancer patients whose operations were delayed or cancelled at CHBAH, the closure of surgical services at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) had put them under severe strain.

While the hospital noted the lockdown made it challenging for cancer patients to access treatment centres and that the fire which ravaged parts of CMJAH was an unwelcome complication, they were forced to act swiftly.

“We managed to open a grant supported chemotherapy centre at CHBAH which will largely facilitate access to care.”

While the improved Covid-19 vaccine roll-out in South Africa has made patients largely more willing to visit medical centres, CHBAH said there is no relation between vaccines and cancer screening.

But Discovery Health said the roll-out of the jabs coincided with the third wave of Covid-19 infections in South Africa.

“This will significantly influence the findings during this period,” Nematswerani said.

Despite the coronavirus and lockdown, Malek has urged South Africans from all walks of life to get screened for cancer in order to improve their chances of survival.

She explained that people should start getting regular pap smears from the age of 21, even if they are not sexually active and even if their results are normal, and screenings should continue on a three years basis.

“Annual screening mammograms are recommended for all women over 40, regardless of symptoms or family history.

“Being diagnosed with a dread disease doesn’t have to be a death sentence and regular screenings mean early detection and treatment, and dread disease cover means you can focus on your health rather than the financial burden of treatment costs.”

The Saturday Star

Related Topics:

Health WelfareCovid-19