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Black and Hispanic Americans are most likely to miss health screenings due to COVID-19. A Penn physician is meeting the need. – WHYY

Posted: February 14, 2021 at 4:56 pm

In the early months of the pandemic, doctors offices suspended appointments and hospitals cancelled routine procedures as they pivoted focus to managing the coronavirus. Even as those operations have slowly opened back up, the fear of contracting COVID-19 has kept thousands of Americans from getting their standard health screenings.

The numbers have been especially stark for cancer-screening rates, which according to Dr. Carmen E. Guerra dropped by 90% for colon and breast cancer at the height of the pandemic.

Guerra is an associate professor of medicine at the University of Pennsylvania and a health equity researcher who studies cancer-screening disparities in Black and immigrant communities. She said that while colorectal cancer is the third most common cancer in both Black men and women, colonoscopies are the only cancer test that are preventative meaning screening for colon cancer could also mitigate the risk of cancer down the line.

Its an invasive procedure and our most complicated test, said Guerra. Most people dont realize that most cancer screenings just detect cancer once its there. But [colonoscopies] remove polyps that look like they want to become dysplastic, which is a term we use for transforming itself into a high-risk lesion.

According to the American Cancer Society, Black Americans have the highest rates of colorectal cancer when compared to other racial/ethnic groups in the United States. They are 40% more likely to die from this cancer as well. Thats largely due to lack of access to health insurance and high-quality medical care, and to being diagnosed at later stages in the disease.

Even before the pandemic, there were a whole host of structural and social barriers that prevented communities of color across the spectrum from getting screened. A cancer-screening test can be as simple as having a blood test. But for colonoscopies, your colon and rectum must be empty and clean so your doctor can see the entire lining during the test. You might hear this referred to as a bowel prep. That requires time off from work, and access to transportation to and from the procedure. In addition, colon cancer tests require sedation during the procedure, which means youll need someone to pick you up when youre finished.

Pre-pandemic, underserved communities were having a really difficult time accessing colonoscopy because they [are not] in an economic position to be able to take off work, said Guerra. Many communities dont have the luxury of having a caregiver. They are stretched, everyone in the household is working.

But then the pandemic swept in, and added another layer of barriers to an already vulnerable segment of the population. Jody Hoyos is the executive vice president of the Prevent Cancer Foundation, which in December, in collaboration with Omnibus, conducted a survey in which 1,200 Black, Hispanic, Asian, and Native Americans were asked questions about their reasons for missed cancer screenings and medical appointments during the pandemic.

Hoyos said the survey found that communities of color, across age and ethnicity, were more likely to have missed appointments during the pandemic than white Americans, with Black and Hispanic Americans about 40% more likely to have missed, postponed, or canceled a health appointment.

The volume of missed appointments is concerning, said Hoyos. We know that the five-year survival rate for cancer is over 80% [when] detected early, but that drops down to 21% if its detected in later stages.

Hoyos also noted that across all groups surveyed, fear of exposure to COVID-19 was the number one reason for missed appointments. For Black and Hispanic Americans in particular, loss of health insurance since the start of the pandemic was the most significant financial barrier this surveyed population brought up.

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Black and Hispanic Americans are most likely to miss health screenings due to COVID-19. A Penn physician is meeting the need. - WHYY

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