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Cancer screenings plummeted during height of COVID-19
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District program manager Sophie Xie works at her desk inside the Hall County Health Department Thursday, Sept. 24, 2020. Medical professionals in the cancer field are concerned about a drop in screenings due to COVID-19, because people are nervous about being at medical facilities during the outbreak. - photo by Scott Rogers
During the height of the COVID-19 shelter-in-place orders, there were only three lung cancer screenings across three Northeast Georgia Health System hospitals that are accustomed to running 70-80 tests per month. 

Angie Caton, the assistant nurse manager for oncology services at NGHS, said there is a concern among health care providers about people delaying essential cancer screening out of fear of going to health care facilities earlier this year. 

"I think the whole cancer community worries that people will put off the screening until they feel safer or till places are more widely open, and then the benefits of a screening if you catch something early, we might miss out on some of those benefits," Caton said. 

Sophie Xie, who runs the breast cancer and cervical cancer program at District 2 Public Health, said they noticed a drop in screenings between February to June of this year compared to the same time period last year. Public health officials did not provide specific data regarding the decrease. 

"We did have some barriers in the early stages of COVID because we didn't have providers that were able to open their labs that we refer our patients to,” Xie said. “They were closed or only providing essential services." 

Though the number of screenings at the respective facilities are back to normal, Xie and Caton said health care providers are trying to spread the message and stay connected with patients to get screened for potential cancers. Xie said they have used email reminders and a patient navigator, who attempts to follow up with people to inform them they are due for screening and set up appointments. 

Men and women ages 50-75 should get screened for colorectal cancer. Men over the age of 50 should get their prostate checked, and Caton said the guidance starts at 45 for Black and Hispanic men. 

Women between the ages of 40 and 49 should receive either annual or biannual screening for breast cancer with annual screening when 50 or older, Caton said. Cervical cancer screening is recommended every three years for women ages 21-30, Xie said. 

For women ages 30-65, Xie said women should still get cervical cancer screening every three years along with human papillomavirus co-testing every five years. 

"There was definitely a drop back in March/April when elective screenings and procedures were paused, though I know they have been working to catch up and push the message that it’s important to continue preventive care," Erin Williamson wrote in an email on behalf of Longstreet Clinic regarding breast cancer screenings. 

Xie said the health department’s program is intended for women who are low-income and not greater than 200% of the federal poverty level. To get more women screened, they have tried to mitigate any concerns like transportation and available child care. 

"We try to offer them times that are more convenient for them, and we also try to offer some space in the health department where they can bring a family member or a visitor with them so that visitor can watch their children while they are getting screened," Xie said. 

Patients are pre-screened for any potential COVID-19 exposure and symptoms before arriving and at their appointment. Xie said they are also implementing temperature checks and mandatory masks, which she said have assuaged some fears for people nervous about going to health care facilities during the coronavirus outbreak. 

If people are still nervous about getting tests at a facility, there are some available at home, such as the stool-based colon cancer screening. 

"In the screening world, the best test is the test that gets done,” Caton said. 

Caton said the downside of the home colon cancer test is a positive result will lead to a colonoscopy, so some patients just "cut straight to the chase” and have the procedure. 

"You can't do a tele-med mammogram. You can't do a tele-health prostate exam,” Caton said. “A lot of those screening exams involve physical touching and require imaging or laboratory tests that cannot be performed through tele-health." 

Caton said it is important to know your body and talk to a doctor when you see anything out of the ordinary. 

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