Six months doesn’t seem like a long time. It’s the length of a typical baseball season or the time between dentist checkups (which never seems long enough).
When it comes to cancer screenings, however, six months can be too long to wait.
“Delaying your cancer screening by six months and missing a colon cancer or an early breast cancer can make a huge difference in terms of your prognosis,” explains Austin Snyder, a Harvard Medical Student working with Mass General radiologist Brent Little, MD.
“If you catch stage one breast cancer on a mammogram, that’s a lot different than getting that mammogram six months later when it’s stage two.”
The first peak of the COVID-19 pandemic and fears of contracting SARS-CoV-2 resulted in the postponement of many primary care visits, preventative screenings and treatment sessions.
As a result, there was a significant decrease in cancer screenings during the spring and summer of 2020. This has health officials worried about the long-term consequences of late diagnosis, which can increase the risk of more serious disease and death.
Did the pandemic also divert public attention from the importance of timely cancer screenings?
That was the question asked by a research team led by Snyder and Little in a recent study published in the Journal of Medical Screening.
Looking at Trends in Google Search Volume
The team analyzed trends in Google search volume for four of the most common cancer screening terms: mammography (breast cancer), colonoscopy (colon/colorectal cancer), lung cancer screening, and pap smear (cervical cancer) from March to August of 2020.
Breast, colon, and lung cancer are three of the most prevalent types of cancer in the United States. Cervical cancer is not as prevalent, but pap smears are a common cancer screening that women are recommended to undergo every three years starting at age 21.
As a control group, the researchers examined trends in search volume for four highly prevalent chronic diseases—arthritis, diabetes, heart disease, and hypertension—as well as searches for the term “doctor.”
Why look at internet searches? A landmark Pew Research Study in 2014 found that 72% of patients seek health information online and 77% start with a search engine.
What the Team Found
The analysis by Snyder and colleagues showed that searches for both chronic disease and cancer screening terms dropped significantly from March 2020 to August 2020 compared to the months leading up to the pandemic. The decline in cancer screening searches was much more pronounced, however.
Searches for mammogram, colonoscopy and lung cancer screening all dropped by roughly 75%, while searches for pap smear were down by roughly 50%. In the control group, searches for cancer dropped by 31%, arthritis by 25%, heart disease and hypertension by 21%, diabetes by 14%, and doctor by 20%.
| Cancer screening search terms | Pre-pandemic mean weekly search volume | Pandemic lowest weekly search volume | Percent change |
|---|---|---|---|
| Pap smear | 172,000 | 79,000 | -54% |
| Lung cancer screening | 8,000 | 2,000 | -72% |
| Mammogram | 65,000 | 17,000 | -74% |
| Colonoscopy | 130,000 | 31,000 | -76% |
| Control terms | Pre-pandemic mean weekly search volume | Pandemic lowest weekly search volume | Percent change |
|---|---|---|---|
| Cancer | 1,091,000 | 750,000 | -31% |
| Arthritis | 256,000 | 192,000 | -25% |
| Diabetes | 3,370,000 | 2,914,000 | -14% |
| Heart disease | 188,000 | 148,000 | -21% |
| Hypertension | 719,000 | 568,000 | -21% |
| Doctor | 608,000 | 484,000 | -20% |
The steeper decrease in searches for cancer screenings may be due to a several factors, says Snyder.
“One theory we have is that during the start of the pandemic, people were less likely to visit their primary care doctors and get notified they are due for a screening, then go home and search online to learn more about that procedure.”
The shift in public attention to the more immediate threat of COVID-19 may have also played a role, Snyder says. He notes that internet searches for three of the main symptoms of COVID-19—cough, fever, and fatigue—shot up during the same time frame and have remained high.
With vaccination rates increasing and most hospitals and health care providers operating at pre-pandemic levels, it’s important to know what cancer screenings you’re due for based on your age and risk factors and to schedule those screenings as soon as possible, Snyder says.
Additional Resources:
- U.S. Preventive Services Cancer Screening Recommendations
- American Cancer Society Guidelines for Early Detection of Cancer
About the Mass General Research Institute
Research at Massachusetts General Hospital is interwoven through more than 30 different departments, centers and institutes and includes fundamental, lab-based science; clinical trials to test new drugs, devices and diagnostic tools; and community and population-based research to improve health outcomes across populations and eliminate disparities to care.
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