Pandemic Disrupted Preventive Health Care: Here’s How To Get Back On Track | Lifestyles
The Philadelphia Investigator
(TNS) – Did you forget or postpone your checkups during the endless 20 month pandemic?
A new study suggests that cancer diagnoses in the United States have declined due to upheaval linked to the pandemic. The average monthly number of newly identified cases of eight types of cancer plunged nearly 30% in the first pandemic shutdowns, then rebounded when doctors’ offices reopened – but fell again by 19% last winter.
Ignoring screenings and exams could lead to a cancer diagnosis at later stages, which could lead to poorer outcomes, the study authors wrote last month in the JAMA Network Open.
And it’s not just cancer. The pandemic has disrupted the diagnosis and preventive care of diabetes, high blood pressure, high cholesterol, heart disease, depression and many other conditions, especially for those who struggled to access care quality before the pandemic.
“We know that COVID-19 unfortunately shed light on the many disparities in health care that existed – and then added another,” said Delana Wardlaw, a primary care physician at Temple Health who was named 2020 Pennsylvania Family Physician of the Year. “People with poorly controlled or undiagnosed disease are at higher risk of severe COVID-19 and death. “
A year ago, Wardlaw and his twin sister, pediatrician Elana McDonald, launched TwinSisterDocs – available at TheTwinSisterDocs.com, and on Twitter, Facebook and Instagram – to promote wellness, self-advocacy and address health disparities in the underserved communities where they have worked for two decades.
Jefferson Health’s Sidney Kimmel Cancer Center also recently launched an effort to better serve vulnerable populations in the Philadelphia area: a mobile cancer screening van funded by a $ 1.4 million donation from Dietz & Watson, the manufacturer of cold cuts. Initially, the mobile unit offers mammograms to detect breast cancer, but will eventually offer screening for prostate, head and neck, and skin cancers. It will also connect patients with cancer resources, such as smoking cessation programs and cancer clinical trials.
If you don’t have any particular pain or problem, it’s easy to take the attitude that “it ain’t broke, so don’t fix it”. But a healthier attitude is, “You can’t fix what you don’t know. “
Here’s a rundown of the preventive health checkups you should get, even in the event of a pandemic:
No one wants a colonoscopy, but this screening test really does prevent colorectal cancer because the doctor can find and remove precancerous polyps.
A first colonoscopy is now recommended at 45, instead of 50, because colorectal cancer is on the increase in young adults, especially in black patients. “We absolutely want to make sure people have colonoscopies,” Wardlaw said.
The interval for a repeat colonoscopy will vary depending on the risk factors and the results of the first screening.
If you’re at medium risk, stool tests are home alternatives for screening, but positive results mean you need a colonoscopy.
For women, breast and cervical cancer screening guidelines have evolved. Leading organizations say average-risk women 55 and older can have mammograms every two years, rather than once a year, if the results show no signs of cancer. So you may be within the recommended interval, even though you skipped your mammogram last year.
The smears, which were done annually, are no longer recommended more often than every three years. And if you add a test for HPV, the virus that causes cervical cancer, you can wait five years after normal results to get tested again.
Prostate cancer screening advice has also changed. Men should talk to their doctor about the pros and cons of routine PSA blood tests. For men at higher risk, including black men, screening may be prudent. But experts say the risks of detecting and treating an inconsequential tumor should be discussed.
Skin cancer, including melanoma, the most dangerous type, is linked to sun exposure (and sunlamps), skin type, and age. If you have fair skin or have been treated for basal or squamous cell skin cancer, monthly self-checks and annual check-ups by a doctor are a good idea. The rates of all types of skin cancer have been increasing over the past 30 years.
For this JAMA Network study on declining cancer diagnoses, Quest Diagnostics researchers used records of newly diagnosed cancer patients who were tested at Quest. In the year before the start of the pandemic, the monthly average of new diagnoses was 32,000. During the most recent period, from November 2020 to March 2021, the monthly average was around 26,000, which suggests that thousands of people have skipped drug tests or exams in the past year.
Routine blood pressure and blood cholesterol checks are important because abnormal levels usually do not cause any symptoms, until cardiovascular damage develops.
The same can be said for diabetes, which can damage organs all over the body if it is not diagnosed and controlled. Many people with high blood sugar don’t know this because they haven’t had an A1C test to check their level after fasting. So-called prediabetes can often be reversed with improved diet and weight loss. If he progresses to diabetes, “be sure to get your A1C checked,” Wardlaw said. “If you need medication, it can be initiated or adjusted. “
Thyroid function tests are usually done based on symptoms or because a doctor feels a lump at the base of the neck, where the gland is located. A surprisingly diverse list of symptoms, including weight loss or gain, heartbeat, severe constipation, and hand tremors, can signal thyroid problems. The American Thyroid Foundation says adults over 35 should be screened once every five years.
Bone density screening for osteoporosis, done using an x-ray called DEXA, is recommended for women age 65 and younger women with certain risk factors, including a parent with a history of hip fracture. The Centers for Disease Control and Prevention suggests using the FRAX risk assessment tool to see if you should take a DEXA scan. A number of osteoporosis medications are available.
Vaccines against influenza, pneumonia and shingles are strongly recommended for adults.
So, of course, is the COVID-19 vaccine. If you are unsure, speak with a trusted doctor to understand how vaccination protects you and your loved ones (including children too young to be vaccinated), while contributing to the global goal of ending the pandemic. The Twin Sister Docs have worked tirelessly to reassure and persuade their hesitant patients, even making a video with Walgreens.
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