Cancer screening rates plummeted during the COVID-19 pandemic, but recent data shows cancer mortality has returned to stable pre-pandemic levels, defying earlier dire predictions.
At a Glance
- An estimated 9.4 million cancer screening tests were missed in 2020 due to the COVID-19 pandemic
- 20% of cancer patients reported treatment delays during the pandemic, while 23-30% experienced screening delays
- Despite initial fears, cancer death rates continue to decline
- Advanced-stage cancer diagnoses temporarily increased in 2020 but returned to normal levels by 2021
- health literacy was linked to greater delays in colorectal cancer screening
Pandemic-Era Cancer Screening Disruptions
When COVID-19 was declared a global pandemic in March 2020, healthcare systems worldwide were forced to redirect resources toward virus containment and emergency care. Regular cancer screenings—colonoscopies, mammograms, and other potentially life-saving early detection procedures—were postponed or canceled as hospitals prioritized COVID-19 patients and reduced non-urgent services. This disruption created immediate concern among healthcare professionals who feared the potential long-term consequences of delayed cancer diagnoses.
According to research published in medical journals, the decline in screening was substantial across multiple cancer types. A systematic review categorized the pandemic’s impact on cancer care into four dimensions: decline in screening and pathology samples, reduced diagnosis rates, increase in advanced cancers, and potential effects on mortality rates. The National Cancer Institute estimated approximately 9.4 million cancer screening tests were missed during 2020 alone, creating a significant backlog that healthcare systems are still working to address.
— Drew Ponder (@drew_ponder) February 13, 2025
The Impact on Cancer Detection and Treatment
A study conducted at an NCI-designated cancer center revealed the extent of these disruptions. Among 1,533 participants, 20% of those with a cancer diagnosis reported delays in treatment, while 23-30% experienced delays in cancer screening. The data showed that delays in colorectal cancer screening were particularly prevalent among those with limited health literacy, highlighting how certain population groups may have been disproportionately affected by pandemic-related healthcare disruptions.
Medical centers across the country reported sharp declines in routine screenings during the height of the pandemic. Pathology samples decreased, biopsies were postponed, and new cancer diagnoses fell significantly compared to pre-pandemic years. This led many experts to predict that cancers would be caught at more advanced stages once patients returned to regular care, potentially resulting in worse outcomes and higher mortality rates in subsequent years.
Reassuring Return to Pre-Pandemic Levels
Contrary to the most alarming projections, recent data provides a surprisingly positive outlook. According to statistics from cancer registries analyzed in 2023, while there was indeed a temporary increase in late-stage cancer diagnoses in 2020, this trend normalized by 2021. Cancer death rates have continued their pre-pandemic decline, suggesting that the healthcare system’s response and patients’ eventual return to screening may have mitigated the worst potential outcomes.
Interestingly, researchers found that the decline in new cancer diagnoses was consistent across different states, regardless of their COVID-19 restrictions. This indicates that individual human behavior and local hospital policies likely influenced cancer diagnosis patterns more than state-level pandemic policies. As one study noted, “We didn’t see any notable shifts” between states with different approaches to pandemic restrictions.
Strategies for Recovery and Future Resilience
Healthcare organizations have implemented multiple strategies to address the screening backlog. The American College of Surgeons and the American Cancer Society launched the Return-to-Screening study to help facilities restore screening rates to pre-pandemic levels. These efforts included public awareness campaigns, extended screening hours, provider reminders, and financial support for uninsured patients. Virtual care options and at-home tests have also emerged as valuable tools for maintaining cancer screening schedules.
Medical experts now emphasize the importance of integrating health literacy assessments into cancer care systems. This approach would allow healthcare providers to tailor education and re-engagement strategies to each patient’s needs, ensuring that those most vulnerable to screening delays—especially those with limited health literacy—receive appropriate support. Safety measures implemented at healthcare facilities have also helped reassure patients that in-person visits can be conducted with minimal COVID-19 risk.
