Sometimes unpleasant, but always necessary: Cancer screenings are back in full swing at Penn Medicine.
“Screenings declined when everything shut down at the beginning of the coronavirus pandemic. But as we got a handle on COVID-19 and managing life around it, Penn Medicine resumed screenings,” says Amrita Kochhar, MD, an internal medicine specialist at Penn. “There may be patients who postponed cancer screenings during that time, but it's important for them to reschedule. The idea behind screening is to find things before they become a problem — when we can actually do something about them.”
Cancer won’t wait for the pandemic to end — and neither should screenings. That’s why it’s critical to put preventive care back on your to-do list.
When the Benefits Outweigh the Risks: Cancer Screening During COVID-19
When the country shut down in March, so did routine cancer screenings at Penn Medicine — and with good reason.
“You can't do breast imaging remotely. Unless you’ve had a mammogram, you may not understand how intimate and close you are with the technologist while they position you for the study — the way the technologist almost has to hug you. You’re face-to-face while the mammographic unit takes the X-ray,” says Emily Conant, MD, a Penn Medicine breast radiologist. “However, we have needed to weigh the risk of viral exposure against the risk of delaying breast care for a month or so. As a result, we significantly limited our schedule to women with urgent needs, such as those who felt a worrisome lump or were newly diagnosed with cancer and needed further studies.”
While non-urgent patients again have the green light to come in, many aren’t taking advantage of it. Penn Medicine’s appointment no-show rate is also higher than it was pre-COVID-19.
“There are lots of patients who are still afraid. They're worried about getting exposed,” says Dr. Kochhar. “But we have processes in place to minimize exposure. And while there may be a lot of changes in this new normal, they’re vital. There are changes at the grocery store, so there will definitely be changes at your doctor's office.”
Three Cancer Screenings You Shouldn’t Delay
Depending on your age, Dr. Kochhar recommends these three screenings for the general public, regardless of personal health history.
1. Mammograms to screen for breast cancer
While there have been some mixed messages over the years, experts agree that women aged 50 and older should have a mammogram every one to two years.
“But for women between the ages of 40 and 50, there’s some difference in opinion in recommendations,” notes Dr. Kochhar. “At Penn, we recommend shared decision-making. This process is a discussion between the patient and their health care provider about care and cancer screening goals and health history. It’s coming to an individualized decision together.”
2. Colonoscopies to screen for colon cancer
If you’re at an average risk for developing colon cancer, you should have a colonoscopy every 10 years, starting at age 50.
“If you have other risk factors, such as a family history, your doctor might recommend you start younger than that,” adds Dr. Kochhar. “There are other forms of colon cancer screening, but we consider colonoscopy the gold standard.”
3. Pap smears to screen for cervical cancer
Experts recommend that women aged 21 and older have regular Pap smears. “If the results are normal, then they can get one every three to five years,” says Dr. Kochhar. “Between 21 and 29, it's every three years. From 30 to generally 65, it's every three to five years, depending on whether you get a reflex HPV test with the Pap smear.”
The interval for Pap smear screening for healthy women can vary based on age, health history and prior Pap smears, so speak with your provider about what’s right for you.
Why Is Cancer Screening Important?
“Screenings are critical. The later we detect cancer, the more complicated the treatment plan becomes,” explains Dr. Kochhar.
Colon cancer is a classic example. Colonoscopies not only look for cancerous tumors, they also detect precancerous polyps. “By detecting and removing those, it reduces the chance that the polyps develop into cancer,” say Dr. Kochhar.
Mammograms can find breast cancers that are too small for you or your provider to detect during a breast exam. They have been a game-changer for breast cancer outcomes: In a recent study, researchers found that women who participate in routine screenings have 41 percent less risk of dying from breast cancer within 10 years and 25 percent less risk of developing advanced cancer.
“Advanced cancers mean more aggressive surgery and more aggressive chemotherapy,” says Dr. Conant. “I also worry about younger women planning to skip their mammogram for a year because of coronavirus. While breast cancer is less common when you're between the ages of 40 and 55, these younger women tend to have faster-growing cancers.”
Seven Ways Penn Is Protecting Patients During Cancer Screenings
Penn Medicine has put certain measures in place to protect against COVID-19 during cancer screenings. These new procedures include:
- Universal mask policy: Everyone at Penn must wear a mask — from health care providers to patients and visitors.
- More personal protective equipment (PPE): “We all use eye guards, gloves, masks and in some cases, face shields,” says Dr. Conant.
- Rigorous sanitation and disinfection protocols: “These processes involve the regular cleaning of every space — especially high-touch surfaces,” notes Dr. Kochhar.
- Accessible hand sanitizer: “You can't walk three feet without seeing a dispenser,” she adds.
- Physical distancing: “The idea of a packed waiting room is probably a thing of the past,” says Dr. Kochhar. “Through scheduling and telemedicine appointments, we're minimizing the amount of staff and patients that are physically in the building at the same time.” Elevators can only have four people or fewer in them as well.
- More ways to use myPennMedicine: myPennMedicine is Penn’s online patient portal. To minimize physical contact, patients can now use it to check in early for appointments, pay bills and see test results — all on their mobile devices or computers.
- Temperature screenings: To enter a Penn facility, you must have your temperature taken.
“We have fewer infections in our hospital than out in the world because we’re so careful,” says Dr. Conant. “We’re screening you on the phone before you come in. We expedite how fast you go from your car to the room with our technologists. You go back, change, get compressed for screening and you're done.”
“If you have a health concern, it should not wait,” says Dr. Kochhar. “If you’re wondering if you should get a cancer screening during coronavirus or if you can delay it, reach out to your health care provider. They are your best resource.”
To schedule a screening or physical exam, contact your provider or call 800-789-7366 (PENN).