Avoiding Covid-19 Only to Die of Cancer? The Shadow Curve of Other Diseases

If this “hidden” curve is ignored, the consequence could mean a higher rate of death from cancer than from Covid-19

By Antonio Giordano

Soon after its onset, the COVID-19 pandemic urged public health authorities to adopt measures to minimize the virus spread. Among them, limiting in-person visits to urgent matters only, and encouraging patients to postpone non-essential screenings and health care check-ups. Other than limiting the virus spread, these measures allowed the hospitals to get organized and equipped for assisting COVID-19 patients.

These days, health experts are raising some concerns, and believe that patients should resume their health care routines, to avoid undiagnosed and untreated illnesses, including cancer, heart disease, neurologic disorders and other diseases. As explained by Dr. Basu, president and CEO of Cancer Treatment Centers of America, one of the side effects of the pandemic is a possible spiking of a so called “shadow curve”, which indicates the rate of undiagnosed and untreated non-coronavirus diseases.

He advises patients who postponed screenings or follow-up appointments to reschedule them soon, and healthy people to remain in touch with the doctor. If this shadow curve remains ignored, the consequences could be a mortality rate for cancer, or other diseases, higher than for COVID-19. Doctors diagnose many cancers during screenings, and many are discovered accidentally during a periodical check-up examination. It has been estimated that considering only the lack of screening and diagnosis during this pandemic, potentially over one hundred thousand cancers may have been missed.

For instance, considering that in the US the number of cancer cases diagnosed every year is approximately 1.7-1.8 million, the consequence of skipped appointments for the past three or more months is that there will be a high number of undiagnosed conditions that would not be detected until the following appointment, when the disease could be worse and maybe no longer treatable.

Unfortunately, the pandemic is present and it will still stay for a long time. And the possibility that other viruses will represent a world threat in the near future looks real. We need to accept this and find, as a health system, the best response of preparedness to this emergency, without putting aside other important diseases.

It should not come down to a choice between COVID-19 treatment or cancer treatment, but both diseases should receive the same attention. The health care system should be reaching a point in which it can be able to treat both. Efforts should be made to implement all the measures and procedures that could protect the patient when visiting a doctor, to implement services with telemedicine where possible, to adopt preparedness regulations of nationwide validity, and keep the patient informed on the risks and the needs of certain medical behavior.

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