Digitalizing healthcare

Cancer screening neglected in fear of COVID-19

Software mammography solutions help catch up on delayed cancer screenings

Andrea Lutz
Published on March 2, 2021

Fear of infection, overflowing intensive-care wards and labor-intensive measures to protect against infection: COVID-19 is pushing both healthcare systems and patients to their limits, and that’s now also impacting cancer care. The huge burden on healthcare systems could result in delayed diagnoses and treatment. Add in missed cancer screenings, and the result could be dramatic, potentially costing many lives. Digital solutions will help close this healthcare gap.

<p>In 2020, 4.8 million people in Europe received a cancer diagnosis. That’s more than 13,000 every day, 546 every hour, and nine every minute.<sup>1</sup> Many forms of cancer offer a good chance of a cure if they’re diagnosed early. But priorities have changed: Because many patients worry about becoming infected with COVID-19, they’re deferring their cancer screenings. Although the medical centers are open and have stringent hygiene rules in place, patients are staying away, which could have fatal consequences.</p>
<p>Hans Henri P. Kluge, Regional Director for Europe at the World Health Organization (WHO), describes developments during the pandemic as “catastrophic”: For example, the number of cancer diagnoses at the National Oncology Center in Kyrgyzstan fell by 90 percent in April last year. And in the Netherlands and Belgium, cancer diagnoses during the first lockdown in 2020 decreased by 30 to 40 percent.<sup>2</sup> This “positive trend” is superficial, because the disease hasn’t disappeared: in many cases it’s simply not being detected. At least, not yet. In the UK, delayed diagnoses are expected to lead to a 15-percent increase in deaths from intestinal cancer and nine percent more deaths from breast cancer over the next five years.<sup>3</sup></p>
<p>Many patients want to wait to be sure they don’t become infected with COVID-19 while having a preventive medical check-up. The focus on preventive personal healthcare will resume only when the incidence of COVID-19 has declined further and the public has a greater sense of safety – which could lead to a rush on screening centers. That’s why it’ll be more important than ever to ensure that examinations in medical practices are safe and can proceed even more efficiently. Two new software solutions will help professionals meet the increasing demand for cancer screening with no change in resources, since the number of medical professionals and mammography systems hasn’t changed since the pandemic began. The key to working smoothly through the backlog will therefore be more efficient workflows at screening centers and making optimal use of the mammography systems already in place.</p>
<p>Mammography is at the heart of most breast cancer screening programs. Changes in tissue can be recognized on the mammogram – long before the patient herself or a physician can identify them by touch in the best possible scenario. To generate a meaningful clinical picture, mammography systems use low-dose x-rays to penetrate the breast tissue and make any irregularities visible.</p>
<p>Hearing the words, “We’ve detected some unusual results” can be like a body blow for many patients who’ve had a preventive medical check-up. When they learn that irregularities have been detected in their breast tissue, their minds start to spin: “Is it malignant?”, “Will I have to have chemo?” “Do I need to prepare for the worst?” It can sometimes take a few days before a more definite diagnosis can be made, if other examinations are needed, for example, and it isn’t possible to perform them in quick succession. That means a number of stressful days for the women waiting for the results.<br></p>
This is where new software will bring clarity more quickly by helping radiologists evaluate the clinical images. It isn’t uncommon for radiologists to have to make diagnoses based on datasets from up to 100 patients per hour, and every second that can be saved in this process is valuable. By utilizing artificial intelligence (AI), for example, it’s possible to calculate the probability that irregularities in breast tissue are actually cancerous. <br><br>This kind of pre-analysis increases the throughput of diagnoses and also increases diagnostic accuracy, thanks to the accurate “eye” of the AI system. Of course, careful evaluation by an experienced radiologist is essential when making the final diagnosis, but AI can speed the process up by gathering comparative values and performing analyses automatically and in detail. The software comes with a new user interface that shortens the process by a few clicks. Collectively, these time-saving measures will prevent a further increase in workload for radiology practices, despite an expected recovery in the number of preventive check-ups in the near future. <br><br>Not only do smart digital mammography solutions reduce the period of uncertainty the patients face before they receive their results; they also mean the patients whose tissue does contain a malignant tumor can begin treatment sooner. That can be critical in terms of the course of the disease.
<p>A second software innovation puts all the workflows in a given institution under the microscope and tracks the relevant parameters within a radiology department specializing in women’s health or a women’s health practice. The system displays various parameters from the examination process and helps the radiology team to improve its workflows. Critical resource bottlenecks caused by inefficient workflows can be identified in this way, and appropriate measures can be introduced to improve processes. For example, this could lead to the possibility to have additional capacity for further examinations, that could be used for patients with anomalous results that can’t be clearly diagnosed immediately. Workflow planning can be improved as a result, and further diagnostic and subsequent treatment procedures can be started more quickly.<br><br>In addition, the dashboard documents information from the mammograms in detail, including the radiation dose used in the examination and the level of breast compression, to optimize proven procedures even more.</p>
<p>Many women are afraid of a cancer diagnosis, but with early diagnosis the survival rate can be as high as 99 percent.<sup>4</sup> That’s why the deferral of preventive medical check-ups during the coronavirus pandemic must end as soon as possible.<br><br>Healthcare practices using state-of-the-art equipment that generates three-dimensional images (tomosynthesis), for example, can play an important role in putting the fear of infection with COVID-19 during a preventive medical check-up in the right perspective.</p><p><br></p><p><br></p>

In addition to mammography, three-dimensional imaging in form of tomosynthesis is also a valuable diagnostic tool for detecting abnormalities in the breast at an early stage.

<p>By offering patients the prospect of a quick and clear diagnosis that will provide certainty and is performed in compliance with all hygiene regulations, it will encourage them to start having regular screenings again. There are grounds for optimism in observations from Europe and Canada that show the mortality rate in women who participated in screening programs was reduced by more than 40 percent.<sup>5</sup></p>

By Andrea Lutz
Andrea Lutz is a journalist and business trainer specialized on medical topics, technology, and healthcare IT. She lives in Nuremberg, Germany.