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Studies: Cancer screenings dropped sharply during pandemic

EAU CLAIRE — Experts say there’s been a significant drop in cancer screenings and cancer diagnoses since the beginning of the COVID-19 pandemic.

But Chippewa Valley medical experts say it’s safe for most people to come back to hospitals for screenings — and say that skipping a yearly or scheduled cancer screening could have long-lasting consequences.

“This is an evolving situation, but at this moment we recommend continuing with screenings,” said Dr. Martha Hidalgo, internal medicine physician at Marshfield Medical Center-Eau Claire, adding that patients who are immunosuppressed or in a high-risk category for the virus should consult their doctors before in-person appointments.

In March and April, before the federal government had widely asked people to wear face coverings, hospitals across the country braced for an influx of COVID-19 patients and asked people to reschedule their non-emergency visits.

As a result, cancer screenings and cancer diagnoses dropped off, studies indicate.

Health insurance claims for mammograms, X-rays of the breast to look for early signs of breast cancer, went down by 87% between February and April, according to health data firm IQVIA Institute for Human Data Science. Claims for pap smears were down by 83%; claims for colonoscopies dropped by 90%.

Providers at HSHS Sacred Heart Hospital’s Prevea Cancer Center in Eau Claire noticed a dip in regular cancer screenings, said Jessica Gugel, an oncologist nurse navigator at the hospital’s Prevea Cancer Center.

“Hospitals and health systems cut back on those services, and initially didn’t recommend people come in for fear of big outbreaks,” Gugel said. “Thankfully, here in Eau Claire, we were able to manage patients that came in needing care for COVID-19, but we did say, let’s just put on the brakes for a minute and make sure that when we do bring people in, it’s a safe place for them to be.”

A report from Wisconsin-based medical software developer Epic drew a similar conclusion: Breast, colon and cervical cancer screenings dropped significantly in spring. People missed 285,000 breast cancer screenings alone in the U.S. between mid-March and late May, according to the Epic study.

It’s too early to tell how COVID-19 has specifically impacted cancer care in the Chippewa Valley, said Dr. Timothy Burns, oncologist at Mayo Clinic Health System in Eau Claire.

“At this point it is difficult to accurately predict how COVID-19 will impact the trend of cancer diagnoses per se, but Mayo Clinic is dedicated to researching and answering exact questions like this,” Burns said in an email to the Leader-Telegram, adding that there are ongoing studies on the impact of COVID-19 on cancer care.

Hidalgo agreed.

“At this point, it’s too early to tell,” Hidalgo said of COVID-19’s lasting impact on cancer diagnoses locally. “At the beginning of the pandemic there was a drop (in screenings), but also there has been a recovery after a few weeks ... we all have to be watchful and observe how (screenings) are going to be affected in the near future.”

Nationwide, cancer screening numbers have begun to recover as people come back for their annual physicals and screenings, but they haven’t quite rebounded to pre-pandemic levels.

Screenings began to rise again in June and July, Epic found, but as of June 16, “weekly volumes remained 29%, 36% and 35% lower than their pre-COVID-19 levels for breast, colon and cervical cancer screenings.”

Gugel said that in recent weeks, she’s seen an uptick in people scheduling mammograms at Sacred Heart’s Prevea Cancer Center.

“I feel confident the hospital has done everything they can to ensure we’re a safe place for people to come and receive care, so that we don’t, in six months to a year, have this influx of later-stage cancers,” Gugel said.

While some cancer screenings, like mammograms, colonoscopies and HPV screenings, need to happen in person, there are some limited telehealth options for eligible patients, Hidalgo said, specifically Cologuard, a stool DNA test for colon cancer.

Fewer diagnoses

It’s not just screenings: The number of cancer diagnoses in the U.S. also dwindled this spring and summer, studies indicate.

August research in the medical journal JAMA Network Open showed a downward trend in newly identified cases of six common types of cancer, STAT News reported last month: Between March 1 and April 18, the average “weekly number of newly diagnosed cancer patients plunged 46.4% for all six types: breast, colorectal, lung, gastric, pancreatic and esophageal.”

Experts warn that it doesn’t mean that cancer is impacting fewer people.

“...There is no reason to believe the actual incidence of cancer has dropped,” wrote Norman Sharpless, director of the National Cancer Institute, in a June editorial at the American Association for the Advancement of Science.

Sharpless added: “Cancers being missed now will still come to light eventually, but at a later stage (“upstaging”) and with worse prognoses.”

Local doctors encourage return

Chippewa Valley doctors are encouraging most, if not all, people to get their recommended cancer screenings this year, even if it means having to reschedule canceled spring appointments.

“Cancer screening has been proven to detect cancer early and prevent cancer related deaths for many types of cancers,” Burns said.

Burns noted that hospitals in the Chippewa Valley area are requiring masks, screening patients for COVID-19 symptoms and stepping up sanitizing and cleaning procedures

Gugel has a message for patients: Instead of just skipping your cancer screening this year, there’s still time to schedule one.

“I hope people will pursue getting it scheduled late, as opposed to not at all,” she said. “The sooner we can identify cancer, the easier it is to treat and cure. When cancer is identified later, the chance that it has spread is greater. It becomes harder to treat and cure.”


Aaron Dorf of Augusta plays his saxophone Thursday at the Eau Claire Downtown Farmers Market in Phoenix Park. View more photos at LeaderTelegramPhotos.com.


Politics
AP
Labor Day blitz shows urgency of campaign

HARRISBURG, Pa. (AP) — Democratic presidential nominee Joe Biden and President Donald Trump spent Monday diminishing each other’s credentials on the economy and understanding of the American worker as the presidential campaign entered its final, post-Labor Day stretch.

While workers live by an “American code,” Biden said Trump “lives by a code of lies, greed and selfishness” as he met with labor leaders in Harrisburg, Pennsylvania, a key swing state.

Trump, meanwhile, tried to put the halting economic recovery under the best light in a White House press conference where he said Biden and his running mate, Sen. Kamala Harris, would “destroy this country and would destroy this economy.”

Labor Day typically marks the unofficial start to the fall campaign season as candidates accelerate their activity for the final sprint to Election Day. Both campaigns reflected that urgency Monday, as Harris and Vice President Mike Pence each campaigned in Wisconsin, a state Trump narrowly won in 2016. The events played out against the background of the pandemic, which has upended campaigning and pushed Biden and Harris in particular to conduct much of the traditional election activity online.

While the health of the American economy and status of workers were dominant Labor Day themes, both campaigns also focused on recent protests that have roiled Wisconsin and the rest of the nation after police shot Jacob Blake, a Black man, in Kenosha last month.

Harris, the first Black woman on a major party presidential ticket, met privately with Blake’s family at the Milwaukee airport after arriving in the state, where she spoke with Blake by phone from his hospital bed. Harris told Blake she was proud of him and individually spoke to each of his family members, in person and on the phone, urging them to take care of their physical and mental health, Blake’s lawyers said in a statement.

Biden met with Blake’s family during a visit to Wisconsin last week. Trump did not during a trip of his own last week, instead meeting with law enforcement and business owners whose property had been damaged during protests. Nor did Pence, who touched on the protests during a speech in La Crosse, where he toured an energy facility.

“We will have law and order in every city in this country for every American of every race and creed,” Pence said.

Out on the trail, signs of the pandemic were evident. While Pence didn’t speak with a mask on, workers from the power company he toured did as they stood behind him. Harris was careful not to stray far from blue “X” marks taped on the floor to encourage social distancing as she toured an International Brotherhood of Electrical Workers training facility. While supporters gathered outside the candidates’ stops, they had minimal interaction with members of the public beyond the people invited to their events.

After meeting with Black business owners, Harris greeted a crowd of about 50 supporters outside as she left, removing her mask briefly while telling them, “We have to get this done, I need your help in Milwaukee.” She noted in-person absentee voting begins in the state on Oct. 20, which is her birthday.

Harris also met with Black business owners in Milwaukee, where she said her day of campaigning was focused on “the dignity of work and the dignity of human beings.”

Biden spoke to a small group of labor leaders in a backyard in Lancaster, where he criticized Trump for “refusing to deal with the problems that affect ordinary people” and called for strengthening unions. His campaign announced endorsements from the Laborers’ International Union of North America, the International Union of Elevator Constructors and the National Federation of Federal Employees, collectively representing hundreds of thousands of union workers nationwide.

Later, at an AFL-CIO virtual town hall with union President Richard Trumka, Biden called Trump’s alleged remarks about fallen soldiers being “losers” and “suckers” un-American and said Trump would never understand why Americans serve. Trump has denied the remarks.

“He’ll never understand you, he’ll never understand us, he’ll never understand our cops, our firefighters, because he’s not made of the same stuff,” Biden said.

Earlier in the day, Trump painted Biden as a leader incapable of handling the coronavirus and reviving the economy and pledged his own “undying loyalty to the American worker.”

He boasted of adding more than 10 million jobs since May, without mentioning that’s only about half of the jobs lost since the pandemic began. He also said the unemployment rate “plunged” to 8.4%. It was a sharper decline than many economists expected from the prior month, but economists broadly view the latest report as evidence that further economic improvement will be sluggish.

He alleged Biden and Democrats would “immediately collapse the economy.”

The day marked Harris’ first solo foray onto the campaign trail for in-person events since she became Biden’s running mate nearly a month ago. Biden himself has stepped up his campaigning over the past week, traveling to Pittsburgh and Kenosha and holding two news conferences. Aides say to expect both Biden and Harris to increase their campaigning for the remaining weeks.

Polls consistently show the economy as an issue at the top of voters’ minds.

A strong economy that was Trump’s biggest asset for reelection has now become a potential liability, brought down by the coronavirus. Biden says Trump has had an inadequate response to the pandemic, resulting in more loss of life and jobs than necessary.

The U.S. economy has been steadily rebounding from its epic collapse in the spring as many businesses have reopened and rehired some laid-off employees. Yet the recovery is far from complete. Only about half the 22 million jobs that vanished in the pandemic have been recovered.

Economic inequalities also appear to have widened, with lower-income and minority workers suffering disproportionately while affluent Americans have lost fewer jobs and even benefited from rising stock and home prices.

——

Ronayne reported from Sacramento, California, and Nasir reported from Milwaukee. Associated Press writer Amy Forliti contributed from Minneapolis.


State
AP
A matter of heart: Artwork thanks front-line workers

JANESVILLE (AP) — Painting a heart is often the highlight of Sue Cullen’s day.

The longtime member of the Janesville Art League has painted at least 10 in recent months. Her favorite features an image of Earth at its center, with the words “love” and “hope” circling the fragile planet.

On the outside of the heart’s perimeter are hands, big and small, including those of Cullen’s grandkids.

The heart greets people entering the Janesville Police Department and stands next to another reading: “Thank you. You are the heartbeat of our community.”

Cullen is one of many local artists and community members who have painted more than 60 hearts. Each is a sincere thank-you to city health care providers and other front-line workers who risk their lives because of COVID-19, The Janesville Gazette reported.

The Rock County Historical Society and the art league got together this spring to thank and offer support to medical personnel and first responders at Mercyhealth Hospital and Trauma Center with a project called #HeartArt.

Artists decorated plywood hearts and showcased them on the grounds of the Lincoln Tallman Restorations, where they are visible to workers at the Mercyhealth campus across the street.

“We put them on our property so they would see them coming in and out of work,” said Tim Maahs, historical society executive director.

Eventually, the art league contacted SSM Health St Mary’s Hospital-Janesville for permission to place hearts at its staff and main entrances.

Several weeks ago, the #HeartArt committee decided to spread the love by moving hearts into the community for more people to see and enjoy, Arra Lasse of the league said.

“Many hearts were made out to essential workers, so we thought we would share them with the city,” she said. “When you see the creative efforts on these hearts, it is just amazing. Old people have done them. Little kids have done them.”

Dozens are planted throughout the community, including at Janesville’s iconic cow.

Lasse calls the project unique because undecorated hearts are free to anyone interested in designing and painting a thank you.

People can decorate either a 2-by-2-foot or a 4-by-4-foot heart.

Maahs gets donations of plywood or cash to buy the plywood, and he has a team of volunteers who cut out the hearts.

“People from all walks of life have gotten involved,” Maahs said. “There are so many different ways to show your gratitude.”

Maahs, Lasse and Cullen hatched the idea in March.

“We thought the project would last 90 to 120 days when it started,” Maahs said. “But we are still handing out hearts.”

Painting a heart honors essential workers, but it also is a way for the artist to deal with anxiety in uncertain times.

“This is a joyous and feel-good project,” Cullen said. “If you have something fun in your life, it helps you through a bad time.”

She did a lot of painting with her grandkids because she wants them to be part of a community project.

“Their little handprints on the art are so caring,” she said.

Lasse personally understands the sacrifice of health care workers. Her son-in-law is an emergency room nurse at Mercyhealth Hospital and Trauma Center.

Early in the pandemic, his wife and the couple’s children temporarily moved in with Lasse until June.

“They decided it would be safer,” Lasse explained.

Elana Wistrom, a Mercyhealth doctor, painted several hearts with her children.

“I did it because I wanted to show the community that we are all in this together,” Wistrom said.

One heart carries the words “one world, one love.”

“The world is one community when it comes to the coronavirus,” she said. “We are all in the war against this together. We all have to do our part.”

Wistrom said working on the hearts and viewing the hearts around the city make a big difference to her.

“I can see one on the way to work every day,” she said. “Some days it is difficult to put on all the (protective) gear knowing that you will be exposed to this lethal virus. The heart lifts me up, for sure.”