What do these numbers tell you about the fight against cancer — that despite so many advances in treatment and prevention that cancer is still the number-one cause of death in Colorado?
Before COVID-19, we were moving in the right direction with regard to cancer deaths. Mortality rates were going down, new case rates were going down. We had a good thing going on. Even though we’re still living through a pandemic, we can't drop the cancer ball. We still have to work on prevention; we still have to make sure people are getting screened early for those cancers we can screen for. And of course, we need to continue to make treatment advances. We are moving ahead on all three of those fronts — prevention, screening, and treatment — but we can't stop. It's important now because we've had some setbacks during the pandemic, so it's even more important now to stay the course in the fight against cancer.
What were some of the setbacks during COVID-19?
Cancer screenings took a dive. When you think of mammography screening, colonoscopy, and so on, they all dropped significantly. In some cases it was because hospitals had restricted access because they were dealing with these very sick COVID patients. Another contributing factor was that people just weren't getting primary health care and cancer screening. Also, to get the screenings, for a while, you had to be vaccinated, and we know there's a certain segment of the population that resisted vaccination.
What was the primary effect of those missed screenings?
Patients are being diagnosed at a later stage, and suffer more aggressive, advanced stage cancer because they missed early diagnosis during the pandemic. There’s a paper out of Massachusetts looking at mammography screening, and they noticed a huge decrease in the number of women who are getting their mammography screening. They're waiting for more reports from their cancer registry, but it looks like there was a stage shift — that more women were being diagnosed at a more advanced stage. That's a little worrisome, but we have not yet seen the effect on mortality.
What would you say gives you the most hope in this fight? Are you most excited about better prevention, better treatment? What do you think is the biggest weapon we have?
While I’m focused on public health, I think they're all important. You can't single one strategy out. In a dynamic system, you have to focus on prevention, screening, and treatment. But in my heart, I still believe an ounce of prevention is worth a pound of cure. Cancer treatment is quite effective for some cancers. We've made some great advances. But it's enormously expensive. If we could just prevent it upfront, we wouldn't have to spend so much on treatment. I’m a firm believer in prevention and screening, because I do think it saves lives. Additionally, effective prevention and screening can reduce the cost of cancer, which is just crippling for some people. But I would never say that we don't need research and new advances in treatment. It's just amazing, some of the advances in the past few years to make it so that patients are less sick, have less toxic effects, and have better quality of life and survival after a diagnosis. I don't want to diminish that at all, that's fabulous. But prevention and screening are also key weapons to keep promoting in the fight against cancer, especially because of setbacks during the pandemic.