SC Connecticut News

A recent study published in the American Medical Association journal JAMA Otolaryngology–Head & Neck Surgery reveals a significant decline in thyroid cancer diagnoses during the COVID-19 pandemic. This research raises concerns about a potential increase in more advanced cancer cases in the future.

The study examined thyroid cancer incidence trends from 2016 to 2021 using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. It estimates that around 10,200 thyroid cancer cases went undiagnosed during the first two years of the pandemic. Of these, 5,400 were small papillary cancers and 3,700 were larger papillary tumors.

Researchers warned that these missed diagnoses could lead to an increase in advanced thyroid cancer cases. Dr. Daniel Weinberger, PhD, an associate professor at the Yale School of Public Health and co-author of the study, stated: “The sharp decline in diagnoses, particularly during the variant waves of the pandemic, could be a major public health concern in the future.”

The study highlights how strain on healthcare systems contributed to diagnosis delays. During major COVID-19 waves such as those caused by Alpha and Delta variants, nonurgent health services were postponed, leading many patients to avoid healthcare settings.

Guidelines from institutions like the Centers for Medicare & Medicaid Services and the American College of Surgeons recommended postponing nonemergent surgeries and imaging procedures during these periods. This led to fewer thyroid cancer diagnoses in 2020 and 2021.

Thyroid cancer diagnoses dropped significantly across most types during this period. The decrease was most notable for papillary thyroid cancer—the most common form—with smaller cancers down by 11% and larger ones by 14%. Other forms like follicular and medullary cancers also saw declines.

Despite fewer diagnoses, there was no significant change in tumor size at diagnosis. This suggests missed diagnoses were primarily smaller cancers found incidentally during routine care or unrelated imaging.

Weinberger noted: “Thyroid cancer provides a window into how cancer care was affected more broadly by the pandemic.” He emphasized that similar delays might have occurred with other slow-progressing cancers.

The findings underscore a need for continued monitoring of thyroid cancer trends as healthcare systems recover from pandemic disruptions. The authors urge healthcare providers not to overlook treatable cancers moving forward.

The study was led by VA Disrupted Care National Project with Dr. Rebecca Bell as lead author and Dr. Louise Davies as senior author. It is part of a multi-year project sponsored by the U.S. Department of Veteran Affairs involving academic partners at Yale, Dartmouth, and Stanford.

Dr. Amy Justice serves as project lead in West Haven while Weinberger conducts statistical modeling related to COVID-19's impact on different risk groups within VA populations.