Cancer Screening: Can/should members of the community continue recommended cancer screening activities (e.g. screening mammography)?

To conserve health system resources and reduce patient contact with health care facilities, ASCO recommends that cancer screening procedures proceed as clinically indicated if they can be performed safely. Clinical care teams are advised to carefully weigh the risks and benefits of pursuing elective procedures, such as screening procedures, at this time.

There is some evidence that vaccination with mRNA vaccines prior to breast imaging may cause difficulties in the interpretation of the resulting images. ASCO continues to support screening for breast cancer. The Society for Breast Imaging has published guidance on how these potential difficulties should be managed, available on their COVID resource page.

Diagnosis and Staging: How can/should diagnosis and staging interventions (e.g. imaging visits, biopsy) be modified by the ongoing COVID-19 pandemic?  Is there any evidence that COVID-19 infection influences the ability to diagnose or stage disease (e.g. chest imaging for potential lung cancer)?

ASCO is aware of no evidence that COVID-19 infection interferes with or influences the diagnosis and staging of cancer. In a patient newly diagnosed with cancer, it is reasonable to limit staging procedures only to those that are most necessary to inform the development of the initial care plan. Should evidence become available, this statement will be updated.

Surveillance: Can/should patients receiving ongoing surveillance (e.g. imaging for detection of recurrence, active surveillance for existing disease) have that surveillance delayed/interrupted?

The CDC’s Managing Healthcare Operations page provides recommendations for who might have care delayed, depending on the context of local/community transmission of COVID-19. These recommendations can guide decisions around routine surveillance in patients considered to be at relatively low risk of recurrence and those who are asymptomatic during the follow-up period. In situations where existing recommendations provide frequency ranges for interventions (e.g. every 3-6 months) it is reasonable to delay scheduled interventions to the longest recommended frequency duration.

Disclaimer

Answers to questions about COVID-19 published herein are provided by the American Society of Clinical Oncology, Inc. (“ASCO”) for voluntary, informational use by providers in the rapidly evolving novel coronavirus crisis. This information does not constitute medical or legal advice, is not intended for use in the diagnosis or treatment of individual conditions, does not endorse products or therapies, recommend or mandate any particular course of medical care, and is not a statement of the standard of care. New evidence may emerge between the time information is developed and when it is published or read. The information is not comprehensive or continually updated. This information is not intended to substitute for the independent professional judgment of the treating provider in the context of treating the individual patient. ASCO provides this information on an “as is” basis, and makes no warranty, express or implied, regarding the information. ASCO specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. ASCO assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Use of the information is subject to the complete ASCO website Terms of Use.