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.