‘Hard to get a patient to come in’:Vital screening drops 30 per cent

Doctors are warning that Sydneysiders are delaying crucial screenings and blood tests that detect heart disease and cancers as the city’s lockdown keeps people away from regular checkups and medical appointments.

The peak body representing pathologists say screening in Sydney for abnormal cholesterol levels,heart conditions and certain types of cancers,including cervical and prostate,has fallen 30 per cent overall from August 2019 to the same period this year.

Vital blood tests and other medical screening has declined during Sydney’s lockdown.

Vital blood tests and other medical screening has declined during Sydney’s lockdown.Getty Images

Dr Debra Graves,CEO of the Royal College of Pathologists of Australasia,said the drop in pathology testing had “serious implications”.

“All these pathology tests are vital to diagnose diseases like cancer,diabetes,heart disease,” she said,noting the tests,particularly cancer screening,were designed to pick up diseases in their early stages to give patients a much better prognosis.

Dr Graves said there was “a huge deluge of build-up” after 2020 lockdowns.

“We don’t know the long-term impact yet because obviously cancers do take some time to present,but certainly we are seeing people presenting later,” she said.

According to the latest Medicare Benefits Schedule (MBS) data,between April and June this year a total of 34,385 cervical screening tests were performed in NSW,compared to 110,942 at the same time in 2019.

But Associate Professor Megan Smith,a lead researcher in the Cervical Cancer and HPV Group at Cancer Council NSW,said the decrease could be partially attributed to the pap smear,previously done every two years,being replaced by the five-yearly cervical screening test in 2017.

She said while she expected cervical cancer screening numbers to be “much lower” following the change in the program,some fall is due to disruption caused by the pandemic and patients cutting back on checkups.

“For some people it might not be top of mind and people potentially putting off routine screening,” Professor Smith said. “But it is really important,particularly for cervical cancer because it’s preventable.”

In locked down areas,attending a medical appointment is an approved reason to leave home.

Dr Smith said she hoped the self-collect cervical screening test,introduced in 2019,would “help some women who may have been hesitant to get screening done”.

Tests for cardiac enzymes or cardiac markers,used in the diagnosis of heart attack and acute coronary syndrome,in NSW were down 21 per cent in July on the same time in 2019 figures (a drop from 16,453 tests to 13,010).

Meanwhile,lipid studies,or cholesterol tests,were down 20 per cent on two years ago (from 11,492 in July 2019 to 9135 this year).

“Although the heart disease tests are not as low as the drop in cervical screening,they are still a big worry because,although they’re not quite as immediate,if people go for quite some time without their lipids it can have long-term consequences for their health,” Dr Graves said.

Prostate specific antigen tests,to monitor prostate cancer,was down 23 per cent over the two-year period (a drop from 37,253 to 28,721).

Natalie Raffoul,risk reduction manager at the Heart Foundation,said the trend was “concerning” and confirmed fears about the impact of prolonged lockdowns on heart health and a possible spike in severe disease in future due to fewer early detections.

“People have been reluctant to seek routine medical attention during the pandemic and that includes getting routine cholesterol tests,seeking attention for the warning signs of a heart attack and having preventive health checks with their GP,” she said,noting the movement of staff by local health districts to focus on COVID-19 vaccination clinics was also impeding patients’ access.

Last month,BreastScreen NSWclosed its services in part to allow local health districts to redeploy staff to the pandemic effort. Cancer Institute NSW,which operates BreastScreen,said there had also been a decline in bookings.

Dr Charlotte Hespe,from Glebe Family Medical Practice,said many routine tests have “dropped right off”.

“It can be quite hard to get a patient to come in and do things,and that’s especially true for screening and preventative care,” she said.

“We are certainly trying to get the majority of patients to keep up with routine blood tests but it’s very dependent on how nervous patients are in attending pathology labs or the surgery itself.”

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Lucy Carroll is education editor of The Sydney Morning Herald. She was previously a health reporter.

Mary Ward is a reporter at The Sun-Herald.

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