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Expert Perspectives

The Power of Prevention

By Dr. Peter Nord, Chief Medical Officer, Medcan

The pandemic put preventive screening on the back burner. Now it’s time to catch up.

When did you last visit your primary care physician? Or have routine blood work done? Or undergo an annual physical? Chances are, it’s been a while.

As COVID-19 triggered stay-at-home orders and halted most elective medical care, preventive healthcare has experienced a year-plus pause. This is certain to create lingering health consequences at both the individual and the population level. As restrictions ease and we return to normalcy, all of us will benefit from catching up on our preventive health screening. As the old saying goes, “An ounce of prevention is worth a pound of cure.”

To get a sense of the consequences of this pandemic pause in prevention, let’s examine some numbers. Ontario Health estimates almost one million fewer breast, cervical and colorectal cancer screenings happened in the province between March and December 2020, compared to the same period a year earlier.

As a result, some pre-cancerous lesions will have had the time to grow into actual cancers. Cases we should have caught early will develop into more advanced stages, resulting in more radical surgeries, or chemotherapy that otherwise would not have been necessary. Similar things are happening with other diseases that benefit from early prevention. For example, early heart disease that goes untreated will cause more serious cardiovascular issues, including sudden death.

Sophisticated computer models back this up. According to Statistics Canada, the overall decrease in cancer screening is expected to trigger an uptick in cancer cases, as well as deaths due to cancer. For example, simulations predict that a six-month suspension of colorectal cancer screenings will result in 2,200 more instances of the disease; a six-month stoppage in breast cancer screenings could lead to 670 additional occurrences of advanced cases by 2029.

We’re likely already seeing the consequences of the screening pause. According to data from the Ontario COVID-19 Science Advisory Table, the province has experienced a 12.8 per cent increase in the number of excess deaths compared to pre-pandemic estimates. However, the increased mortality rate can’t be entirely attributed to COVID-19: Most recently, from January to March 2021, 26.9 per cent of excess deaths stemmed from causes other than COVID.

Our healthcare system is based almost entirely on responding to diagnoses and less on preventing these conditions. It was originally designed with the goal of fixing urgent medical problems, rather than promoting optimal wellness. A system focused on prevention and optimal wellness would feature more of an emphasis on screening. As it is, the College of Family Physicians of Canada has long maintained a set of guidelines that suggest certain screening tests depending on age and sex. But these guidelines are based on population-level bell curves, with some people having disease at young ages and some at older ages. They’re created with public budgets and cost pressures in mind. This means that every year people are suffering from diseases, with some losing their lives, because they fell below the cut-off age for screening.

If your age places you near the cut off for eligibility but you have risks that potentially warrant screening (like perhaps a family history of disease at a young age), talk to your Medcan doctor about the options available to you. And in the meantime, here are a few things to consider when thinking about your post-pandemic preventive health strategy:

  • Reconnect with your doctor. Especially if you haven’t in a while. Your physician tracks your screening procedures, so you can ask if you’re behind on any procedures you were due to get through the course of the pandemic. It’s also an opportunity to have a conversation about how COVID and other circumstances may have changed the way you should be managing your preventive health.
  • Look up the guidelines yourself. The College of Family Physicians of Canada maintains preventive care guidelines online. If you’re concerned about a certain type of cancer or other health condition, you can research preventive guidelines yourself. Once you’ve discovered what’s recommended for your age and risk profile, consider bringing up any questions or concerns with your doctor.
  • Focus on the basics. There’s a reason we prescribe eating well, moving well and thinking well at Medcan: Because such simple healthy lifestyle behaviours are major contributors to a long and healthy life. Just before the pandemic, in January 2020, the British Medical Journal published research that analyzed the impact of basic wellness choices. Eating well, exercising, avoiding smoking, maintaining a healthy weight and limiting your drinking was associated with a full decade more of healthy life for women, and eight more years for men.

Prevention pays dividends. It’s one of the best things you can do to promote your health. As society transitions to the next normal, and the healthcare system reopens, it’s time to catch up on your screening. Your body, and loved ones, will thank you.

Medcan’s Annual Health Assessment is an effective and time-efficient way to manage your preventive screening.

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