Seasonal Patterns of Cancer Diagnosis

Well, this post isn't about Follicular Lymphoma, but it's certainly about cancer. And not too complex. And with my bad shoulder, I'm trying to stay in the habit of writing, and "not too complex" is good for that. 

I saw an article this weekend called "Seasonal Patterns and Implications of Cancer Diagnosis Across Calendar Months," published in in JAMA Network Open. 

The objective of the research is pretty straightforward -- is there a month of the year that has more patients in the United States diagnosed with cancer than other months? And if so, why?

The answer is, yes, there is a month with more cancer diagnoses. It's January. This is, of course, the month when I was diagnosed.

The researchers looked at data from cancer registrations and found 30,184,124 cancer diagnoses between 2001 and 2019. (Hey, I was in there!)

They found that January was highest, with 8.81% of cancer diagnoses. Here's the full list:

January 8.81%

February 7.78%

March 8.51%

April 8.35%

May 8.44%

June 8.60%

July 8.17%

August 8.46%

September 7.98%

October 8.58%

November 7.85%

December 7.76% 

There isn't a huge difference between months, but enough to matter. There's a 1% difference between December and January, which is about 300,000 cancer diagnoses. And it's important to keep in mind that these numbers aren't about when people get cancer -- that is, when the disease begins -- but about when they are diagnosed -- when a doctor confirmed that they had it. That's important.

The other question is, why does this pattern exist?

The researchers can't say for sure, but a fairly simple explanation could be that there is lower clinical activity in December and higher in January because of the holidays. In the U.S., "the holidays" starts in late November with Thanksgiving and goes through January 1 with New Year's Day.  People are focused on parties, shopping, spending time with family. It's too happy a time to think about whatever symptoms might be showing up. 

It's also possible that "workforce and specialist availability" has an impact diagnostic timing. It's harder to get an appointment at some parts of the year. 

There are also insurance-related factors. In the U.S., we don't have a public insurance system like in Canada or the UK. It's a complicated system, where something like a "deductible" has an impact. That is, depending on the deductible level, a patient will have to pay for much of their care on their own before health insurance begins to pay. So diagnoses might come later in the year after a deductible level has been reached and some patients can finally afford it. 

And then there are things like awareness campaigns. October has a high number of diagnoses, partly because of an increase in breast cancer diagnoses. October, of course, is breast cancer awareness month. Summer sees a rise in some diagnoses of skin cancers like melanoma. Many people become more aware of skin cancer in the summer months, when they are wearing less clothing and spending more time in the sun.

For me, it seems like it was just coincidence, rather than some seasonal-related issue. I was dealing with health problems starting in June, and it was late November that I went to see a surgeon about the large lymph node near my hip. After some antibiotics didn't work, we scheduled a surgical biopsy, and the results didn't come through until January. I wasn't putting off my health because of the holidays. 

But I think the research makes an important point -- sometimes it's an outside factor that pushes us to take care of our health. It's an easy thing to put off, and I have had loved ones who waited too long to get a diagnosis because they were afraid of what they might find out. Their outcomes were not good, and I lost them much sooner than I wished.

So sometimes we should be the outside force. Not a holiday or an awareness campaign. Just a concerned individual who cares enough about someone to encourage them to see a doctor. 

I'll get back to the FL research soon. But this gives us some things to think about.