2021 CORPORATE RESPONSIBILITY REPORT I 26 “ In the past years, we’ve made so many therapeutic advances in cancer care, but if a cancer isn’t diagnosed, it can’t be treated.” Kristie M. Dolan Vice President and General Manager, Oncology On August 31, 2021, original research from Quest Diagnostics scientists was published in the Journal of the American Medical Association (JAMA) Network Open 1 confirming one of the most dire unintended consequences of mitigation efforts to stop the COVID-19 pandemic: new diagnoses of the 8 most common cancer types in the US sharply declined during most of March 2020 to March 2021, the first year of the pandemic. This included cases of breast, prostate, colorectal, lung, pancreatic, esophageal, cervical, and gastric cancers. After significant decreases in the rate of cancer death from 1991 to 2017, 2 these crucial gains may be lost due to patients’ inability or reluctance to seek care, including regular cancer screenings, because of fear of the COVID-19 virus. In addition, the increased numbers of employees who lost their jobs due to business closures and COVID-19 mandates means a dramatic rise in numbers of Americans who were and may continue to be uninsured and thus even more reluctant to seek healthcare. Without routine screenings, the ability to diagnose early-stage cancers when they are most treatable is greatly reduced. Accordingly, many healthcare providers predict an upcoming wave of patients who were living with undiagnosed cancers during the pandemic who are later diagnosed with advanced cancers, requiring more aggressive treatment and resulting in increased morbidity and mortality. 3 Key insights on current and emerging healthcare issues (continued) A study from Quest Diagnostics and Boston Children's Hospital found that 1 in 2 (50.5%) American children under 6 years of age tested have detectable levels of lead, a toxic metal, in their blood. 4 It is the first study of its size and scale to examine blood lead levels (BLLs) as low as 1.0 μg/dL, which the researchers deemed “detectable” BLL. The researchers found that of the children tested 4 : • 50.5% had a detectable BLL of ≥ 1.0 μg/dL • 1.9% had elevated BLL of ≥ 5.0 ug/dL The research indicates that most American children have been exposed to lead, despite decades of public policy to reduce lead poisoning. A neurotoxin that causes irreversible health effects, including lower IQ, lead is found in many settings, including older homes, water pipes, areas with heavy industry, and some consumer products. “Our Quest analysis finds that while exposure to the highest levels of lead has declined in recent years, most American children are exposed to lead, a substance that, according to the CDC, is not safe for children at any level. Moreover, our analysis finds that kids in areas with the highest rates of poverty are also the most at risk, highlighting the critical role of social disparities in health,” notes Senior Medical Director and Head of Health Trends Research Harvey W. Kaufman, MD . Cancer diagnoses have increased Detectable lead levels in children’s blood TABLE OF CONTENTS 2021 OVERVIEW COVID-19 RESPONSE PROMOTING A HEALTHIER WORLD CREATING AN INSPIRING WORKPLACE BUILDING VALUE REFERENCES