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U.S. Screening Mammogram Rates Rebounding After Pandemic Drop, but Still Low for Certain Groups

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After coming to a halt at the beginning of the COVID-19 pandemic, numbers of screening mammograms are climbing back up to nearly pre-pandemic levels, according to a study. Still, the study also found that rates of screening mammograms among Hispanic and Asian women continue to be lower than average.

The research was published in the March 29, 2021, issue of the Journal of the National Cancer Institute. Read the abstract of “Changes in Mammography Utilization by Women’s Characteristics during the First 5 Months of the COVID-19 Pandemic.”

Breast cancer screening and the pandemic
About the study
What this means for you

Breast cancer screening and the pandemic

At the beginning of the COVID-19 pandemic, most hospitals and other healthcare facilities delayed or cancelled elective procedures, including screening mammograms. This decision was made to help protect people from the increased risk of being infected with the virus that causes COVID-19 and to make sure healthcare providers had the resources they needed to treat people who were infected with the virus.

As healthcare facilities adopted stricter safety practices to reduce the risk of exposing people to COVID-19, screening mammograms and other elective procedures began to be offered again.

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About the study

Health experts knew that screening mammograms in the United States had all but stopped in mid-March 2020 because of the pandemic. The researchers who did this study wanted to know if screening mammogram rates had returned to pre-pandemic levels.

To do the study, researchers from the Breast Cancer Surveillance Consortium looked at information on screening and diagnostic mammograms collected by the consortium. The Breast Cancer Surveillance Consortium is a national network of breast imaging registries funded by the National Cancer Institute.

The mammogram information came from these areas across the United States:

  • Washington state
  • metropolitan Chicago
  • New Hampshire
  • metropolitan Sacramento, Calif.
  • San Francisco
  • Vermont

From January 2019 to July 2020:

  • 461,083 screening mammograms were done
  • 112,207 diagnostic mammograms were done

The people who had the mammograms were:

  • 70.8% white
  • 10.9% Black
  • 7.5% Asian
  • 2.1% Hispanic
  • 8.7% other or unknown race/ethnicity

In 2019, about 28,000 screening mammograms and 6,500 diagnostic mammograms were done per month, on average.

In April 2020:

  • Only 317 screening mammograms were done; this is about 1% of what was done in April 2019.
  • Only 1,452 diagnostic mammograms were done; this is about 21% of what was done in April 2019.

Mammogram rates began increasing in May 2020. By June 2020, diagnostic mammograms were back up to about 98% of pre-pandemic levels.

Still, screening mammogram rates were slower to rebound:

  • rates were about 84% of pre-pandemic rates by June 2020
  • rates were about 90% of pre-pandemic rates by July 2020

The researchers also looked to see if screening mammogram rates varied by race/ethnicity.

Compared to July 2012, in July 2020, screening mammograms rates were:

  • about 7% lower for white women
  • about 3% lower for Black women
  • about 27% lower for Hispanic women
  • about 49% lower for Asian women

“The observed magnitude of reduction in mammography utilization is likely to have an impact on breast cancer diagnosis,” the researchers wrote. “Preliminary results from the University of Wisconsin CISNET (Cancer Intervention and Surveillance Modeling Network) breast cancer model estimated that a 75% reduction in screening over 6 months coupled with a 6-month delay in diagnosis for one-third of women with a positive screening mammogram or clinical symptoms would result in over 5,000 excessive breast cancer deaths (a 1% increase) in the United States between 2020 and 2030. Further research is needed to understand the impact of reduced mammography utilization during the pandemic on breast cancer detection and outcomes.

“Our findings indicate that the rebound in mammography utilization as of July 2020 had lagged considerably among Asian and Hispanic women,” they continued. “These results echo a wide array of evidence suggesting that the COVID-19 pandemic has disproportionately affected racial and ethnic minority groups in the US, although our findings indicate strong rebound in mammography volumes among Black women.”

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What this means for you

We know that many people in the Breastcancer.org Community were upset and frustrated when their mammograms were delayed or cancelled because of COVID-19.

As this study shows, the good news is that most radiology and imaging centers are now offering routine screening mammograms again.

If your annual mammogram was delayed by the COVID-19 pandemic, Breastcancer.org urges you to call your facility and reschedule. If you’re concerned about COVID-19, it makes sense to ask what steps are being taken to protect you from the virus. Many facilities have hotlines you can call. It also makes sense for you to take steps on your own to protect yourself from COVID-19, including:

  • not touching your face while you are at the facility
  • wearing a face mask
  • using hand sanitizer when you leave the facility
  • washing your hands as soon as you get home

Of course, if you have any COVID-19 symptoms, such as cough, shortness of breath, or loss of sense of smell, cancel your appointment, get tested for COVID-19, and self-quarantine for the required amount of time if you test positive.

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Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser


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