Pandemic Fuels Fewer Early-Stage and More Late-Stage Breast Cancer Diagnoses

Pandemic Fuels Fewer Early-Stage and More Late-Stage Breast Cancer Diagnoses

Fewer early-stage and more late-stage breast cancers were diagnosed in 2020 than in 2019.
Mar 10, 2022.
 

A dramatic drop in breast cancer screening rates at the beginning of the COVID-19 pandemic seems to have led to fewer early-stage and more late-stage breast cancer diagnoses in 2020 than in 2019, according to a study.

The research was published on Feb. 15, 2022, by the journal JAMA Network Open. Read “Comparison of Early- and Late-Stage Breast and Colorectal Cancer Diagnoses During vs Before the COVID-19 Pandemic.”

 

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. These measures were designed to help keep the virus from spreading and to ensure healthcare providers had enough resources to treat people who were infected with severe cases.

As restrictions eased, healthcare facilities adopted stricter safety practices to reduce the risk of exposing people to COVID-19. Healthcare providers began to offer screening mammograms and other elective procedures again. Still, many women continued to put off mammograms. A U.S. Centers for Disease Control and Prevention study found that in June 2020, breast cancer screening tests were 39% lower than the previous five-year average.

Many doctors worried that these lower screening rates would delay diagnosis and result in worse breast cancer outcomes.

 

About the study

In this study, the researchers wanted to look at the effects of the COVID-19 pandemic on breast and colorectal cancer diagnoses in 2019 and 2020 at the Moores Cancer Center at University of California San Diego Health.

The researchers looked at the stage of the cancer when it was diagnosed in:

  • people newly diagnosed with breast cancer or colorectal cancer

  • people who wanted a second opinion for either a breast cancer or colorectal cancer diagnosis

In 2019:

  • 216 people were diagnosed with breast cancer (215 women and one man)

  • 45 people were diagnosed with colorectal cancer (24 men and 21 women)

In 2020:

  • 220 people were diagnosed with breast cancer (218 women and two men)

  • 41 people were diagnosed with colorectal cancer (28 men and 13 women)

The average age of the people in the study was 58.1 years.

As the findings show, the number of people who went to the cancer center and were diagnosed with breast or colorectal cancer or wanted a second opinion about the cancers was about the same in 2019 and 2020.

Then the researchers looked at how many people were diagnosed with stage I breast or colorectal cancer versus how many were diagnosed with stage IV breast or colorectal cancer in 2019 and 2020.

For colorectal cancer, eight people were diagnosed with stage I disease in 2019 and six people were diagnosed with stage I disease in 2020. Three people were diagnosed with stage IV disease in 2019 and eight people were diagnosed with stage IV disease in 2020.

So the numbers changed slightly, but these differences were not statistically significant, which means they could have been due to chance.

Breast cancer was a different story. In 2019:

  • 138 people were diagnosed with stage I breast cancer and four people were diagnosed with stage IV breast cancer

In 2020:

  • 116 people were diagnosed with stage I breast cancer and 14 people were diagnosed with stage IV breast cancer

So fewer people were diagnosed with stage I breast cancer and more people were diagnosed with stage IV breast cancer in 2020 than in 2019. These differences were statistically significant, which means they were not due to chance.

The researchers also looked at breast cancer stage for people diagnosed at the cancer center between January and March 2021, which still shows fewer stage I diagnoses and more stage IV diagnoses.

“For breast cancer, at least, these data demonstrate a continuing trend,” first author Jade Zifei Zhou, MD, PhD, a clinical fellow in hematology and oncology at UC San Diego School of Medicine, said in a statement. “They suggest that concerns and consequences caused by the pandemic have prompted at least some patients to delay routine health care, such as screenings or doctor visits, that might have revealed early-stage diagnoses.”

 

What this means for you

Although this study was small and included information from only one cancer center, many experts think it reflects what is happening around the country. A November 2021 analysis by the Cancer Intervention and Surveillance Modeling Network estimated that the reduction in breast cancer screening for the first six months of the pandemic, coupled with delays in diagnosis and chemotherapy treatment, would result in nearly 2,500 extra breast cancer deaths — a 0.52% increase — in the United States by 2030.

Many people were upset and frustrated when their mammograms were delayed or cancelled because of the COVID-19 pandemic. And as this study strongly suggests, delays in breast cancer screening can lead to later-stage cancer diagnoses, which are more difficult to treat.

If your annual mammogram was delayed because of the pandemic, it’s important to reschedule your appointment immediately. If you’re concerned about exposure to the coronavirus, it makes sense to ask your healthcare provider about risk-reducing safety measures at the facility. Many healthcare facilities have hotlines you can call.

It also makes sense for you to take steps to protect yourself from the virus, including:

  • not touching your face while you are at the healthcare facility

  • wearing a face mask with two or more layers of washable, breathable fabric that fits snugly against the sides of your face and completely covers your nose, mouth, and chin

  • using hand sanitizer when you leave the healthcare 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 new loss of taste or smell — cancel your appointment, get tested, and self-quarantine for the required amount of time if you test positive.

Written by: Jamie DePolo, senior editor

— Last updated on July 14, 2022, 4:23 PM

Reviewed by 1 medical adviser
 
Brian Wojciechowski, MD
Crozer Health System, Philadelphia area, PA
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