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Breast Cancer Screening Declined Sharply When Pandemic Started

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Breast cancer screening rates dropped dramatically at the beginning of the COVID-19 pandemic, especially among women of certain racial and ethnic groups, as well as women living in rural areas, according to a U.S. Centers for Disease Control and Prevention (CDC) study.

The research was published online on June 30, 2021, by the journal Preventive Medicine. Read “COVID-19 impact on screening test volume through the National Breast and Cervical Cancer early detection program, January-June 2020, in the United States.”

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. Healthcare providers made this decision to help protect people from the increased risk of being infected with the virus that causes COVID-19 and to make sure they had the resources 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, healthcare providers began to offer screening mammograms and other elective procedures again.

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About the study

The information analyzed for this study came from the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), a program that offers cancer screening services to women with low incomes and inadequate health insurance. The NBCCEDP was created to help eliminate disparities in breast cancer and cervical cancer outcomes by making screening available to more women, regardless of income or health insurance status.

According to the researchers, the NBCCEDP funded 630,264 breast cancer screening tests and 594,566 cervical cancer screening tests between January and June every year from 2015 to 2020.

Among the 487,645 women screened for breast cancer through the program:

  • 47.5% were Hispanic
  • 28.1% were white
  • 14.9% were Black
  • 4.3% were Asian Pacific Islander
  • 3.5% were American Indian or Alaska Native
  • 0.4% were multi-racial
  • 1.2% were of unknown race
  • 80.5% lived in metropolitan areas
  • 14.9% lived in urban areas
  • 2.1% lived in rural areas

Compared with the previous 5-year averages, in April 2020:

  • breast cancer screening tests declined by 87%
  • cervical cancer screening tests declined by 84%

By June 2020, screening rates had started to rebound but were still a bit low:

  • Breast cancer screening tests were 39% below the 5-year average.
  • Cervical cancer screening tests were 40% below the 5-year average.

The researchers also looked to see if certain racial or ethnic groups had larger drops in screening tests compared with other groups.

The greatest decline in breast cancer screening tests was in April 2020. Compared with the previous 5-year average, breast cancer screening dropped by:

  • 98% for American Indian or Alaska Native women
  • 97% for Asian Pacific Islander women
  • 84% for Hispanic women

The researchers also looked at rates of breast cancer screening declines based on where the women lived. The pattern of decline was similar, with the biggest decline in screening tests happening in April 2020. Compared with the previous 5-year average, breast cancer screening dropped by:

  • 86% in metropolitan areas
  • 88% in urban areas
  • 89% in rural areas

“Prolonged delays in screening related to the COVID-19 pandemic may lead to delayed diagnoses, poor health consequences, and an increase in cancer disparities among women already experiencing health inequities,” the CDC said in a statement.

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What this means for you

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

The results of this study echo the results of other studies: Breast cancer screening rates dropped dramatically when the COVID-19 pandemic started.

It’s important to know that a drop in breast cancer screening may lead to an increase in deaths from breast cancer. Early results from the University of Wisconsin 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 more than 5,000 extra breast cancer deaths — a 1% increase — in the United States between 2020 and 2030.

If your annual mammogram was delayed by the COVID-19 pandemic, Breastcancer.org urges you to call your healthcare facility and reschedule right away. If you’re concerned about COVID-19, it makes sense to ask what steps your healthcare provider is taking to protect you from the virus. Many healthcare facilities have hotlines you can call.

It also makes sense for you to take your own steps to protect yourself from COVID-19, including:

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