THE ADVERSE EFFECTS OF THE COVID-19 PANDEMIC ON BREAST CANCER SCREENING HAVE NOT ENDED FOR LOW-INCOME POPULATIONS
While in the initial throes of the pandemic, there were precipitous drops in breast cancer screening (BCS) as well as higher breast cancer mortality (BCM) (American Cancer Society. Cancer Detection Facts and Figures 2019-20). This study (Fedewa et al.) from the American Cancer Society study shows the pandemic has impacted screening in lower socio-economic populations. The authors examined breast cancer screen rate (BCSR) from 32 community health centers serving an underserved population.
The authors studied 32 community health care centers serving the underserved. As background, breast cancer screening rose 18% from 2018-2019. As the pandemic began in 2019-2020, screening fell by 8%. Modeling showed that had the 2018-2019 trend continued, 63% of women would have been screened in 2020. As pandemic took hold in 2020, only 49.6% underwent breast cancer screening resulting in potentially more significant than 45,000 fewer mammograms and 242 missed breast cancer diagnoses.
The pattern of breast screening that decreased between 2018-2019 and 2019-2020 existed across all clinical characteristics though the extent varied. Community health clinics with a more significant proportion of black patients and a lower fraction of uninsured patients experienced the greatest declines. Interestingly, there were no significant differences noted among those clinics located in the South.
Conclusion: In this study of 32 community health centers serving the underserved, screening declined by 8% from 7/2019 to 2020, reversing an 18% improvement in the prior year. The researchers used computer models showing that a 75% decline over six months could lead to a national surplus of 5000 breast cancers by 2030. Reductions were more significant in clinics serving centers serving predominately black patients. Whereas southern clinics maintained screening numbers, one might postulate that this may represent lower baseline rates.