Breast cancer stands as the second most common cancer among women in the United States, highlighting the critical importance of early detection through regular screening. However, the onset of the COVID-19 pandemic severely disrupted these efforts, leading to temporary suspensions of many screening programmes due to concerns over viral exposure and strain on healthcare systems. This study aimed to evaluate the pandemic’s impact on breast cancer screening utilisation across the U.S. using real-world electronic health records (EHR), focusing on changes in screening rates and follow-up behaviours.
Using the TriNetX Research Network, the study analysed data from 1,186,669 women eligible for breast cancer screening between January 2017 and February 2022. Researchers examined monthly screening frequencies, noting significant drops during the early pandemic months from February to April 2020, where volumes plummeted by 80.57%. Despite a gradual recovery towards pre-pandemic levels after June 2020, follow-up screening rates continued to decline. On average, the COVID-19 period saw a 2.47% reduction in follow-up screenings, indicating substantial missed opportunities for early detection.
The study also uncovered disparities in screening adherence, with older women over 65 and racial minority groups (excluding Hispanics) showing lower rates of returning for follow-up screenings during the pandemic. These findings suggest a heightened risk of late-stage diagnoses and poorer health outcomes among these demographics. The implications are profound, highlighting the need for targeted interventions to ensure equitable access to screening services and mitigate health disparities exacerbated by the pandemic.
The decrease in follow-up screening rates underscores missed opportunities for timely diagnosis and treatment of breast cancer, potentially leading to more advanced stages at diagnosis and poorer prognoses. Addressing these challenges requires innovative approaches such as telehealth for consultations and reminders, which could help bridge gaps in access to healthcare services, especially for vulnerable populations. Community-based interventions and culturally tailored outreach programmes ensure that all women receive the necessary support and information to adhere to screening guidelines.
Understanding the impact of medical comorbidities and social determinants on screening adherence during crises like COVID-19 is crucial for healthcare providers and systems. This knowledge enables them to tailor strategies effectively and deliver optimal care to diverse patient populations. By addressing disparities in screening participation and enhancing access to preventive services, healthcare providers can mitigate the long-term effects of disrupted healthcare delivery and improve public health resilience.
While the COVID-19 pandemic significantly disrupted breast cancer screening efforts in the U.S., it also underscores the need for resilient healthcare systems and targeted interventions to mitigate disparities and ensure continuous access to critical preventive services. By learning from these challenges, healthcare providers can enhance early detection, improve treatment outcomes, and bolster public health preparedness for future health crises.
More information: Andrew Chung et al, Breast Cancer Screening During the COVID-19 Pandemic in the United States: Results From Real-World Health Records Data, The Annals of Family Medicine. DOI: 10.1370/afm.3098
Journal information: The Annals of Family Medicine Provided by American Academy of Family Physicians
