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. 2021 Aug;189(1):237-246.
doi: 10.1007/s10549-021-06252-1. Epub 2021 May 25.

Impact of the COVID-19 pandemic on breast cancer screening volumes and patient screening behaviors

Matthew M Miller  1 , Max O Meneveau  2 , Carrie M Rochman  3 , Anneke T Schroen  2 , Courtney M Lattimore  2 , Patricia A Gaspard  3 , Richard S Cubbage  3 , Shayna L Showalter  2
Affiliations

Impact of the COVID-19 pandemic on breast cancer screening volumes and patient screening behaviors

Matthew M Miller et al. Breast Cancer Res Treat. 2021 Aug.

Abstract

Purpose: In order to facilitate targeted outreach, we sought to identify patient populations with a lower likelihood of returning for breast cancer screening after COVID-19-related imaging center closures.

Methods: Weekly total screening mammograms performed throughout 2019 (baseline year) and 2020 (COVID-19-impacted year) were compared. Demographic and clinical characteristics, including age, race, ethnicity, breast density, breast cancer history, insurance status, imaging facility type used, and need for interpreter, were compared between patients imaged from March 16 to October 31 in 2019 (baseline cohort) and 2020 (COVID-19-impacted cohort). Census data and an online map service were used to impute socioeconomic variables and calculate travel times for each patient. Logistic regression was used to identify patient characteristics associated with a lower likelihood of returning for screening after COVID-19-related closures.

Results: The year-over-year cumulative difference in screening mammogram volumes peaked in week 21, with 2962 fewer exams in the COVID-19-impacted year. By week 47, this deficit had reduced by 49.4% to 1498. A lower likelihood of returning for screening after COVID-19-related closures was independently associated with younger age (odds ratio (OR) 0.78, p < 0.001), residence in a higher poverty area (OR 0.991, p = 0.014), lack of health insurance (OR 0.65, p = 0.007), need for an interpreter (OR 0.68, p = 0.029), longer travel time (OR 0.998, p < 0.001), and utilization of mobile mammography services (OR 0.27, p < 0.001).

Conclusion: Several patient factors are associated with a lower likelihood of returning for screening mammography after COVID-19-related closures. Knowledge of these factors can guide targeted outreach to vulnerable patients to facilitate breast cancer screening.

Keywords: Breast cancer; COVID-19 pandemic; Patient travel time; Screening mammography.

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Conflict of interest statement

None of the authors has any conflict of interest or competing interests related to this study.

Figures

Fig. 1
Fig. 1
Impact of COVID-19 on mammographic breast cancer screening volumes: a Screening mammograms performed by week for 2019 (baseline year) and 2020 (COVID-19-impacted year). b Cumulative year-to-date screening mammograms performed by week for 2019 and 2020. c Cumulative difference of year-to-date screening mammograms between 2019 and 2020
Fig. 2
Fig. 2
Impact of COVID-19 on mammographic breast cancer screening volumes by geographic region: a Number of patients screened at a University of Virginia mammography facility in 2019 by census tract. b Percent change in number of patients from a particular census tract screened at a University of Virginia facility in 2020 compared to 2019. Percent change calculated as [(# screened in 2020 − # screened in 2019)/# screened in 2019] × 100%
See this image and copyright information in PMC

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