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. 2023 Mar 1;7(2):pkad025.
doi: 10.1093/jncics/pkad025.

Breast exam use during the protracted COVID-19 pandemic, by age, race, and geography

Eboneé N Butler  1   2 , Thad Benefield  3 , Louise Henderson  2   3 , Cherie Kuzmiak  2   3 , Michael Pritchard  3 , Sarah Nyante  2   3
Affiliations

Breast exam use during the protracted COVID-19 pandemic, by age, race, and geography

Eboneé N Butler et al. JNCI Cancer Spectr. .

Abstract

In this study we analyzed data collected from the onset of the COVID-19 pandemic through March 31, 2022, to identify temporal shifts in breast exam volume. Screening mammography volume stabilized toward the end of the study period, and diagnostic exam volume varied over time and by age. Older women experienced a decline in diagnostic exam volume between August 2020 and April 2021 that was not observed among women aged younger than 50 years (50-69 years: monthly percentage change [MPC] = -6.5%; and 70 years and older: MPC = -15.7%). With respect to breast biopsy volume, women aged younger than 70 years had increased exam volume beginning in April 2020 and June 2020, whereas a corresponding increase among older women was delayed until April 2021 (70 years and older: MPC = 9.3%). Findings from our study suggest a temporal shift in the use of breast exams that could result in differential detection of breast cancer by age.

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Conflict of interest statement

The authors made no disclosures.

Figures

Figure 1.
Figure 1.
Adjusted screening mammogram exam volume in the Carolina Mammography Registry, over the 39-month period from January 1, 2019, through March 31, 2022. The figure shows adjusted monthly exam volume stratified by the following: age: (A) younger than 50 years, (B) 50-69 years, and (C) 70 years and; race: (D) White and (E) Black; and geography: (F) rural and (G) urban. Monthly exam volume was adjusted by a factor of 12/365.12 to account for the variable number of days between months. The segmented line represents the most parsimonious joinpoint regression model, with a maximum of 4 joinpoints allowed. *Indicates that the monthly percentage change (MPC) differs from zero at a statistically significant level of alpha = .05.
Figure 2.
Figure 2.
Adjusted diagnostic mammogram exam volume in the Carolina Mammography Registry, over the 39-month period from January 1, 2019, through March 31, 2022. The figure shows adjusted monthly exam volume stratified by the following: age: (A) younger than 50 years, (B) 50-69 years, and (C) 70 years and older; race: (D) White and (E) Black; and geography: (F) rural and (G) urban. Monthly exam volume was adjusted by a factor of 12/365.12 to account for the variable number of days between months. The segmented line represents the most parsimonious joinpoint regression model, with a maximum of 4 joinpoints allowed. *Indicates that the monthly percentage change (MPC) differs from zero at a statistically significant level of alpha = .05.
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