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Article ; Online: Changes in breast cancer screening rates among 32 community health centers during the COVID-19 pandemic.

Fedewa, Stacey A / Cotter, Megan M / Wehling, Kristen A / Wysocki, Karla / Killewald, Richard / Makaroff, Laura

Cancer

2021  Volume 127, Issue 23, Page(s) 4512–4515

Abstract: ... populations are unknown. This study examined changes in breast cancer screening rates (BCSRs) during ... disease 2019 (COVID-19) pandemic. However, the effects on breast cancer screening in lower income ... the pandemic among 32 community health centers (CHCs) that provided health care to lower income populations ...

Abstract Background: Breast cancer screening utilization steeply dropped at the start of the coronavirus disease 2019 (COVID-19) pandemic. However, the effects on breast cancer screening in lower income populations are unknown. This study examined changes in breast cancer screening rates (BCSRs) during the pandemic among 32 community health centers (CHCs) that provided health care to lower income populations.
Methods: Secondary data from 32 CHCs participating in an American Cancer Society grant program to increase breast cancer screening services were used. BCSRs were defined as the percentage of women aged 50 to 74 years who had a medical visit in the past 12 months (142,207 in 2018, 142,003 in 2019, and 150,630 in 2020) and received a screening mammogram within the last 27 months. BCSRs in July 2020, July 2019, and June 2018 were compared with screening rate ratios (SRRs) and corresponding 95% confidence intervals (CIs).
Results: BCSRs significantly rose by 18% between 2018 and 2019 (from 45.8% to 53.9%; SRR, 1.18; 95% CI, 1.17-1.18) and then declined by 8% between 2019 and 2020 (from 53.9% to 49.6%; SRR, 0.92; 95% CI, 0.92-0.93). If the 2018-2019 BCSR trends had continued through 2020, 63.3% of women would have been screened in 2020 in contrast to the 49.6% who were; this potentially translated into 47,517 fewer mammograms and 242 missed breast cancer diagnoses in this population.
Conclusions: In this study of 32 CHCs, BCSRs declined by 8% from July 2019 to 2020, and this reversed an 18% improvement between July 2018 and 2019. Declining BCSRs among CHCs during the COVID-19 pandemic call for policies to support and resources to identify women in need of screening.
MeSH term(s) Breast Neoplasms/diagnosis ; Breast Neoplasms/epidemiology ; COVID-19 ; Community Health Centers ; Early Detection of Cancer/statistics & numerical data ; Female ; Humans ; Mammography ; Mass Screening/statistics & numerical data ; Pandemics ; United States/epidemiology
Language English
Publishing date 2021-08-26
Publishing country United States
Document type Journal Article
ZDB-ID 1429-1
ISSN 1097-0142 ; 0008-543X ; 1934-662X
ISSN (online) 1097-0142
ISSN 0008-543X ; 1934-662X
DOI 10.1002/cncr.33859
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