Population‐level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures
Autor: | Sarah J. Nyante, Kathryn Earnhardt, Thad Benefield, Cherie M. Kuzmiak, Louise M. Henderson, Michael Pritchard |
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Rok vydání: | 2021 |
Předmět: |
Adult
Breast biopsy Cancer Research medicine.medical_specialty Adolescent Epidemiology Breast imaging mammography Biopsy Breast Neoplasms Discipline Young Adult 03 medical and health sciences Breast cancer screening 0302 clinical medicine Breast cancer Health care medicine Humans Mammography Breast 030212 general & internal medicine interrupted time series analysis skin and connective tissue diseases Early Detection of Cancer Aged Aged 80 and over medicine.diagnostic_test SARS-CoV-2 business.industry Obstetrics screening COVID-19 Original Articles Middle Aged medicine.disease Oncology 030220 oncology & carcinogenesis Original Article Female coronavirus disease 2019 (COVID‐19) business Diagnostic Mammography |
Zdroj: | Cancer |
ISSN: | 1097-0142 0008-543X |
Popis: | BACKGROUND To understand how health care delays may affect breast cancer detection, the authors quantified changes in breast‐related preventive and diagnostic care during the coronavirus disease 2019 (COVID‐19) pandemic. METHODS Eligible women (N = 39,444) were aged ≥18 years and received a screening mammogram, diagnostic mammogram, or breast biopsy between January 1, 2019 and September 30, 2020, at 7 academic and community breast imaging facilities in North Carolina. Changes in the number of mammography or breast biopsy examinations after March 3, 2020 (the first COVID‐19 diagnosis in North Carolina) were evaluated and compared with the expected numbers based on trends between January 1, 2019 and March 2, 2020. Changes in the predicted mean monthly number of examinations were estimated using interrupted time series models. Differences in patient characteristics were tested using least squares means regression. RESULTS Fewer examinations than expected were received after the pandemic's onset. Maximum reductions occurred in March 2020 for screening mammography (−85.1%; 95% CI, −100.0%, −70.0%) and diagnostic mammography (−48.9%; 95% CI, −71.7%, −26.2%) and in May 2020 for biopsies (−40.9%; 95% CI, −57.6%, −24.3%). The deficit decreased gradually, with no significant difference between observed and expected numbers by July 2020 (diagnostic mammography) and August 2020 (screening mammography and biopsy). Several months after the pandemic's onset, women who were receiving care had higher predicted breast cancer risk (screening mammography, P < .001) and more commonly lacked insurance (diagnostic mammography, P < .001; biopsy, P < .001) compared with the prepandemic population. CONCLUSIONS Pandemic‐associated deficits in the number of breast examinations decreased over time. Utilization differed by breast cancer risk and insurance status, but not by age or race/ethnicity. Long‐term studies are needed to clarify the contribution of these trends to breast cancer disparities. In this observational study, the use of screening mammography, diagnostic mammography, and breast biopsy is significantly lower than expected after the onset of the COVID‐19 pandemic in North Carolina, but the deficits decrease over time. Health insurance status and predicted breast cancer risk are identified as predictors of mammography and biopsy receipt during the pandemic. |
Databáze: | OpenAIRE |
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