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Cancer Screening in the United States During the Second Year of the COVID-19 Pandemic

. 2023 Sep 20;41(27):4352-4359. doi: 10.1200/JCO.22.02170. Epub 2023 Feb 23. Cancer Screening in the United States During the Second Year of the COVID-19 Pandemic

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Cancer Screening in the United States During the Second Year of the COVID-19 Pandemic

Jessica Star et al. J Clin Oncol. 2023.

. 2023 Sep 20;41(27):4352-4359. doi: 10.1200/JCO.22.02170. Epub 2023 Feb 23. Affiliations

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Abstract

Purpose: To examine whether cancer screening prevalence in the United States during 2021 has returned to prepandemic levels using nationally representative data.

Methods: Information on receipt of age-eligible screening for breast (women age 50-74 years), cervical (women without a hysterectomy age 21-65 years), prostate (men age 55-69 years), and colorectal cancer (men and women age 50-75 years) according to the US Preventive Services Task Force recommendations was obtained from the 2019 and 2021 National Health Interview Survey. Past-year screening prevalence in 2019 and 2021 and adjusted prevalence ratios (aPRs), 2021 versus 2019, with their 95% CIs were calculated using complex survey logistic regression models.

Results: Between 2019 and 2021, past-year screening in the United States decreased from 59.9% to 57.1% (aPR, 0.94; 95% CI, 0.91 to 0.97) for breast cancer, from 45.3% to 39.0% (aPR, 0.85; 95% CI, 0.82 to 0.89) for cervical cancer, and from 39.5% to 36.3% (aPR, 0.9; 95% CI, 0.84 to 0.97) for prostate cancer. Declines were most notable for non-Hispanic Asian persons. Colorectal cancer screening prevalence remained unchanged because an increase in past-year stool testing (from 7.0% to 10.3%; aPR, 1.44; 95% CI, 1.31 to 1.58) offset a decline in colonoscopy (from 15.5% to 13.8%; aPR, 0.88; 95% CI, 0.83 to 0.95). The increase in stool testing was most pronounced in non-Hispanic Black and Hispanic populations and in persons with low socioeconomic status.

Conclusion: Past-year screening prevalence for breast, cervical, and prostate cancer among age-eligible adults in the United States continued to be lower than prepandemic levels in the second year of the COVID-19 pandemic, reinforcing the importance of return to screening health system outreach and media campaigns. The large increase in stool testing emphasizes the role of home-based screening during health care system disruptions.

[Media: see text].

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/authors/author-center .

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians ( Open Payments ).

Priti Bandi

Employment: Syneos Health (I)

Xuesong Han

Research Funding: AstraZeneca

No other potential conflicts of interest were reported.

Figures

FIG 1.

Number of age-eligible adults who…

FIG 1.

Number of age-eligible adults who reported receipt of screening in the past year…

FIG 1.

Number of age-eligible adults who reported receipt of screening in the past year in 2019 and 2021 in the United States.

Comment in Similar articles Cited by References
    1. Centers for Disease Control and Prevention : Framework for healthcare systems providing non-COVID-19 clinical care during the COVID-19 pandemic. https://www.agd.org/docs/default-source/advocacy-papers/non-covid-19-car...
    1. Teglia F, Angelini M, Astolfi L, et al. : Global association of COVID-19 pandemic measures with cancer screening: A systematic review and meta-analysis. JAMA Oncol 8:1287-1293, 2022 - PMC - PubMed
    1. McBain RK, Cantor JH, Jena AB, et al. : Decline and rebound in routine cancer screening rates during the COVID-19 pandemic. J Gen Intern Med 36:1829-1831, 2021 - PMC - PubMed
    1. Song H, Bergman A, Chen AT, et al. : Disruptions in preventive care: Mammograms during the COVID-19 pandemic. Health Serv Res 56:95-101, 2021 - PMC - PubMed
    1. Miller MM, Meneveau MO, Rochman CM, et al. : Impact of the COVID-19 pandemic on breast cancer screening volumes and patient screening behaviors. Breast Cancer Res Treat 189:237-246, 2021 - PMC - PubMed

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