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Showing content from https://pubmed.ncbi.nlm.nih.gov/34258611/ below:

Impact of the COVID-19 Pandemic on Breast Cancer Mortality in the US: Estimates From Collaborative Simulation Modeling

. 2021 Nov 2;113(11):1484-1494. doi: 10.1093/jnci/djab097. Impact of the COVID-19 Pandemic on Breast Cancer Mortality in the US: Estimates From Collaborative Simulation Modeling Kathryn P Lowry², Allison W Kurian³, Jeanne S Mandelblatt⁴, Mehmet A Ergun⁵, Hui Huang⁶, Sandra J Lee⁷, Clyde B Schechter⁸, Anna N A Tosteson⁹, Diana L Miglioretti¹⁰, Amy Trentham-Dietz¹¹, Sarah J Nyante¹², Karla Kerlikowske¹³, Brian L Sprague¹⁴, Natasha K Stout¹⁵; from the CISNET Breast Working Group

Affiliations

¹ Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA.
² Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA.
³ Departments of Medicine and of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
⁴ Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA.
⁵ Department of Industrial Engineering, Istanbul Technical University, Istanbul, Turkey.
⁶ Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.
⁷ Department of Data Science, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
⁸ Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
⁹ Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA.
¹⁰ Department of Public Health Sciences, University of California at Davis, Davis, CA, USA.
¹¹ Department of Population Health Sciences and the Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
¹² Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹³ Departments of Medicine and Epidemiology/Biostatistics, University of California at San Francisco, San Francisco, CA, USA.
¹⁴ Department of Surgery and the University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington, VT, USA.
¹⁵ Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.

PMID: 34258611
PMCID: PMC8344930
DOI: 10.1093/jnci/djab097

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Impact of the COVID-19 Pandemic on Breast Cancer Mortality in the US: Estimates From Collaborative Simulation Modeling

Oguzhan Alagoz et al. J Natl Cancer Inst. 2021.

. 2021 Nov 2;113(11):1484-1494. doi: 10.1093/jnci/djab097. Authors Oguzhan Alagoz¹, Kathryn P Lowry², Allison W Kurian³, Jeanne S Mandelblatt⁴, Mehmet A Ergun⁵, Hui Huang⁶, Sandra J Lee⁷, Clyde B Schechter⁸, Anna N A Tosteson⁹, Diana L Miglioretti¹⁰, Amy Trentham-Dietz¹¹, Sarah J Nyante¹², Karla Kerlikowske¹³, Brian L Sprague¹⁴, Natasha K Stout¹⁵; from the CISNET Breast Working Group Affiliations

¹ Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA.
² Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA.
³ Departments of Medicine and of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
⁴ Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA.
⁵ Department of Industrial Engineering, Istanbul Technical University, Istanbul, Turkey.
⁶ Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.
⁷ Department of Data Science, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
⁸ Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
⁹ Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA.
¹⁰ Department of Public Health Sciences, University of California at Davis, Davis, CA, USA.
¹¹ Department of Population Health Sciences and the Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
¹² Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹³ Departments of Medicine and Epidemiology/Biostatistics, University of California at San Francisco, San Francisco, CA, USA.
¹⁴ Department of Surgery and the University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington, VT, USA.
¹⁵ Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.

PMID: 34258611
PMCID: PMC8344930
DOI: 10.1093/jnci/djab097

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Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has disrupted breast cancer control through short-term declines in screening and delays in diagnosis and treatments. We projected the impact of COVID-19 on future breast cancer mortality between 2020 and 2030.

Methods: Three established Cancer Intervention and Surveillance Modeling Network breast cancer models modeled reductions in mammography screening use, delays in symptomatic cancer diagnosis, and reduced use of chemotherapy for women with early-stage disease for the first 6 months of the pandemic with return to prepandemic patterns after that time. Sensitivity analyses were performed to determine the effect of key model parameters, including the duration of the pandemic impact.

Results: By 2030, the models project 950 (model range = 860-1297) cumulative excess breast cancer deaths related to reduced screening, 1314 (model range = 266-1325) associated with delayed diagnosis of symptomatic cases, and 151 (model range = 146-207) associated with reduced chemotherapy use in women with hormone positive, early-stage cancer. Jointly, 2487 (model range = 1713-2575) excess breast cancer deaths were estimated, representing a 0.52% (model range = 0.36%-0.56%) cumulative increase over breast cancer deaths expected by 2030 in the absence of the pandemic's disruptions. Sensitivity analyses indicated that the breast cancer mortality impact would be approximately double if the modeled pandemic effects on screening, symptomatic diagnosis, and chemotherapy extended for 12 months.

Conclusions: Initial pandemic-related disruptions in breast cancer care will have a small long-term cumulative impact on breast cancer mortality. Continued efforts to ensure prompt return to screening and minimize delays in evaluation of symptomatic women can largely mitigate the effects of the initial pandemic-associated disruptions.

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Figures
Figure 1.

Cumulative excess breast cancer mortality…

Figure 1.

Cumulative excess breast cancer mortality according to exemplar model (University of Wisconsin-Madison and…

Figure 1.

Cumulative excess breast cancer mortality according to exemplar model (University of Wisconsin-Madison and Harvard Medical School model) over time. A) The number of cumulative excessive deaths when each disruption is modeled separately. B) The number of excessive deaths when disruptions are combined.

Figure 2.

Cumulative excess breast cancer mortality…

Figure 2.

Cumulative excess breast cancer mortality according to exemplar model (University of Wisconsin-Madison and…

Figure 2.

Cumulative excess breast cancer mortality according to exemplar model (University of Wisconsin-Madison and Harvard Medical School model) over time when the pandemic-related disruptions last for 12 months. A) The number of cumulative excessive deaths when each disruption is modeled separately. B) The number of excessive deaths when disruptions are combined.