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Trends in breast and prostate cancer screening and diagnostic procedures during the COVID-19 pandemic in central MassachusettsMara M Epstein et al. Cancer Causes Control. 2022 Oct.
. 2022 Oct;33(10):1313-1323. doi: 10.1007/s10552-022-01616-4. Epub 2022 Aug 6. AffiliationsItem in Clipboard
AbstractPurpose: We calculated rates of breast and prostate cancer screening and diagnostic procedures performed during the COVID-19 pandemic through December 2021 compared to the same months in 2019 in a large healthcare provider group in central Massachusetts.
Methods: We included active patients of the provider group between January 2019 and December 2021 aged 30-85 years. Monthly rates of screening mammography and digital breast tomosynthesis, breast MRI, total prostate specific antigen (PSA), and breast or prostate biopsy per 1,000 people were compared by year overall, by age, and race/ethnicity. Completed procedures were identified by relevant codes in electronic health record data.
Results: Rates of screening mammography, tomosynthesis, and PSA testing reached the lowest levels in April-May 2020. Breast cancer screening rates decreased 43% in March and 99% in April and May 2020, compared to 2019. Breast cancer screening rates increased gradually beginning in June 2020 through 2021, although more slowly in Black and Hispanic women and in women aged 75-85. PSA testing rates decreased 34% in March, 78% in April, and 53% in May 2020, but rebounded to pre-pandemic levels by June 2020; trends were similar across groups defined by age and race/ethnicity.
Conclusion: The observed decline in two common screening procedures during the COVID-19 pandemic reflects the impact of the pandemic on cancer early detection and signals potential downstream effects on the prognosis of delayed cancer diagnoses. The slower rate of return for breast cancer screening procedures in certain subgroups should be investigated to ensure all women return for routine screenings.
Keywords: Breast cancer; COVID-19; Mammography; Prostate cancer; Prostate specific antigen; Screening.
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Conflict of interest statementThe authors have no relevant financial or non-financial interests to disclose.
FiguresFig. 1
Overall rates of screening mammography…
Fig. 1
Overall rates of screening mammography and tomosynthesis and Prostate Specific Antigen (PSA) testing…
Fig. 1Overall rates of screening mammography and tomosynthesis and Prostate Specific Antigen (PSA) testing per 1,000 people with COVID-19 monthly case counts in Massachusetts, January 2019–December 2021. Massachusetts COVID-19 case data acquired from the Massachusetts Department of Public Health COVID-19 Raw Data, accessed 17 September 2021 and 31 March 2022
Fig. 2
Monthly rates of screening mammography…
Fig. 2
Monthly rates of screening mammography and tomosynthesis testing per 1,000 women overall and…
Fig. 2Monthly rates of screening mammography and tomosynthesis testing per 1,000 women overall and by age group in a central Massachusetts medical provider group, 2019–2021
Fig. 3
Rates of screening mammography and…
Fig. 3
Rates of screening mammography and tomosynthesis per 1,000 women by race/ethnic group in…
Fig. 3Rates of screening mammography and tomosynthesis per 1,000 women by race/ethnic group in a central Massachusetts medical provider group, 2019–2021
Fig. 4
Results of Interrupted Time Series…
Fig. 4
Results of Interrupted Time Series analysis comparing trends in a overall mammography and…
Fig. 4Results of Interrupted Time Series analysis comparing trends in a overall mammography and tomosynthesis and b PSA testing rates between three time periods defined by the COVID-19 pandemic: January 2019–February 2020 (pre-pandemic), March 2020–June 2020 (initial pandemic shutdown), and July 2020–December 2021 (reopening)
Fig. 5
Rates of PSA testing per…
Fig. 5
Rates of PSA testing per 1,000 men overall and by age group in…
Fig. 5Rates of PSA testing per 1,000 men overall and by age group in a central Massachusetts medical provider group, 2019–2021
Fig. 6
Rates of PSA testing per…
Fig. 6
Rates of PSA testing per 1,000 men by race/ethnicity in a central Massachusetts…
Fig. 6Rates of PSA testing per 1,000 men by race/ethnicity in a central Massachusetts medical provider group, 2019–2021
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