Department of Surgery, Office of Health Promotion Research, University of Vermont Larner College of Medicine, Burlington, VT, USA.
Department of Radiology, University of Vermont Larner College of Medicine, Burlington, VT, USA.
J Natl Cancer Inst. 2021 Sep 4;113(9):1161-1167. doi: 10.1093/jnci/djab045.
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic led to a near-total cessation of mammography services in the United States in mid-March 2020. It is unclear if screening and diagnostic mammography volumes have recovered to prepandemic levels and whether use has varied by women's characteristics. METHODS: We collected data on 461 083 screening mammograms and 112 207 diagnostic mammograms conducted during January 2019 through July 2020 at 62 radiology facilities in the Breast Cancer Surveillance Consortium. We compared monthly screening and diagnostic mammography volumes before and during the pandemic stratified by age, race and ethnicity, breast density, and family history of breast cancer. RESULTS: Screening and diagnostic mammography volumes in April 2020 were 1.1% (95% confidence interval [CI] = 0.5% to 2.4%) and 21.4% (95% CI = 18.7% to 24.4%) of the April 2019 prepandemic volumes, respectively, but by July 2020 had rebounded to 89.7% (95% CI = 79.6% to 101.1%) and 101.6% (95% CI = 93.8% to 110.1%) of the July 2019 prepandemic volumes, respectively. The year-to-date cumulative volume of screening and diagnostic mammograms performed through July 2020 was 66.2% (95% CI = 60.3% to 72.6%) and 79.9% (95% CI = 75.4% to 84.6%), respectively, of year-to-date volume through July 2019. Screening mammography rebound was similar across age groups and by family history of breast cancer. Monthly screening mammography volume in July 2020 for Black, White, Hispanic, and Asian women reached 96.7% (95% CI = 88.1% to 106.1%), 92.9% (95% CI = 82.9% to 104.0%), 72.7% (95% CI = 56.5% to 93.6%), and 51.3% (95% CI = 39.7% to 66.2%) of the July 2019 prepandemic volume, respectively. CONCLUSIONS: Despite a strong overall rebound in mammography volume by July 2020, the rebound lagged among Asian and Hispanic women, and a substantial cumulative deficit in missed mammograms accumulated, which may have important health consequences.
背景:2020 年 3 月中旬,美国因 2019 年冠状病毒病(COVID-19)大流行几乎完全停止了乳房 X 光检查服务。目前尚不清楚筛查和诊断性乳房 X 光检查的数量是否已恢复到大流行前的水平,以及使用情况是否因女性特征而异。
方法:我们收集了 2019 年 1 月至 2020 年 7 月期间在乳腺癌监测联盟的 62 个放射科设施中进行的 461083 次筛查性乳房 X 光检查和 112207 次诊断性乳房 X 光检查的数据。我们按年龄、种族和民族、乳房密度以及乳腺癌家族史对大流行前后的每月筛查和诊断性乳房 X 光检查量进行了分层比较。
结果:2020 年 4 月的筛查和诊断性乳房 X 光检查量分别为 2019 年 4 月大流行前水平的 1.1%(95%置信区间[CI]为 0.5%至 2.4%)和 21.4%(95% CI 为 18.7%至 24.4%),但到 2020 年 7 月,已分别反弹至 2019 年 7 月大流行前水平的 89.7%(95% CI 为 79.6%至 101.1%)和 101.6%(95% CI 为 93.8%至 110.1%)。截至 2020 年 7 月,筛查和诊断性乳房 X 光检查的累计年度量分别为 2019 年 7 月前的 66.2%(95% CI 为 60.3%至 72.6%)和 79.9%(95% CI 为 75.4%至 84.6%)。截至 2020 年 7 月,黑人、白人、西班牙裔和亚裔妇女的每月筛查性乳房 X 光检查量分别达到了 2019 年 7 月大流行前水平的 96.7%(95% CI 为 88.1%至 106.1%)、92.9%(95% CI 为 82.9%至 104.0%)、72.7%(95% CI 为 56.5%至 93.6%)和 51.3%(95% CI 为 39.7%至 66.2%)。
结论:尽管到 2020 年 7 月,乳房 X 光检查量总体上强劲反弹,但亚洲和西班牙裔妇女的反弹滞后,错过的乳房 X 光检查数量累积大量减少,这可能会产生重要的健康后果。
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