Office of Cancer Research and Implementation, American Cancer Society, Atlanta, Georgia.
Cancer. 2021 Dec 1;127(23):4512-4515. doi: 10.1002/cncr.33859. Epub 2021 Aug 26.
Breast cancer screening utilization steeply dropped at the start of the coronavirus disease 2019 (COVID-19) pandemic. However, the effects on breast cancer screening in lower income populations are unknown. This study examined changes in breast cancer screening rates (BCSRs) during the pandemic among 32 community health centers (CHCs) that provided health care to lower income populations.
Secondary data from 32 CHCs participating in an American Cancer Society grant program to increase breast cancer screening services were used. BCSRs were defined as the percentage of women aged 50 to 74 years who had a medical visit in the past 12 months (142,207 in 2018, 142,003 in 2019, and 150,630 in 2020) and received a screening mammogram within the last 27 months. BCSRs in July 2020, July 2019, and June 2018 were compared with screening rate ratios (SRRs) and corresponding 95% confidence intervals (CIs).
BCSRs significantly rose by 18% between 2018 and 2019 (from 45.8% to 53.9%; SRR, 1.18; 95% CI, 1.17-1.18) and then declined by 8% between 2019 and 2020 (from 53.9% to 49.6%; SRR, 0.92; 95% CI, 0.92-0.93). If the 2018-2019 BCSR trends had continued through 2020, 63.3% of women would have been screened in 2020 in contrast to the 49.6% who were; this potentially translated into 47,517 fewer mammograms and 242 missed breast cancer diagnoses in this population.
In this study of 32 CHCs, BCSRs declined by 8% from July 2019 to 2020, and this reversed an 18% improvement between July 2018 and 2019. Declining BCSRs among CHCs during the COVID-19 pandemic call for policies to support and resources to identify women in need of screening.
2019 年冠状病毒病（COVID-19）大流行开始时，乳腺癌筛查的利用率急剧下降。然而，其对低收入人群乳腺癌筛查的影响尚不清楚。本研究通过 32 个社区卫生中心（CHC）的二次数据分析了大流行期间低收入人群乳腺癌筛查率（BCSR）的变化，这些 CHC 提供了医疗服务。
使用参与美国癌症协会（ACS）提高乳腺癌筛查服务的赠款计划的 32 个 CHC 的二级数据。BCSR 定义为在过去 12 个月中进行医疗访问的 50 至 74 岁女性的百分比（2018 年为 142,207 人，2019 年为 142,003 人，2020 年为 150,630 人），并且在过去 27 个月内接受了筛查乳房 X 光检查。2020 年 7 月、2019 年 7 月和 2018 年 6 月的 BCSR 与筛查率比（SRR）和相应的 95%置信区间（CI）进行了比较。
2018 年至 2019 年 BCSR 显著上升 18%（从 45.8%升至 53.9%；SRR，1.18；95%CI，1.17-1.18），然后 2019 年至 2020 年下降 8%（从 53.9%降至 49.6%；SRR，0.92；95%CI，0.92-0.93）。如果 2018-2019 年 BCSR 趋势持续到 2020 年，那么 2020 年将有 63.3%的女性接受筛查，而实际上只有 49.6%的女性接受了筛查；这可能意味着该人群减少了 47,517 次乳房 X 光检查和 242 例乳腺癌漏诊。
在这项对 32 个 CHC 的研究中，2019 年 7 月至 2020 年 BCSR 下降了 8%，这扭转了 2018 年 7 月至 2019 年 18%的改善。COVID-19 大流行期间 CHC 中 BCSR 的下降呼吁制定支持政策并提供资源，以确定需要筛查的女性。
