Foster Nia, Milton Arissa, Woods Ryan W, Elezaby Mai, Neuner Joan, Hackett Kelly, LoConte Noelle, Burnside Elizabeth S, Narayan Anand K
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
J Am Coll Radiol. 2025 Mar;22(3):315-323. doi: 10.1016/j.jacr.2025.01.001.
Studies conducted prior to COVID-19 suggested that racial and ethnic disparities in mammographic screening have reduced over time. COVID-19 has had devastating effects on racial and ethnic minority populations, resulting in delays in preventive screening. Our purpose was to determine if racial and ethnic minority groups were less likely to receive mammographic screening during the COVID-19 pandemic.
Retrospective cross-sectional study was conducted in a multisite academic medical center in the Upper Midwest to evaluate screening disparities during the COVID-19 pandemic. Participants included 50- to 74-year-old female individuals (June 2021 to May 2022). Additional control group was included for pre-COVID-19 case-control comparison (June 2018 to May 2019). Unadjusted and adjusted logistic regression analyses estimated the association between screening and race and ethnicity including interaction terms to assess temporal interactions associated with COVID-19. Study was deemed exempt from institutional review board review.
In all, 37,509 eligible female patients were included. Of them, 73.8% of eligible patients received a mammogram within the last 2 years (White 74.7%, Black 57.6%, Asian 67.0%, American Indian 60.1%, Hispanic 64.2%). In our adjusted analyses, Black (P < .001), Asian (P = .003), and American Indian patients (P = .001) were less likely to receive screening. Hispanic patients were comparably likely to receive screening (P = .338). Non-English-preferred languages, uninsured or Medicaid, and living in rural areas were associated with decreased screening (P < .001). In all, 36,768 eligible female patients were included for pre-COVID-19 comparison. Compared with the pre-COVID-19 time period, COVID-19 was associated with increased screening disparities (P < .001) for Black and Hispanic women (P < .001).
The COVID-19 pandemic was associated with increased racial and ethnic screening disparities. Targeted outreach efforts are required to ensure equitable access to mammographic screening for medically underserved patient populations.
在2019冠状病毒病（COVID-19）之前进行的研究表明，随着时间的推移，乳房X光筛查中的种族和族裔差异有所减少。COVID-19对少数种族和族裔人群产生了毁灭性影响，导致预防性筛查延迟。我们的目的是确定在COVID-19大流行期间，少数种族和族裔群体接受乳房X光筛查的可能性是否较低。
在上中西部的一个多地点学术医疗中心进行了回顾性横断面研究，以评估COVID-19大流行期间的筛查差异。参与者包括50至74岁的女性个体（2021年6月至2022年5月）。还纳入了一个额外的对照组，用于COVID-19前的病例对照比较（2018年6月至2019年5月）。未经调整和调整后的逻辑回归分析估计了筛查与种族和族裔之间的关联，包括交互项，以评估与COVID-19相关的时间交互作用。该研究被认为无需经过机构审查委员会审查。
总共纳入了37509名符合条件的女性患者。其中，73.8%的符合条件的患者在过去2年内接受了乳房X光检查（白人74.7%，黑人57.6%，亚洲人67.0%，美洲印第安人60.1%，西班牙裔64.2%）。在我们的调整分析中，黑人（P <.001）、亚洲人（P =.003）和美洲印第安人患者（P =.001）接受筛查的可能性较小。西班牙裔患者接受筛查的可能性相当（P =.338）。使用非英语首选语言、未参保或参加医疗补助以及居住在农村地区与筛查减少相关（P <.001）。总共纳入了36768名符合条件的女性患者进行COVID-19前的比较。与COVID-19之前的时间段相比，COVID-19与黑人和西班牙裔女性的筛查差异增加相关（P <.001）。
COVID-19大流行与种族和族裔筛查差异增加相关。需要有针对性的外展工作，以确保医疗服务不足的患者群体能够公平获得乳房X光筛查。
