新冠疫情对乳腺癌筛查的干扰与就诊时临床分期升级有关：人口统计学、社会经济地位及未满足的社会需求的影响

COVID-19 pandemic interruption of breast cancer screening is linked to clinical upstaging at presentation: the roles of demographics, socioeconomic status and unmet social needs.

作者信息

Hadidchi Roham, Duong Katie S, Hou Julia, Maldjian Takouhie, Chung Julie, Hou Wei, Fineberg Susan, Lu Jinyu, Makower Della, Duong Tim Q

机构信息

Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.

Department of Oncology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, NY, USA.

出版信息

Breast Cancer Res Treat. 2025 May 15. doi: 10.1007/s10549-025-07713-7.

DOI:10.1007/s10549-025-07713-7

PMID:40372534

Abstract

BACKGROUND

COVID-19 pandemic-related disruptions of mammography screening, breast cancer diagnosis, staging, and treatment options are not well understood with respect to social determinants of health, especially three years post-pandemic.

METHODS

This retrospective observational study included patients screened by mammography or diagnosed with breast cancer from January 2019 to February 2023 in the urban population in the Bronx.

RESULTS

Screening and diagnostic mammography, and breast cancer diagnoses from April to August 2020 dropped by 61%, 47%, and 42%, respectively, compared to pre-pandemic (Jan 2019-Mar 2020) and largely recovered by September 2020. Compared to pre-pandemic baseline, patients diagnosed with breast cancer from September 2020 to January 2021 were 1.48 times (95% CI [1.03, 2.13]) more likely to present with clinical stage 2-4, and 1.47 [1.04-2.08] times more likely to present with T stage 2-4. Black patients experienced a more significant increase in odds of presenting with clinical stage 2-4 (4.41 [1.36, 14.24]) and nodal involvement (4.61 [1.27, 16.82]) compared to non-Hispanic Whites from Apr 2020 to Jan 2021.

CONCLUSION

Interruption of breast cancer screening during the pandemic coincided with increased proportions of patients presenting with more advanced disease, especially among Black patients. The results underscore the need for targeted public health interventions to address health disparities among these populations.

摘要

背景

关于健康的社会决定因素，尤其是在疫情爆发三年后，人们对与COVID-19大流行相关的乳房X光检查筛查、乳腺癌诊断、分期和治疗选择的中断情况了解不足。

方法

这项回顾性观察研究纳入了2019年1月至2023年2月期间在布朗克斯区城市人口中接受乳房X光检查筛查或被诊断为乳腺癌的患者。

结果

与疫情前（2019年1月至2020年3月）相比，2020年4月至8月期间的筛查性和诊断性乳房X光检查以及乳腺癌诊断分别下降了61%、47%和42%，到2020年9月基本恢复。与疫情前基线相比，2020年9月至2021年1月被诊断为乳腺癌的患者出现临床2-4期的可能性高1.48倍（95%置信区间[1.03, 2.13]），出现T2-4期的可能性高1.47倍[1.04-2.08]。与非西班牙裔白人相比，2020年4月至2021年1月期间，黑人患者出现临床2-4期（4.41 [1.36, 14.24]）和淋巴结受累（4.61 [1.27, 16.82]）的几率增加更为显著。