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      Impact of the COVID-19 breast cancer screening hiatus on clinical stage and racial disparities in New York City

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          Abstract

          Background

          The impact of the COVID-19 mammography screening hiatus as well as of post-hiatus efforts promoting restoration of elective healthcare on breast cancer detection patterns and stage distribution is unknown.

          Methods

          Newly diagnosed breast cancer patients (2019–2021) at the New York Presbyterian (NYP) Hospital Network were analyzed. Chi-square and student's t-test compared characteristics of patients presenting before and after the screening hiatus.

          Results

          A total of 2137 patients were analyzed. Frequency of screen-detected and early-stage breast cancer declined post-hiatus (59.7%), but returned to baseline (69.3%). Frequency of screen-detected breast cancer was lowest for African American (AA) (57.5%) and Medicaid patients pre-hiatus (57.2%), and this disparity was reduced post-hiatus (65.3% for AA and 63.2% for Medicaid).

          Conclusions

          The return to baseline levels of screen-detected cancer, particularly among AA and Medicaid patients suggest that large-scale breast health education campaigns may be effective in resuming screening practices and in mitigating disparities.

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          Changes in the Number of US Patients With Newly Identified Cancer Before and During the Coronavirus Disease 2019 (COVID-19) Pandemic

          Harvey Kaufman, Zhen. Chen, Justin Niles … (2020)
          This cross-sectional study examines changes in the number of patients with newly identified cancer before and during the coronavirus disease 2019 (COVID-19) pandemic in the United States.
          Article 0 comments Cited 207 times – based on 0 reviews     Review now
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            Association of Cancer Screening Deficit in the United States With the COVID-19 Pandemic

            Ronald C Chen, Kevin Haynes, Simo Du … (2021)
            Article 0 comments Cited 128 times – based on 0 reviews     Review now
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              Two-month stop in mammographic screening significantly impacts on breast cancer stage at diagnosis and upfront treatment in the COVID era

              A Toss, C. Isca, M Venturelli … (2021)
              Introduction The present analysis aims to evaluate the consequences of a 2-month interruption of mammographic screening on breast cancer (BC) stage at diagnosis and upfront treatments in a region of Northern Italy highly affected by the severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) virus. Methods This retrospective single-institution analysis compared the clinical pathological characteristics of BC diagnosed between May 2020 and July 2020, after a 2-month screening interruption, with BC diagnosed in the same trimester of 2019 when mammographic screening was regularly carried out. Results The 2-month stop in mammographic screening produced a significant decrease in in situ BC diagnosis (−10.4%) and an increase in node-positive (+11.2%) and stage III BC (+10.3%). A major impact was on the subgroup of patients with BC at high proliferation rates. Among these, the rate of node-positive BC increased by 18.5% and stage III by 11.4%. In the subgroup of patients with low proliferation rates, a 9.3% increase in stage III tumors was observed, although node-positive tumors remained stable. Despite screening interruption, procedures to establish a definitive diagnosis and treatment start were subsequently carried out without delay. Conclusion Our data showed an increase in node-positive and stage III BC after a 2-month stop in BC screening. These findings support recommendations for a quick restoration of BC screening at full capacity, with adequate prioritization strategies to mitigate harm and meet infection prevention requirements.
              Article 0 comments Cited 53 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Am J Surg
                Journal ID (iso-abbrev): Am J Surg
                Title: American Journal of Surgery
                Publisher: Elsevier Inc.
                ISSN (Print): 0002-9610
                ISSN (Electronic): 1879-1883
                Publication date PMC-release: 27 May 2022
                Publication date (Electronic): 27 May 2022
                Affiliations
                [a ]New York Presbyterian-Weill Cornell Medicine, Department of Breast Surgery, 1283 York Avenue, 4th Floor, New York, NY, 10065, USA
                [b ]New York Presbyterian – Weill Cornell Medicine Department of Population Health Sciences, 402 East 67th Street, LA-219, New York, NY, 10065, USA
                [c ]New York Presbyterian-Brooklyn Methodist Hospital, Department of Breast Surgery, 506 6th Street, Brooklyn, NY, 11215, USA
                [d ]New York Presbyterian – Queens Hospital, Department of Breast Surgery, 56-45 Main Street Queens, NY, 11355, USA
                [e ]Weill Cornell Imaging at New York Presbyterian, 425 East 61st Street, 9th Floor, New York, NY, 10021, USA
                [f ]New York Presbyterian-Weill Cornell Medicine, Department of Radiation Oncology, 1283 York Avenue, 4th Floor, New York, NY, 10065, USA
                [g ]New York Presbyterian-Brooklyn Methodist Hospital, Department of Medical Oncology, 263 7th Ave, Suite 4H, Brooklyn, NY, 11215, USA
                [h ]New York Presbyterian-Brooklyn Methodist Hospital, Department of Radiation Oncology, 506 6th Street, Brooklyn, NY, 11215, USA
                [i ]New York Presbyterian – Queens Hospital, Department of Medical Oncology, 56-45 Main Street Queens, NY, 11355, USA
                [j ]Henry Ford Health System, Department of Surgery, 1 Ford Place, Detroit, MI, 48202, USA
                Author notes
                [∗ ]Corresponding author. East 70th Street, New York, NY, 10021, USA.
                Article
                Publisher Item ID: S0002-9610(22)00391-9
                DOI: 10.1016/j.amjsurg.2022.05.037
                PMC ID: 9135673
                PubMed ID: 35641320
                SO-VID: d2c22064-e91b-493f-97da-14c4e7cb8886
                Copyright © © 2022 Elsevier Inc. All rights reserved.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 29 November 2021
                Date revision received : 5 May 2022
                Date accepted : 24 May 2022
                Categories
                Subject: Article

                Keywords: breast cancer,mammography,healthcare disparities,covid-19,screening
                Data availability:
                Keywords: breast cancer, mammography, healthcare disparities, covid-19, screening

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