Brian L Sprague1,2,3, Kathryn P Lowry4, Diana L Miglioretti5,6, Nila Alsheik7, Erin J A Bowles6, Anna N A Tosteson8, Garth Rauscher9, Sally D Herschorn2,3, Janie M Lee4, Amy Trentham-Dietz10, Donald L Weaver3,11, Natasha K Stout12, Karla Kerlikowske13,14. 1. Department of Surgery, Office of Health Promotion Research, University of Vermont Larner College of Medicine, Burlington, VT, USA. 2. Department of Radiology, University of Vermont Larner College of Medicine, Burlington, VT, USA. 3. University of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, VT, USA. 4. Department of Radiology, University of Washington and Seattle Cancer Care Alliance, Seattle, WA, USA. 5. Division of Biostatistics, Department of Public Health Sciences, University of California Davis, Davis, CA, USA. 6. Kaiser Permanente Washington Health Research Institute, Kaiser Permanente WA, Seattle, WA, USA. 7. Advocate Caldwell Breast Center, Advocate Lutheran General Hospital, Park Ridge, IL, USA. 8. The Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA. 9. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA. 10. Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA. 11. Department of Pathology and Laboratory Medicine, University of Vermont Larner College of Medicine, Burlington, VT, USA. 12. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. 13. Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, CA, USA. 14. Department of Veterans Affairs, General Internal Medicine Section, University of California, San Francisco, CA, USA.
Abstract
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.
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.
Authors: Kathryn P Lowry; Michael C S Bissell; Diana L Miglioretti; Karla Kerlikowske; Nila Alsheik; Tere Macarol; Erin J A Bowles; Diana S M Buist; Anna N A Tosteson; Louise Henderson; Sally D Herschorn; Karen J Wernli; Donald L Weaver; Natasha K Stout; Brian L Sprague Journal: Radiology Date: 2021-10-19 Impact factor: 29.146
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Authors: Brian L Sprague; Ellen S O'Meara; Christoph I Lee; Janie M Lee; Louise M Henderson; Diana S M Buist; Nila Alsheik; Teresita Macarol; Hannah Perry; Anna N A Tosteson; Tracy Onega; Karla Kerlikowske; Diana L Miglioretti Journal: Prev Med Date: 2021-06-30 Impact factor: 4.018