Disruptions in preventive care: Mammograms during the COVID-19 pandemic

Health Serv Res. 2021 Feb;56(1):95-101. doi: 10.1111/1475-6773.13596. Epub 2020 Nov 4.


Objective: To measure the extent to which the provision of mammograms was impacted by the COVID-19 pandemic and surrounding guidelines.

Data sources: De-identified summary data derived from medical claims and eligibility files were provided by Independence Blue Cross for women receiving mammograms.

Study design: We used a difference-in-differences approach to characterize the change in mammograms performed over time and a queueing formula to estimate the time to clear the queue of missed mammograms.

Data collection: We used data from the first 30 weeks of each year from 2018 to 2020.

Principal findings: Over the 20 weeks following March 11, 2020, the volume of screening mammograms and diagnostic mammograms fell by 58% and 38% of expected levels, on average. Lowest volumes were observed in week 15 (April 8 to 14), when screening and diagnostic mammograms fell by 99% and 74%, respectively. Volumes began to rebound in week 19 (May), with diagnostic mammograms reaching levels to similar to previous years' and screening mammograms remaining 14% below expectations. We estimate it will take a minimum of 22 weeks to clear the queue of missed mammograms in our study sample.

Conclusions: The provision of mammograms has been significantly disrupted due to the COVID-19 pandemic.

Keywords: COVID-19; early detection of cancer; mammography; missed diagnosis; preventive medicine.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / prevention & control*
  • COVID-19 / epidemiology*
  • Early Detection of Cancer
  • Female
  • Health Services Accessibility*
  • Humans
  • Mammography / statistics & numerical data*
  • Mass Screening
  • Middle Aged
  • Pandemics
  • SARS-CoV-2
  • United States / epidemiology