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. 2021 Oct:151:106559.
doi: 10.1016/j.ypmed.2021.106559. Epub 2021 Jun 30.

COVID-19 impact on screening test volume through the National Breast and Cervical Cancer early detection program, January-June 2020, in the United States

A DeGroff  1 , J Miller  2 , K Sharma  3 , J Sun  3 , W Helsel  4 , W Kammerer  4 , T Rockwell  4 , A Sheu  4 , S Melillo  2 , J Uhd  2 , K Kenney  2 , F Wong  2 , M Saraiya  2 , L C Richardson  2
Affiliations

COVID-19 impact on screening test volume through the National Breast and Cervical Cancer early detection program, January-June 2020, in the United States

A DeGroff et al. Prev Med. 2021 Oct.

Abstract

Women from racial and ethnic minority groups face a disproportionate burden of cervical and breast cancers in the United States. The Coronavirus Disease 2019 (COVID-19) pandemic might exacerbate these disparities as supply and demand for screening services are reduced. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides cancer screening services to women with low income and inadequate health insurance. We examined COVID-19's impact on NBCCEDP screening services during January-June 2020. We found the total number of NBCCEDP-funded breast and cervical cancer screening tests declined by 87% and 84%, respectively, during April 2020 compared with the previous 5-year averages for that month. The extent of declines varied by geography, race/ethnicity, and rurality. In April 2020, screening test volume declined most severely in Health and Human Services Region 2 - New York (96% for breast, 95% for cervical cancer screening) compared to the previous 5-year averages. The greatest declines were among American Indian/Alaskan Native women for breast cancer screening (98%) and Asian Pacific Islander women for cervical cancer screening (92%). Test volume began to recover in May and, by June 2020, NBCCEDP breast and cervical cancer screening test volume was 39% and 40% below the 5-year average for that month, respectively. However, breast cancer screening remained over 50% below the 5-year average among women in rural areas. NBCCEDP programs reported assisting health care providers resume screening.

Keywords: Breast cancer screening; COVID-19; Cervical cancer screening; Medically underserved; Public health.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
NBCCEDP awardees by HHS region.
Fig. 2
Fig. 2
Monthly NBCCEDP Breast and Cervical Cancer Screening Tests for January–June 2020* Compared with the 5-Year Average in 2015—2019. Footnote: Blue line represents screening tests conducted in 2020; grey line represents average screening tests conducted over the 5-year period, 2015–2019. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Fig. 3
Fig. 3
Monthly NBCCEDP Breast Cancer Screening Tests for January–June 2020 Compared with the 5-Year Average in 2015–2019, by HHS Region. Footnote: Blue line represents screening tests conducted in 2020; grey line represents average screening tests conducted over the 5-year period, 2015–2019. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Fig. 4
Fig. 4
Monthly NBCCEDP Cervical Cancer Screening Tests for January–June 2020 Compared with the 5-Year Average in 2015–2019, by HHS Region. Footnote: Blue line represents screening tests conducted in 2020; grey line represents average screening tests conducted over the 5-year period, 2015–2019. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Fig. 5
Fig. 5
Monthly NBCCEDP Breast Cancer Screening Tests for January–June 2020 Compared with the 5-Year Average in 2015–2019, by Racial/Ethnic Group.
Fig. 6
Fig. 6
Monthly NBCCEDP Cervical Cancer Screening Tests for January–June 2020 Compared with the 5-Year Average in 2015–2019, by Racial/Ethnic Group.
Fig. 7
Fig. 7
Monthly NBCCEDP Breast Cancer Screening Tests in January–June 2020 Compared with the 5-Year Average in 2015–2019, by Rurality.
Fig. 8
Fig. 8
Monthly NBCCEDP Cervical Cancer Screening Tests in January–June 2020 Compared with the 5-Year Average in 2015–2019, by Rurality.
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