A rapid review on the COVID-19's global impact on breast cancer screening participation rates and volumes from January-December 2020

  1. Reagan Lee
  2. Wei Xu
  3. Marshall Dozier
  4. Ruth McQuillan
  5. Evropi Theodoratou
  6. Jonine Figueroa  Is a corresponding author
  7. on behalf of UNCOVER and the International Partnership for Resilience in Cancer Systems (I-PaRCS), Breast Cancer Working Group 2
  1. University of Edinburgh, United Kingdom
  2. National Cancer Institute, United States

Abstract

COVID-19 has strained population breast mammography screening programs that aim to diagnose and treat breast cancers earlier. As the pandemic has affected countries differently, we aimed to quantify changes in breast screening volume and uptake during the first year of COVID-19 crisis. We systematically searched Medline, the WHO (World Health Organization) COVID-19 database, and governmental databases. Studies covering January 2020 to March 2022 were included. We extracted and analyzed data regarding study methodology, screening volume and uptake. To assess for risk-of-bias, we used the Joanna Briggs Institute Critical Appraisal tool. Twenty-six cross-sectional descriptive studies (focusing on 13 countries) were included out of 935 independent records. Reductions in screening volume and uptake rates were observed among eight countries. Changes in screening participation volume in five countries with national population-based screening ranged from -13% to –31%. Among two countries with limited population-based programs the decline ranged from -61% to -41%. Within the USA, population participation volumes varied ranging from +18% to -39% with suggestion of differences by insurance status (HMO, Medicare, and low-income programs). Almost all studies had high risk-of-bias due to insufficient statistical analysis and confounding factors. Extent of COVID-19-induced reduction in breast screening participation volume differed by region and data suggested potential differences by healthcare setting (e.g., national health insurance vs private health care). Recovery efforts should monitor access to screening and early diagnosis to determine if prevention services need strengthening to increase coverage of disadvantaged groups and reduce disparities.

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Source data included as excel file

Article and author information

Author details

  1. Reagan Lee

    Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  2. Wei Xu

    Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  3. Marshall Dozier

    Information Services, University of Edinburgh, Edinburgh, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  4. Ruth McQuillan

    Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-0998-9540
  5. Evropi Theodoratou

    Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  6. Jonine Figueroa

    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, United States
    For correspondence
    jonine.figueroa@ed.ac.uk
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-5100-623X

Funding

National Cancer Institute (Jonine Figueroa research is supported by the intramural program)

  • Jonine Figueroa

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Rafael Meza, Univeristy of Michigan, United States

Version history

  1. Received: December 20, 2022
  2. Preprint posted: February 6, 2023 (view preprint)
  3. Accepted: August 20, 2023
  4. Accepted Manuscript published: September 12, 2023 (version 1)
  5. Version of Record published: October 12, 2023 (version 2)

Copyright

This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

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  1. Reagan Lee
  2. Wei Xu
  3. Marshall Dozier
  4. Ruth McQuillan
  5. Evropi Theodoratou
  6. Jonine Figueroa
  7. on behalf of UNCOVER and the International Partnership for Resilience in Cancer Systems (I-PaRCS), Breast Cancer Working Group 2
(2023)
A rapid review on the COVID-19's global impact on breast cancer screening participation rates and volumes from January-December 2020
eLife 12:e85680.
https://doi.org/10.7554/eLife.85680

Share this article

https://doi.org/10.7554/eLife.85680

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