According to the CDC’s National Breast and Cervical Cancer Early Detection Program, breast cancer screenings for underserved women decreased by 87%, and by 84% for cervical cancer, during April 2020 when compared to the previous five years of averages for the month.
In a statement, lead study author and CDC health scientist Amy DeGroff said results “reinforce the need to safely maintain routine healthcare services during the pandemic, especially when the healthcare environment meets COVID-19 safety guidelines.”
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A similar study published last year in JAMA found that the weekly number of newly diagnosed cancer patients dropped by 46.4% on average between March 1 and April 18, 2020 for six types of cancer: breast, colorectal, lung, pancreatic, gastric and oesophageal.
Health experts warn that the drop in screenings will lead to delays in cancer diagnoses — and treatments.
Disparities between racial and ethnic minorities were also observed in the new study, published in the journal Preventive Medicine. Native American women skipped check-ups last year at a rate of 98% — the steepest drop of all the groups studied, while cervical cancer screenings of Asian Pacific Islander women also fell steeply, by 92%.
Location was also a factor. Breast and cervical cancer screenings were 86% and 85% lower for metro areas; 88% and 77% lower in urban areas; and 89% and 82% lower in rural regions, respectively.
Black and Hispanic women have the highest rates of cervical cancer at 8.3 and 8.9 per 100,000 women, respectively, compared to white women with 7.3 per 100,000. Breast cancer rates are similar between white and black women, however, black women are more likely to die of the disease at a rate of 26.9 per 100,000, compared to white women at 19.4 per 100,000. Additionally, the study notes, black and Hispanic women are also more likely to be diagnosed with the most aggressive form of breast cancer.
Screening declines observed in the Early Detection Program coincided with the rapid onset of COVID-19 cases in spring 2020. Screening site closures and the temporary suspension of breast and cervical cancer screening services due to COVID-19 are actors that likely contributed to the declines during this period. The requirement or recommendation to stay at home and the fear of contracting COVID-19 also likely deterred individuals from seeking healthcare services, including cancer screening.
Authors of the study say this research help inform public health policymakers on the desperate need to provide basic preventative care to underprivileged people, especially as many of the health resources that were available during the pandemic no longer available.
DeGroff urges healthcare professionals and women especially to return to routine screening as soon as possible: “the CDC encourages healthcare professionals to help minimise delays in testing by continuing routine cancer screening for women having symptoms or at high risk for breast or cervical cancer.”