Screenings for breast and cervical cancer among low-income women plummeted early in the pandemic, with test volume picking up into the summer, according to a study linking the declines to pandemic-related closures and patients’ fear of COVID-19 infection.
Health experts worry over declines in screenings due to delayed diagnoses, health consequences and worsened cancer disparities among women suffering health inequities, the Centers for Disease Control and Prevention (CDC) wrote in a related release.
Researchers with the CDC published findings in the Preventative Medicine journal on Thursday, drawing on data from the CDC’s National Breast and Cervical Cancer Early Detection Program, which funds cancer screening services for women with low income and inadequate health insurance, from January to June 2020.
Results indicated breast and cervical cancer screenings plummeted by 87% and 84%, respectively, during April 2020 compared to prior five-year averages for the month. Declines varied across regions, race/ethnicity and rurality.
“This study highlights a decline in cancer screening among women of racial and ethnic minority groups with low incomes when their access to medical services decreased at the beginning of the pandemic,” Amy DeGroff, PhD, MPH, CDC health scientist and lead author, said in a statement. “They reinforce the need to safely maintain routine health care services during the pandemic, especially when the health care environment meets COVID-19 safety guidelines.”
Health experts worry over declines in screenings due to delayed diagnoses, health consequences and worsened cancer disparities among women suffering health inequities. (iStock)
New York was associated with the most severe declines, at 96% and 95%, respectively, for breast and cervical cancer screenings. American Indian/Alaskan Native women claimed the largest declines for breast cancer screenings at 98%, and Asian Pacific Islander women were tied with a steep 92% decline for cervical cancer screenings. Data also suggested women in rural areas suffered the greatest declines in breast cancer screenings at 89%, followed by women in urban (88%) and metro (86%) areas in April, though the order shifted for cervical cancer screenings at 85% and 82% for metro and rural, followed by 77% for urban.
Test volume increased by May and June, though screenings were still down by about 40% compared to the five-year average. However, women in rural areas still faced larger declines at about 50%.
The CDC noted screening declines in the early pandemic coincided with the onset of surging COVID-19 infections last spring. Declines were associated with screening site closures and temporary suspensions in screening services. Stay-at-home orders and fear of contracting the virus also likely contributed to the drop-off in screening, the agency suggested.
“CDC encourages health care professionals to help minimize delays in testing by continuing routine cancer screening for women having symptoms or at high risk for breast or cervical cancer,” DeGroff said. “The Early Detection Program can help women overcome barriers to health equity by educating them about the importance of routine screening, addressing their concerns about COVID-19 transmission, and helping them to safely access screening through interventions like patient navigation.”