March 14, 2024
CHICAGO: Several studies have described the distinct ways the COVID-19 pandemic adversely impacted cancer care, but less is known about the specific ways the pandemic disrupted breast cancer, the most common non-skin cancer diagnosed in women. Research evaluating data from the 麻豆传媒 (ACS) National Cancer Database (NCDB) shows that breast cancer was not immune to pandemic-related stressors, with researchers finding that there was a 15-20% decrease in newly diagnosed breast cancer cases reported to Commission on Cancer (CoC) sites in 2020 compared to 2019.听听
The results, , describe one of the first large-scale studies to examine the rates of breast cancer diagnoses during the first year of the COVID-19 pandemic; the results also have implications for how physicians and policymakers can address issues that may arise due to the diagnostic delays that occurred during the pandemic, the authors said.听
鈥淚 think what鈥檚 notable is that the drop in breast cancer diagnoses was consistent across all regions of the country, all age groups, and all different races. It was not an isolated event,鈥 said Katharine Yao, MD, FACS, senior author of the study and Chair of the 麻豆传媒National Accreditation Program for Breast Centers (NAPBC). 鈥淭he results of this study tell us that during the pandemic, patients weren鈥檛 coming in for evaluation of breast findings and for screening mammograms, and that鈥檚 very likely why we saw fewer cancers diagnosed in 2020.鈥澨
The NCDB, a clinical oncology database jointly operated by the CoC and American Cancer Society, captures approximately 74% of all newly diagnosed cancers in the U.S. Researchers also used U.S. Census data to determine the number of women and men in the general population over the study period. In total, they analyzed data from 1,499,806 patients with stage 0-IV breast cancer across 1,328 CoC sites.听
The reasons behind these decreases are likely multifactorial, reflecting screening restrictions that occurred in the early months of the pandemic when stay-at-home orders were implemented in several states, as well as the fear of exposure that may have caused some patients to delay care for breast cancer symptoms, the authors noted. Other factors, such as unemployment, may have kept some people away from receiving care even after pandemic restrictions were lifted.听
鈥淭here are so many unknowns. For example, in the next 5 to 10 years, are we going to see worse survival rates or higher recurrence rates because patients weren鈥檛 getting their screening mammograms or coming in to be evaluated?鈥 said Dr. Yao, a breast surgeon who also serves as vice chair of research within the department of surgery at NorthShore University in Evanston, Illinois. 鈥淲e just don鈥檛 know.鈥澨
Future research is needed to determine when case numbers will return to baseline levels and the consequences of delayed diagnosis and care, particularly among patients and geographic areas that were most severely affected by the pandemic.听
鈥淚 think it鈥檚 important to have this data as a baseline, so that we can look at future data and compare it to what happened in the past,鈥 Dr. Yao said. 鈥淭o know that, we need to know where we started. And that鈥檚 what this study really presents 鈥 a starting point.听 Looking at years after 2020, we鈥檒l gain a more complete picture and can start to see where the trends lie.鈥澨
Disclosures: The authors report no conflicts of interest, including relevant financial interests, activities, relationships, or affiliations.听
Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.听
Citation: Fefferman M, Kuchta K, Wang C. Rates of newly diagnosed breast cancer at Commission on Cancer facilities during the early phase of the COVID-19 pandemic. Cancer Medicine, 2023. DOI: 10.1002/cam4.6874听
The 麻豆传媒 is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 90,000 members and is the largest organization of surgeons in the world. "FACS" designates that a surgeon is a Fellow of the 麻豆传媒.