Disruptions in the healthcare system during the COVID-19 pandemic caused delays in breast cancer treatment that could lead to increased deaths, a new study suggests.
Researchers from the University of Wisconsin found that in March 2020, the number of mammograms went down 80 percent while breast cancer patients experienced treatment delays and reductions in chemotherapy treatments.
The team predicts these delays could lead to about 2,500 excess breast cancer deaths by 2030 – indicating a 0.52 percent increase over the next 10 years.
Still, the impact could have been worse. If screenings and treatments were delayed by a full year instead of six months, excess deaths doubled, the researchers found.
Healthcare facilities should now prioritize screening women who missed their routine mammography exam during the pandemic, the researchers say.
The Covid pandemic delayed breast cancer screenings and treatments, leading to excess deaths in the coming years, a new study finds (File image)
The researchers estimated 2,500 excess deaths from breast cancer before 2030, caused by missed cancer screenings, delayed diagnoses, and missed chemotherapy
During early months of the pandemic, many doctors’ appointments and medical procedures were delayed or canceled – leading to delays in breast cancer screenings and treatments.
This care was deemed ‘nonessential’ compared to the Covid patients that became all healthcare systems’ top priority.
Some hospitals banned elective surgeries, such as mammograms – procedures using X-rays to check for breast cancer.
Chemotherapy and other breast cancer treatments were also delayed for some patients.
Many women also wanted to avoid nonessential appointments – like breast cancer screening – in order to reduce their exposure to the coronavirus.
As a result, breast cancer screenings declined by over 80 percent in spring 2020 compared to previous years.
These delays had an impact on future cancer deaths in the U.S., according to newly published research from the University of Wisconsin, University of Washington, Georgetown University, and other collaborators.
For the study, published Wednesday in the Journal of the National Cancer Institute, researchers used modeling to estimate breast cancer cases and deaths between 2020 and 2030.
The models have been previously used by the U.S. Preventative Services Task Force to develop screening guidelines.
To determine the impacts of COVID-19, the researchers simulated several different scenarios: one with no reductions in screening and treatment in 2020, one with disruptions for six months, and one with disruptions for twelve months.
The six-month reduction was closest to reality because most clinics had reopened within six months of the March 2020 lockdowns.
By 2030, the models predicted about 2,500 excess breast cancer deaths among women between the ages of 30 and 84 – compared to a no-Covid scenario.
This included 950 deaths due to reduced screening, 1,300 due to delayed diagnosis of cases, and 150 due to reduced chemotherapy for women with early stage breast cancer.
Those 2,500 excess deaths represent a 0.52 percent increase in breast cancer deaths between 2020 and 2030, compared to a world without Covid.
Delaying screenings for one year rather than six months would lead to 5,000 excess deaths rather than 2,500
This number could have been much worse, according to the researchers.
If the same reductions in screening and treatment occurred for a full year instead of six months, excess deaths would have doubled.
The researchers suggest that this low increase is thanks to healthcare facilities that adapted quickly to the pandemic, finding ways to provide safe screenings and treatments to their patients.
‘We found that the rapid adaptations of healthcare facilities to devise strategies to resume breast cancer screening, diagnosis, and treatment services within a six-month period greatly mitigated the potential impact on breast cancer mortality,’ said lead author Dr Oguzhan Alagoz, s scientist at the University of Wisconsin.
As a result, the researchers recommend that anyone who missed a breast cancer screening during the pandemic should make it up now.
If women skipped their mammograms rather than delaying these screenings by six months, breast cancer deaths would be four times higher – going from 400 to 1,600 – according to the models.
The researchers also suggest that women in vulnerable communities should be priorities for breast cancer screenings. Hispanic and Asian women in particular have seen slower rebounds for screening and diagnostic services.
‘Facilities should prioritize screening women who missed their routine mammography exam during the pandemic to reduce the impact of pandemic on mortality,’ Alagoz said.