Sharp Declines in Breast and Cervical Cancer Screening

The total number of cancer screening tests received by women through CDC’s National Breast and Cervical Cancer Early Detection Program (Early Detection Program) declined by 87% for breast cancer and 84% for cervical cancer during April 2020 as compared with the previous 5-year averages for that month.

Prolonged delays in screening related to the COVID-19 pandemic may lead to delayed diagnoses, poor health consequences, and an increase in cancer disparities among women already experiencing health inequities.

“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, said Amy DeGroff, PhD, MPH, CDC health scientist and lead author.  “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.”

Screening declines observed in the Early Detection Program coincided with the rapid increase of COVID-19 cases in spring 2020. Factors that might have contributed to the declines during this time include screening site closures and the temporary suspension of breast and cervical cancer screening services due to COVID-19. The requirement or recommendation to stay at home and the fear of contracting COVID-19 also likely deterred individuals from seeking health care services, including cancer screening.

Published in the journal Preventive Medicine, the study examined COVID-19’s impact on the Early Detection Program’s screening services during January-June 2020.

Health equity impact:

• Declines in breast cancer screening varied from 84% percent among Hispanic women to 98% among American Indian/Alaskan Native women.
• Declines in cervical cancer screening varied from 82% among Black women to 92% among Asian Pacific Islander women.
• In April, the number of screening tests for breast cancer declined in metro (86%), urban (88%), and rural (89%) areas compared to the respective five-year averages. The decline for cervical cancer screening tests was 85% and 82% for metro and rural areas, respectively, and 77% for urban areas.
• Screening volumes had begun to recover in all groups by June 2020, the end of the observation period.

“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,” said DeGroff. “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.”

For more information about CDC’s work on breast and cervical cancer, please visit https://youtu.be/mDlYzBjgNHQ and https://www.cdc.gov/cancer/nbccedp/

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

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