Identifying Patients at Risk of Delayed Breast Imaging Due to the COVID-19 Pandemic

Objective: Epidemiological models predict worse cancer outcomes due to COVID-19 pandemic-related delays in cancer surveillance and treatment. This study evaluated patient demographic factors associated with delayed breast imaging or procedure appointments due to COVID-19. Methods: Patients attending a breast imaging or procedure appointment at the Pennsylvania Hospital Breast Center from December 28, 2020 to January 31, 2021 were asked to complete a voluntary and anonymous survey on the impact of COVID-19. Chi-squared and two-sample t-tests were used to analyze correlations between having a delayed appointment and various demographic variables. Results: Five hundred seventy patients completed the survey. Participants were more likely to have delayed a breast imaging or procedure appointment if they were younger (53.9 versus 57.4 years old, p=0.014), had more total household residents (2.7 versus 2.2, p=0.019) or children (0.8 versus 0.4, p=0.016), personally had COVID-19 (p=0.04), or personally had to quarantine (p<0.01). Race, ethnicity, education, income level, and marital status were not found to statistically significantly correlate with having a delayed appointment. Conclusion: This study found that younger age, a greater number of residents and children in the household, and having a personal history of COVID-19 infection or quarantining were factors significantly correlated with delaying a breast imaging or procedure appointment. As radiology practices prepare to mitigate the impact of COVID-19 on screening practices and cancer outcomes, these findings may help imaging centers refine patient outreach efforts and policy accommodations to protect the most vulnerable populations.