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Changes in Cancer Screening in the US During the COVID-19 Pandemic

IMPORTANCE: Health care was disrupted in the US during the first quarter of 2020 with the emergence of the COVID-19 pandemic. Early reports in selected samples suggested that cancer screening services decreased greatly, but population-based estimates of cancer screening prevalence during 2020 have n...

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Autores principales: Fedewa, Stacey A., Star, Jessica, Bandi, Priti, Minihan, Adair, Han, Xuesong, Yabroff, K. Robin, Jemal, Ahmedin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166223/
https://www.ncbi.nlm.nih.gov/pubmed/35657622
http://dx.doi.org/10.1001/jamanetworkopen.2022.15490
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author Fedewa, Stacey A.
Star, Jessica
Bandi, Priti
Minihan, Adair
Han, Xuesong
Yabroff, K. Robin
Jemal, Ahmedin
author_facet Fedewa, Stacey A.
Star, Jessica
Bandi, Priti
Minihan, Adair
Han, Xuesong
Yabroff, K. Robin
Jemal, Ahmedin
author_sort Fedewa, Stacey A.
collection PubMed
description IMPORTANCE: Health care was disrupted in the US during the first quarter of 2020 with the emergence of the COVID-19 pandemic. Early reports in selected samples suggested that cancer screening services decreased greatly, but population-based estimates of cancer screening prevalence during 2020 have not yet been reported. OBJECTIVE: To examine changes in breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC) screening prevalence with contemporary national, population-based Behavioral Risk Factor Surveillance System (BRFSS) data. DESIGN, SETTING, AND PARTICIPANTS: This survey study included respondents from the 2014, 2016, 2018, and 2020 BRFSS surveys who were eligible for BC (women aged 50-74 years), CC (women aged 25-64 years), and CRC (women and men aged 50-75 years) screening. Data analysis was performed from September 2021 to February 2022. EXPOSURES: Calendar year. MAIN OUTCOMES AND MEASURES: Self-reported receipt of a recent (defined as in the past year) BC, CC, and CRC screening test. Adjusted prevalence ratios (aPRs) comparing 2020 vs 2018 prevalence and 95% CIs were computed. RESULTS: In total, 479 248 individuals were included in the analyses of BC screening, 301 453 individuals were included in CC screening, and 854 210 individuals were included in CRC screening, In 2020, among respondents aged 50 to 75 years, 14 815 (11.4%) were Black, 12 081 (12.6%) were Hispanic, 156 198 (67.3%) were White, and 79 234 (29.9%) graduated from college (all percentages are weighted). After 4 years (2014-2018) of nearly steady prevalence, past-year BC screening decreased by 6% between 2018 and 2020 (from 61.6% in 2018 to 57.8% in 2020; aPR, 0.94; 95% CI, 0.92-0.96), and CC screening decreased by 11% (from 58.3% in 2018 to 51.9% in 2020; aPR, 0.89; 95% CI, 0.87-0.91). The magnitude of these decreases was greater in people with lower educational attainment and Hispanic persons. CRC screening prevalence remained steady; past-year stool testing increased by 7% (aPR, 1.07; 95% CI, 1.02-1.12), offsetting a 16% decrease in colonoscopy (aPR, 0.84; 95% CI, 0.82-0.88) between 2018 and 2020. CONCLUSIONS AND RELEVANCE: In this survey study, stool testing increased and counterbalanced a decrease in colonoscopy during 2020, and BC and CC screening modestly decreased. How these findings might be associated with outcomes is not yet known, but they will be important to monitor, especially in populations with lower socioeconomic status, who experienced greater screening decreases during the COVID-19 pandemic.
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spelling pubmed-91662232022-06-16 Changes in Cancer Screening in the US During the COVID-19 Pandemic Fedewa, Stacey A. Star, Jessica Bandi, Priti Minihan, Adair Han, Xuesong Yabroff, K. Robin Jemal, Ahmedin JAMA Netw Open Original Investigation IMPORTANCE: Health care was disrupted in the US during the first quarter of 2020 with the emergence of the COVID-19 pandemic. Early reports in selected samples suggested that cancer screening services decreased greatly, but population-based estimates of cancer screening prevalence during 2020 have not yet been reported. OBJECTIVE: To examine changes in breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC) screening prevalence with contemporary national, population-based Behavioral Risk Factor Surveillance System (BRFSS) data. DESIGN, SETTING, AND PARTICIPANTS: This survey study included respondents from the 2014, 2016, 2018, and 2020 BRFSS surveys who were eligible for BC (women aged 50-74 years), CC (women aged 25-64 years), and CRC (women and men aged 50-75 years) screening. Data analysis was performed from September 2021 to February 2022. EXPOSURES: Calendar year. MAIN OUTCOMES AND MEASURES: Self-reported receipt of a recent (defined as in the past year) BC, CC, and CRC screening test. Adjusted prevalence ratios (aPRs) comparing 2020 vs 2018 prevalence and 95% CIs were computed. RESULTS: In total, 479 248 individuals were included in the analyses of BC screening, 301 453 individuals were included in CC screening, and 854 210 individuals were included in CRC screening, In 2020, among respondents aged 50 to 75 years, 14 815 (11.4%) were Black, 12 081 (12.6%) were Hispanic, 156 198 (67.3%) were White, and 79 234 (29.9%) graduated from college (all percentages are weighted). After 4 years (2014-2018) of nearly steady prevalence, past-year BC screening decreased by 6% between 2018 and 2020 (from 61.6% in 2018 to 57.8% in 2020; aPR, 0.94; 95% CI, 0.92-0.96), and CC screening decreased by 11% (from 58.3% in 2018 to 51.9% in 2020; aPR, 0.89; 95% CI, 0.87-0.91). The magnitude of these decreases was greater in people with lower educational attainment and Hispanic persons. CRC screening prevalence remained steady; past-year stool testing increased by 7% (aPR, 1.07; 95% CI, 1.02-1.12), offsetting a 16% decrease in colonoscopy (aPR, 0.84; 95% CI, 0.82-0.88) between 2018 and 2020. CONCLUSIONS AND RELEVANCE: In this survey study, stool testing increased and counterbalanced a decrease in colonoscopy during 2020, and BC and CC screening modestly decreased. How these findings might be associated with outcomes is not yet known, but they will be important to monitor, especially in populations with lower socioeconomic status, who experienced greater screening decreases during the COVID-19 pandemic. American Medical Association 2022-06-03 /pmc/articles/PMC9166223/ /pubmed/35657622 http://dx.doi.org/10.1001/jamanetworkopen.2022.15490 Text en Copyright 2022 Fedewa SA et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Fedewa, Stacey A.
Star, Jessica
Bandi, Priti
Minihan, Adair
Han, Xuesong
Yabroff, K. Robin
Jemal, Ahmedin
Changes in Cancer Screening in the US During the COVID-19 Pandemic
title Changes in Cancer Screening in the US During the COVID-19 Pandemic
title_full Changes in Cancer Screening in the US During the COVID-19 Pandemic
title_fullStr Changes in Cancer Screening in the US During the COVID-19 Pandemic
title_full_unstemmed Changes in Cancer Screening in the US During the COVID-19 Pandemic
title_short Changes in Cancer Screening in the US During the COVID-19 Pandemic
title_sort changes in cancer screening in the us during the covid-19 pandemic
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166223/
https://www.ncbi.nlm.nih.gov/pubmed/35657622
http://dx.doi.org/10.1001/jamanetworkopen.2022.15490
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