COVID-19 pandemic impact on the potential exacerbation of screening mammography disparities: A population-based study in Ontario, Canada
Strategies to ramp up breast cancer screening after COVID-19 require data on the influence of the pandemic on groups of women with historically low screening uptake. Using data from Ontario, Canada, our objectives were to 1) quantify the overall pandemic impact on weekly bilateral screening mammogra...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335523004692 |
| _version_ | 1827395277145767936 |
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| author | Rui Fu Jill Tinmouth Qing Li Anna Dare Julie Hallet Natalie Coburn Lauren Lapointe-Shaw Nicole J. Look Hong Irene Karam Linda Rabeneck Monika Krzyzanowska Rinku Sutradhar Antoine Eskander |
| author_facet | Rui Fu Jill Tinmouth Qing Li Anna Dare Julie Hallet Natalie Coburn Lauren Lapointe-Shaw Nicole J. Look Hong Irene Karam Linda Rabeneck Monika Krzyzanowska Rinku Sutradhar Antoine Eskander |
| author_sort | Rui Fu |
| collection | DOAJ |
| description | Strategies to ramp up breast cancer screening after COVID-19 require data on the influence of the pandemic on groups of women with historically low screening uptake. Using data from Ontario, Canada, our objectives were to 1) quantify the overall pandemic impact on weekly bilateral screening mammography rates (per 100,000) of average-risk women aged 50–74 and 2) examine if COVID-19 has shifted any mammography inequalities according to age, immigration status, rurality, and access to material resources. Using a segmented negative binomial regression model, we estimated the mean change in rate at the start of the pandemic (the week of March 15, 2020) and changes in weekly trend of rates during the pandemic period (March 15—December 26, 2020) compared to the pre-pandemic period (January 3, 2016—March 14, 2020) for all women and for each subgroup. A 3-way interaction term (COVID-19*week*subgroup variable) was added to the model to detect any pandemic impact on screening disparities. Of the 3,481,283 mammograms, 8.6 % (n = 300,064) occurred during the pandemic period. Overall, the mean weekly rate dropped by 93.4 % (95 % CI 91.7 % – 94.8 %) at the beginning of COVID-19, followed by a weekly increase of 8.4 % (95 % CI 7.4 % – 9.4 %) until December 26, 2020. The pandemic did not shift any disparities (all interactions p > 0.05) and that women who were under 60 or over 70, immigrants, or with a limited access to material resources had persistently low screening rate in both periods. Interventions should proactively target these underserved populations with the goals of reducing advanced-stage breast cancer presentations and mortality. |
| first_indexed | 2024-03-08T18:29:49Z |
| format | Article |
| id | doaj.art-83522aebc38a4af5ab33d170192f97a1 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-03-08T18:29:49Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-83522aebc38a4af5ab33d170192f97a12023-12-30T04:44:13ZengElsevierPreventive Medicine Reports2211-33552024-01-0137102578COVID-19 pandemic impact on the potential exacerbation of screening mammography disparities: A population-based study in Ontario, CanadaRui Fu0Jill Tinmouth1Qing Li2Anna Dare3Julie Hallet4Natalie Coburn5Lauren Lapointe-Shaw6Nicole J. Look Hong7Irene Karam8Linda Rabeneck9Monika Krzyzanowska10Rinku Sutradhar11Antoine Eskander12ICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Odette Cancer Centre–Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Ontario Health (Cancer Care Ontario), Toronto, Ontario, CanadaICES, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Odette Cancer Centre–Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, CanadaDepartment of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, CanadaICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Corresponding author at: Department of Otolaryngology–Head and Neck Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., M1-102, Toronto, Ontario M4N 3M5, Canada.Strategies to ramp up breast cancer screening after COVID-19 require data on the influence of the pandemic on groups of women with historically low screening uptake. Using data from Ontario, Canada, our objectives were to 1) quantify the overall pandemic impact on weekly bilateral screening mammography rates (per 100,000) of average-risk women aged 50–74 and 2) examine if COVID-19 has shifted any mammography inequalities according to age, immigration status, rurality, and access to material resources. Using a segmented negative binomial regression model, we estimated the mean change in rate at the start of the pandemic (the week of March 15, 2020) and changes in weekly trend of rates during the pandemic period (March 15—December 26, 2020) compared to the pre-pandemic period (January 3, 2016—March 14, 2020) for all women and for each subgroup. A 3-way interaction term (COVID-19*week*subgroup variable) was added to the model to detect any pandemic impact on screening disparities. Of the 3,481,283 mammograms, 8.6 % (n = 300,064) occurred during the pandemic period. Overall, the mean weekly rate dropped by 93.4 % (95 % CI 91.7 % – 94.8 %) at the beginning of COVID-19, followed by a weekly increase of 8.4 % (95 % CI 7.4 % – 9.4 %) until December 26, 2020. The pandemic did not shift any disparities (all interactions p > 0.05) and that women who were under 60 or over 70, immigrants, or with a limited access to material resources had persistently low screening rate in both periods. Interventions should proactively target these underserved populations with the goals of reducing advanced-stage breast cancer presentations and mortality.http://www.sciencedirect.com/science/article/pii/S2211335523004692COVID-19PandemicBreast cancer screeningMammographyCancer screeningEarly detection of cancer |
| spellingShingle | Rui Fu Jill Tinmouth Qing Li Anna Dare Julie Hallet Natalie Coburn Lauren Lapointe-Shaw Nicole J. Look Hong Irene Karam Linda Rabeneck Monika Krzyzanowska Rinku Sutradhar Antoine Eskander COVID-19 pandemic impact on the potential exacerbation of screening mammography disparities: A population-based study in Ontario, Canada Preventive Medicine Reports COVID-19 Pandemic Breast cancer screening Mammography Cancer screening Early detection of cancer |
| title | COVID-19 pandemic impact on the potential exacerbation of screening mammography disparities: A population-based study in Ontario, Canada |
| title_full | COVID-19 pandemic impact on the potential exacerbation of screening mammography disparities: A population-based study in Ontario, Canada |
| title_fullStr | COVID-19 pandemic impact on the potential exacerbation of screening mammography disparities: A population-based study in Ontario, Canada |
| title_full_unstemmed | COVID-19 pandemic impact on the potential exacerbation of screening mammography disparities: A population-based study in Ontario, Canada |
| title_short | COVID-19 pandemic impact on the potential exacerbation of screening mammography disparities: A population-based study in Ontario, Canada |
| title_sort | covid 19 pandemic impact on the potential exacerbation of screening mammography disparities a population based study in ontario canada |
| topic | COVID-19 Pandemic Breast cancer screening Mammography Cancer screening Early detection of cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2211335523004692 |
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