Patient-reported impact of the COVID-19 pandemic on breast cancer screening, diagnosis, andtreatment: A national survey

ABSTRACT

Introduction: The COVID-19 pandemic has altered the health care delivery system. The purpose of this study wasto determine the impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment. Methods: Potential survey respondents were identified through partnerships with breast cancer organizationsincluding Dr. Susan Love Foundation for Breast Cancer Research, SHARE, Survivingbreastcancer.org, SistersNetwork Inc., the African American Breast Cancer Alliance, and through ResearchMatch.org. Study information wasshared via social media, websites, or email. Individuals were eligible for this study if they 1) receive routine breastcancer screening, or 2) are undergoing diagnostic evaluation for breast cancer, or 3) had ever been diagnosed withbreast cancer. Participants accessed and completed the 10-15-minute REDCap survey either by emailing theresearch team and receiving a private survey link or by clicking a public link. The survey collected information onrespondent demographics;breast cancer screening and diagnosis;the extent to which screening, diagnosis, ortreatment had been changed, delayed, or canceled because of COVID-19;personal protective practices;extent ofworry about financial and health implications of COVID-19;and use of telemedicine. We used descriptive statisticalanalyses to better understand the impact of the COVID-19 pandemic on respondents. Results: There are currently 415 survey respondents, 404 of whom agreed to participate in the study. 46.8%(N=189) of respondents were white, 26.7% (N=108) Black, 6.7% (N=27) Asian, and 5.5% Hispanic or Latino (N=22).Most respondents were between the ages of 50 and 69 years (52.2%, N=211). 43.3% (N=175) of respondents hadbeen diagnosed with breast cancer and, of those, 36% (N=63) were in active treatment. More than a quarter ofparticipants (26.5%, N=107) reported delayed or canceled breast cancer care due to COVID-19;the most frequentlyaffected care was screening mammogram, ultrasound, or MRI (97.2%, N=104). 20.6% (N=13) of women in activetreatment reported delayed or canceled surgery, chemotherapy, or radiation visits. 22.3% (N=90) of respondentsreported that an in-person visit was changed to a phone call or videoconference, and 39.1% (N=158) said they haddiscussed COVID-19 with a health care provider. 29.1% (N=51) of those with breast cancer were worried or veryworried that the COVID-19 pandemic would make it harder for them to get cancer care;among those without breastcancer, 34.9% (N=80) were worried that COVID-19 would make it harder to obtain health care, including breastcancer screening and diagnosis. Conclusions: The COVID-19 pandemic continues to disrupt breast cancer-related care, primarily screening.Planning and coordination are necessary to ensure the timely return of these patients to care. Most participantsagreed to be contacted for follow-up, allowing us to investigate the long-term effects of delayed breast cancerscreening, diagnostic evaluation, and treatment on health outcomes.