Breast Cancer Coverage from Every Angle

COVID-19 and Breast Cancer Screening in Washington State: Did Socioeconomics Play a Role?

By: Kayci Reyer
Posted: Tuesday, August 10, 2021

A research letter published in JAMA Network Open suggests that breast cancer screening rates in Washington State experienced a deep overall decline throughout the COVID-19 pandemic. The steepest dropoff in screening mammograms occurred among women of color and people living in rural communities.

“We know that the COVID-19 virus has had disproportionate impacts on certain populations, including racial and ethnic minority groups,” noted Pablo Monsivais, PhD, MPH, of Washington State University, in an institutional press release. “What our study adds is that some of the secondary effects of the COVID-19 pandemic are also disproportionately impacting those populations, so it’s a double whammy.”

The study included 55,678 screening mammograms performed within a statewide community health-care system in Washington State between April 1, 2018, and December 31, 2020. The average patient age was 62 years, and 81.8% (n = 45,572) of patients were non-Hispanic White. Most patients (98.1%, n = 54,620) lived in urban areas, and 40.9% (n = 22,761) had commercial insurance.

A total of 27,522 screening mammograms were performed in 2020 versus 55,678 in 2019—a 49% decline. The decrease was particularly pronounced in women of color, including women who were Hispanic (–64.2%), American Indian/Alaska Native (–60.9%), mixed race (–56.2%), Native Hawaiian or Pacific Islander (54.5%), Asian (–54.5%), or Black (–53.9%). White patients experienced a 49.2% reduction in screenings.

A more significant decline in mammogram screenings was reported in women living in rural areas than in women living in urban areas. Status as an insured person and source of insurance were also factors. Women who received insurance through Medicaid or who self-paid for medical care experienced a much larger reduction in screening than did women who were insured through Medicare or a commercial provider.

Disclosure: The study authors reported no conflicts of interest.

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