Comparison of health disparities among different race/ethnicities for breast cancer screening before and during the COVID-19 pandemic in a community hospital: A retrospective cohort analysis.
*Kabriya Bolbolan, *Tiffany Cheung, *Lei Yang, Michael DiSiena
General Surgery, Berkshire Medical Center, Pittsfield , MA, United States.
Early detection for breast cancer is imperative for early diagnosis, treatment, and improved survival. The COVID-19 pandemic was concerningly disruptive, resulting in reductions in breast cancer screening across the world, including reports of racial and ethnic inequalities in breast cancer screening. Our purpose was to examine whether COVID-19 resulted in reduction in breast cancer screening at our institution and across the community cancer hospitals in Massachusetts and to examine any obvious health disparities among those diagnosed with breast cancer. We used the National Cancer Data Base (NCDB), which included the breast cancer screening across all 21 community cancer program hospitals (CCPH) in Massachusetts and examined the data from 2012 to 2020. We also examined the total number of breast cancer screenings at our single institution and breast cancer diagnosis separated based on the various races: White, African American, Hispanic, and Asian or Pacific Islander between years 2018-2022. In total, 28,022, breast cancer diagnoses were made between 2012-2020 among Massachusetts CCPH. In descending order, most breast cancer diagnoses were made within the White population at 87% (24,389), followed by African American at 5.1% (1,425), Asian and Pacific Islander 3.6% (1,005), Hispanic 3.1% (869), and Native American 0.05% (14 cases). Our institution followed similar trend. The total number of breast cancer screenings totaled over 3000 every year between 2012-2019, but had decreased to 2794 in 2020, similar to the worldwide trend. However, at our institution, we maintained our number of breast cancer diagnoses and had increased our diagnoses from 102(2018) and 116(2019) to 184(2020) and 207(2021). The trend in breast cancer screening and detection among the various races at our institution was similar to entire other state-wide 20 CCPH in Massachusetts between years 2018-2021. Across the NCDB in Massachusetts, the majority of breast cancer screening were greatest amongst the White population, followed by African American, Hispanic Asian & Pacific Islander, and Native Americans across 2012-2020. At our institution, this distribution was similarly seen. COVID-19 pandemic effected in reducing the number of breast cancer screening and detection and was observed state-wide in Massachusetts, however, this was not replicated at our institution. As part of our institution NAPBC, we made significant efforts to maintain and increase our breast cancer screening rates during the pandemic. Various efforts included a radio podcast to the community, flyers that were handed out to primary care providers, and direct accessibility to sign up for breast cancer screenings at the COVID-19 vaccine clinics. Furthermore, our radiologists opened extra slots for breast cancer screening/imaging on the weekends to help facilitate this. Ultimately, this increased our equality and accessibility for breast cancer screenings even during and after the COVID-19 pandemic.
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