In Low-Income Communities, Breast Cancer Screenings Declined During Pandemic


Key Takeaways

  • A study found that breast cancer screening rates declined by 8% among low-income communities during the pandemic.
  • This is a reversal of the 18% improvement witnessed researchers found between 2018 to 2019. 
  • While telehealth was posed as a potential solution to delayed pandemic care, experts say it isn’t as accessible for low-income neighborhoods.

Throughout the pandemic, people have delayed healthcare procedures and check-ups. Now, new research finds that breast cancer screening rates also declined during this time.

From July 2019 to July 2020, breast cancer screenings declined by 8% within community clinics that serve low-income communities. This percentage was a reversal of the 18% improvement in breast cancer screenings researchers found between 2018 and 2019.

To calculate this percentage, lead study author Stacey Fedewa, PhD, MPH, scientific director at the American Cancer Society (ACS), relied on secondary data from 32 community health centers that participated in the ACS’s CHANGE grant program, a program designed to increase breast cancer screening rates and follow-up care. The August study was published in the journal Cancer.

Starting in August 2018, the CHANGE program funded clinics for two years. Throughout the two-year project period, participating community health clinics reported breast cancer screening rates.

These rates were defined as the percentage of women aged 50 to 74 who had a medical visit within the past 12 months and received a mammogram within the last 27 months.

Based on these criteria, 142,207 women in 2018, 142,003 women in 2019, and 150,630 women in 2020 had a medical visit in the past 12 months.

The findings show that if breast cancer screening rate trends from 2018 to 2019 continued through 2020, 63.3% of women would have been screened for breast cancer in 2020 compared to the 49.6% of women that did get screened.

This translates to 47,517 fewer mammograms and 242 missed breast cancer diagnoses.

While the study did not examine why exactly people got screened at lower rates, Fedewa predicts that COVID-19 is one of the major reasons behind this dip. People avoided healthcare visits due to the virus.

She tells Get Meds Info that other individuals might’ve been denied breast cancer screenings, lacked transportation to screening visits, or feared taking public transportation due to COVID.

“We need to intensify some of the efforts to improve cancer screening rates in these clinics to identify the women who are in need of screening,” Fedewa says.

Delayed Screenings and Telehealth

In the U.S., breast cancer is the most commonly diagnosed cancer in women and is the second leading cause of cancer death. Research shows that starting at the age of 40, regular breast cancer screenings can reduce the risk of death from breast cancer.

When women are not able to get screened, it could lead to a delayed diagnosis, according to Anita Ravi, MD, MPH, MSHP, FAAFP, a board-certified family medicine physician based in New York. She tells Get Meds Info that because of the pandemic, “we’re in a position where we might get later diagnoses for things that could have been caught earlier.” 

While certain health care clinics and hospitals have switched to telehealth services, Ravi stresses that telehealth alone is not enough.

“Telehealth is not always an easy, safe, or accessible option for low-income and minority communities,” she says. 

For Ravi, she says that many of her patients did not have access to a steady phone number from month to month.

“So if we’re scheduling a follow-up visit in six weeks through telehealth, I’m not guaranteed that they’re going to have access to do it,” Ravi says. 

According to research conducted by Harvard Medical School and University of Pittsburgh researchers:

  • 41% of Medicare patients did not have a smartphone with a wireless data plan
  • 41% lacked access to a desktop or laptop with high-speed internet
  • 26% did not have access to either of the options.

Coupled with lack of access to telehealth, some communities, especially in intergenerational households, may not benefit from telehealth because they may not have access to a safe and confidential space for the visit.

“People are shutting themselves in the bathroom or sitting in a car having this private visit,” Ravi explains. “We need to be thoughtful about the ways in which we deliver care for this population.” 

What This Means For You

The American Cancer Society recommends that women with an average risk of breast cancer undergo regular mammography screening starting at the age of 45. Women ages 45 to 54 should be screened regularly and women 55 years or older should undergo biennial screening.

How to Access a Free or Low Cost Breast Cancer Screening

The National Breast Cancer Foundation offers a directory to help you find a facility that offers mammograms near you here.

Other organizations also offer free or low-cost breast cancer screenings to people in need, including:

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