Abstract P019: Continued depression of breast and lung cancer screening among Medicare enrollees during the COVID-19 pandemic

Abstract

Abstract Background: Several studies reported sharp decreases in screening mammography for breast cancer and low-dose computerized tomographic screening for lung cancer in the early months of the COVID-19 pandemic, followed by a return to normal or near-normal levels in the summer of 2020. Objective: To determine the observed vs. expected mammography and low dose computed tomography rates from the beginning of the pandemic through April 2022. Methods: Retrospective cohort study assessing mammography and low dose computed tomography rates from January 2017 through April 2022. Data for January 2016 to February 2020 were used to generate expected rates for the period March 2020 to April 2022.Setting: United States Medicare population. Participants: A 20% national sample of Medicare fee-for-service enrollees among women aged 50-74 for mammography, and men and women aged 55-79 for low dose computerized tomography. Main outcome: Receipt of screening mammography or low dose computed tomography. Results: From January 2017 through February 2020, monthly mammography rates were flat, while there was a monotonic increase in low dose computed tomography rates, from approximately 500 per million per month in early 2017 to 1100 per million per month by January 2020. Over the period from March 2020 to April 2022, there were episodic drops in both mammography and low dose computed tomography rates, coincident with increases in national COVID-19 infection rates. For the periods from March 2020 to February 2020 and March 2021 to February 2022, the observed low dose computed tomography rates were 24% (95% Confidence Interval: 23%, 24%) and 14% (95% Confidence Interval: 13%, 15%) below expected rates, while mammography rates were 17% (95% Confidence Interval: 17%, 18%) and 4% (95% Confidence Interval: 4%, 3%) below expected. Conclusions and Relevance: The negative impact of the COVID-19 pandemic on lung cancer screening and breast cancer screening did not resolve after the initial pandemic surges. Successful interventions to improve screening rates should address pandemic-specific reasons for low screening participation. Citation Format: Christopher Huy D. Doan, Shuang Li, James Goodwin. Continued depression of breast and lung cancer screening among Medicare enrollees during the COVID-19 pandemic. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P019.