Characteristics associated with healthcare disruptions during the COVID-19 pandemic for women in the United States at high risk for breast cancer

Abstract

Delays in healthcare, including breast cancer screening, were documented during the coronavirus disease 2019 (COVID-19) pandemic. However, no studies have examined the impact of COVID-19 on healthcare among women at high (≥20 % lifetime) risk for breast cancer. This study fills that gap. Between August 2020 and January 2021, high-risk women (N = 225) living in the United States (US) completed an online survey assessing COVID-related healthcare disruptions. Descriptive statistics characterized the frequency of breast cancer screening (mammogram and breast magnetic resonance imaging [MRI]) since the beginning of the COVID-19 pandemic. Multivariable linear regression analysis with backward selection examined demographic characteristics associated with COVID-related healthcare disruptions. Since March 2020, 40 % of participants had received a mammogram and 12 % had received a screening breast MRI. On average, participants reported low levels of COVID-related healthcare disruptions (M = 1.97 on a 0–4 scale, higher = more disruptions). Participants who were younger (β = -0.21, p = 0.002) and not working (β = 0.18, p = 0.009) reported more COVID-related healthcare disruptions. Compared to non-Hispanic White participants, those from any other racial or ethnic group reported fewer COVID-related healthcare disruptions (β = −0.15, p = 0.020). Although few high-risk women received breast cancer screening after the declaration of the COVID-19 pandemic, they reported overall low levels of COVID-related healthcare disruptions. Results identify subgroups of high-risk women whose healthcare may have been more affected by the pandemic. Efforts to encourage US women at high risk for breast cancer to return to routine preventive care (including breast cancer screening) may need to be targeted towards women who are younger, not working, and non-Hispanic White.