Changes in Mammography Use by Women's Characteristics During the First 5 Months of the COVID-19 Pandemic
Changes in Mammography Use by Women's Characteristics During the First 5 Months of the COVID-19 Pandemic
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DOI：
10.1093/jnci/djab045
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发表时间：
2021-07-06
影响因子：
10.3
通讯作者：
Kerlikowske, Karla
中科院分区：
文献类型：
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作者：
Sprague, Brian L.;Lowry, Kathryn P.;Kerlikowske, Karla
背景资料：2019冠状病毒病（COVID-19）疫情导致美国于2020年3月中旬几乎完全停止乳房X光检查服务。目前尚不清楚筛查和诊断性乳房X光检查的数量是否已恢复到大流行前的水平，以及使用情况是否因妇女的特点而异。研究方法：我们收集了2019年1月至2020年7月期间在乳腺癌监测联盟的62个放射设施进行的461083次筛查性乳房X线检查和112207次诊断性乳房X线检查的数据。我们比较了大流行前和大流行期间每月筛查和诊断性乳腺X射线摄影的数量，这些数量按年龄、种族和民族、乳腺密度和乳腺癌家族史分层。结果如下：2020年4月的筛查和诊断性乳腺X射线摄影量为1.1%（95%置信区间[CI] = 0.5%至2.4%）和21.4%（95% CI = 18.7%至24.4%），但到2020年7月，分别反弹至2019年7月大流行前数量的89.7%（95%CI = 79.6%至101.1%）和101.6%（95%CI = 93.8%至110.1%）。截至2020年7月，筛查和诊断性乳房X线检查的年初至今累积量分别为截至2019年7月年初至今量的66.2%（95%CI = 60.3%至72.6%）和79.9%（95%CI = 75.4%至84.6%）。不同年龄组和乳腺癌家族史的筛查性乳房X线摄影反弹相似。2020年7月，黑人、白色、西班牙裔和亚裔女性的每月筛查乳腺X射线摄影量达到96.7%（95% CI = 88.1%至106.1%）、92.9%（95% CI = 82.9%至104.0%）、72.7%（95% CI = 56.5%至93.6%）和51.3%（95% CI = 39.7%至66.2%）。结论：尽管到2020年7月，乳房X光检查量整体强劲反弹，但亚裔和西班牙裔女性的反弹滞后，错过乳房X光检查的累积赤字大幅增加，这可能会对健康产生重要影响。
Background: The coronavirus disease 2019 (COVID-19) pandemic led to a near-total cessation of mammography services in the United States in mid-March 2020. It is unclear if screening and diagnostic mammography volumes have recovered to prepandemic levels and whether use has varied by women's characteristics. Methods: We collected data on 461 083 screening mammograms and 112 207 diagnostic mammograms conducted during January 2019 through July 2020 at 62 radiology facilities in the Breast Cancer Surveillance Consortium. We compared monthly screening and diagnostic mammography volumes before and during the pandemic stratified by age, race and ethnicity, breast density, and family history of breast cancer. Results: Screening and diagnostic mammography volumes in April 2020 were 1.1% (95% confidence interval [CI] = 0.5% to 2.4%) and 21.4% (95% CI = 18.7% to 24.4%) of the April 2019 prepandemic volumes, respectively, but by July 2020 had rebounded to 89.7% (95% CI = 79.6% to 101.1%) and 101.6% (95% CI = 93.8% to 110.1%) of the July 2019 prepandemic volumes, respectively. The year-to-date cumulative volume of screening and diagnostic mammograms performed through July 2020 was 66.2% (95% CI = 60.3% to 72.6%) and 79.9% (95% CI = 75.4% to 84.6%), respectively, of year-to-date volume through July 2019. Screening mammography rebound was similar across age groups and by family history of breast cancer. Monthly screening mammography volume in July 2020 for Black, White, Hispanic, and Asian women reached 96.7% (95% CI = 88.1% to 106.1%), 92.9% (95% CI = 82.9% to 104.0%), 72.7% (95% CI = 56.5% to 93.6%), and 51.3% (95% CI = 39.7% to 66.2%) of the July 2019 prepandemic volume, respectively. Conclusions: Despite a strong overall rebound in mammography volume by July 2020, the rebound lagged among Asian and Hispanic women, and a substantial cumulative deficit in missed mammograms accumulated, which may have important health consequences.