- Implementing an optimal strategy to restart breast cancer screening after COVID-19 disruption will be challenging while keeping a balance between minimizing excess mortality and strain on programs.
Why this matters
- In the Netherlands, new breast cancer diagnoses declined sharply from historical levels starting in February 2020.
- Dutch researchers conducted a modeling study to simulate 4 strategies for restarting breast cancer screening after a 6-month disruption:
- Everyone delay;
- First rounds no delay;
- Continue after stopping age; and
- Catch-up after stop.
- Funding: None.
- 5872 women would be screened in the second half of 2020 if screening proceeded without disruption.
- The screening capacity was essentially similar for all restarting strategies, except for the catch-up-after-stop strategy, which would need a doubling of that number.
- Although the temporal pattern of breast cancer incidence varied as per the restarting strategy early on, it returned to that expected with undisrupted screening by 2025 for all 4 strategies.
- In the long term, breast cancer mortality increased slightly and transiently above the expected level with the catch-up-after-stop strategy, but sizable, long-lasting increases were seen with the other strategies.
- Compared with undisrupted screening, excess breast cancer mortality during 2020-2030 in absolute terms was:
- 181 with everyone-delay strategy;
- 155 with first-rounds-no-delay strategy;
- 145 with continue-after-stopping-age strategy; and
- 14 with catch-up-after-stop strategy.
- Model is based on the Dutch population and screening program.