Resuming breast cancer screening after COVID-19 disruption not a piece of cake

  • EBCC 2020

  • Pavankumar Kamat
  • Univadis Clinical Summaries
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Takeaway

  • 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. 

Study design

  • Dutch researchers conducted a modeling study to simulate 4 strategies for restarting breast cancer screening after a 6-month disruption:
    1. Everyone delay;
    2. First rounds no delay;
    3. Continue after stopping age; and
    4. Catch-up after stop.
  • Funding: None.

Key results

  • 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.

Limitations

  • Model is based on the Dutch population and screening program.