A systematic review of the impact of the COVID-19 pandemic on
breast cancer screening and diagnosis
by Tong Li,
Brooke Nickel, Preston Ngo, Kathleen McFadden, Meagan Brennan, M Luke
Marinovich, Nehmat Houssami
The Breast: VOLUME 67, P78-88, FEBRUARY
2023
Background
Breast cancer care
has been affected by the COVID-19 pandemic. This systematic review aims to
describe the observed pandemic-related changes in clinical and health services
outcomes for breast screening and diagnosis.
Methods
Seven databases
(January 2020–March 2021) were searched to identify studies of breast cancer
screening or diagnosis that reported observed outcomes before and related to
the pandemic. Findings were presented using a descriptive and narrative
approach.
Results
Seventy-four
studies were included in this systematic review; all compared periods before
and after (or fluctuations during) the pandemic. None were assessed as being at
low risk of bias. A reduction in screening volumes during the pandemic was
found with over half of studies reporting reductions of ≥49%. A majority (66%)
of studies reported reductions of ≥25% in the number of breast cancer
diagnoses, and there was a higher proportion of symptomatic than
screen-detected cancers. The distribution of cancer stage at diagnosis during
the pandemic showed lower proportions of early-stage (stage 0–1/I-II, or Tis
and T1) and higher proportions of relatively more advanced cases than that in
the pre-pandemic period, however population rates were generally not reported.
Conclusions
Evidence of
substantial reductions in screening volume and number of diagnosed breast
cancers, and higher proportions of advanced stage cancer at diagnosis were
found during the pandemic. However, these findings reflect short term outcomes,
and higher-quality research examining the long-term impact of the pandemic is
needed.
