Table 1. Descriptive characteristics of included cross-sectional studies (n = 26).
| Study | Publication type | Study design | Country | Region (If not national) | Total Female Population of Study Area | Sample size | Study screening data source | Screening (National/Regional) | Screening age range | Screening type | Screening time comparison | Types of Restrictions present over study period† | COVID-19 7 day new infection rate in region of focus (per 100000)* | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| International Travel Limits | Internal Movement Controls | Stay at home requirement | Public transport closure | Ban on gatherings of >10 people | Public events ban | Workplace closure | School closure | Minimum infection rate in study period | Maximum infection rate in study period | ||||||||||||
| Europe (n=7) | |||||||||||||||||||||
| Campbell et al., 2021 | Peer- reviewed | Cross sectional | Scotland (UK) | 2728000 | Not specified | NHS Scotland | National | 50–70 | Digital Mammography | Aug – Dec 2019 vs Aug -Dec 2020 | Yes | Yes | No | No | Yes | Yes | Yes | No | 10.14 | 212.67 | |
| Jidkova et al., 2022 | Peer- reviewed | Cross sectional | Belgium | Flanders | 3382265 | Not specified | Flanders Online Screening Database | Regional | 50–69 | Digital Mammography | Jul – Nov 2019 vs Jul – Nov 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 3.58 | 580.63 |
| Knoll et al., 2022 | Preprint | Cross sectional | Austria | Innsbruck | 567300 | 596 | Database from gynecological oncological center in Austria, Tyrol | Local | 45–69 years invited for screening. Women aged 40–44 years and 70–75 years may opt in | Digital Mammography | Mar – Dec 2019 vs Mar – Dec 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | no data | no data |
| Eijkelboom et al., 2021 | Peer- reviewed | Cross sectional | Netherlands | 8701000 | 3371 | Netherlands Cancer Registry | National | 50–75 | Digital Mammography | Jan – Feb 2020 vs Jul – Aug 2020 | Yes | No | No | No | Yes | No | Yes | No | 0.32 | 67.25 | |
| Losurdo et al., 2022 | Peer- reviewed | Cross sectional | Italy | Friuli Venezia Giulia | 624418 | 58643 | “Data-Breast” database of the “Eusoma certified SSD Breast Unit of Trieste and from the Surgical Department of DAI Chirurgia Generale—ASUGI. | Regional | 50–69 | Digital Mammography | Oct – Dec 2019 vs Oct – Dec 2020 | Yes‡ | Yes‡ | Yes‡ | No‡ | Yes‡ | Yes‡ | Yes‡ | Yes‡ | 19.2 | 497.6 |
| Toss et al., 2021 | Peer- reviewed | Cross sectional | Italy | Northern Italy, Emilia Romagna | 2291000 | 24994 | Emilia Romagna National Healthcare System | Regional | 45–79 | Digital Mammography | 2019 vs 2020 | Yes‡ | Yes‡ | Yes‡ | Yes‡ | Yes‡ | Yes‡ | Yes‡ | Yes‡ | 4.00 | 390.9 |
| NHS England, 2021 | Government paper | Cross sectional | England (UK) | 33940000 | 2230000 | NHS England | National | 50–71 | Digital Mammography | 2019 vs 2020 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | 0.00 | 92.36 | |
| Oceania (n=2) | |||||||||||||||||||||
| BreastScreen Australia, 2020 | Government Paper | Cross sectional | Australia | 12780000 | Not specified | BreastScreen Australia | National | 50–74 | Digital Mammography | May – Sep 2018 vs May – Sep 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 0.18 | 13.31 | |
| BreastScreen Aoteroa, 2022 | Government Paper | Cross sectional | New Zealand | 2497000 | Not specified | BreastScreen Aotearoa | National | 45–69 | Digital Mammography | May – Dec 2018 vs May - Dec 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 0 | 1.06 | |
| Asia (n=1) | |||||||||||||||||||||
| Shen et al., 2022 | Peer- reviewed | Cross sectional | China | Taiwan | 11981657 | 699911 | Taiwan National Infectious Disease Statistics system | Regional | 40–69 | Digital Mammography | Jan – Apr 2019 vs Jan – Apr 2020 | Yes | No | No | No | No | No | No | Yes | no data | no data |
| Americas (n=16) | |||||||||||||||||||||
| Bessa, 2021 | Peer- reviewed | Cross sectional | Brazil | 106500000 | (2019: 20636636; 2020: 21140958) | Brazilian Unified Health System (SUS) | National | 50–69 | Digital Mammography | 2019 vs 2020 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | 0.00 | 149.68 | |
| Ribeiro et al., 2022 | Peer- reviewed | Cross sectional | Brazil | 106500000 | 5996798 | Brazilian National Health Service (SUS) Outpatient Information System (SIA/SUS), SUS Hospital Information System (SIH/SUS), High Complexity Procedure Authorizations database (APAC), Cancer Information System (ISCAN). | National | 50–69 | Digital Mammography | Jul – Dec 2019 vs Jul – Dec 2020 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | 53.72 | 149.68 | |
| Chiarelli et al., 2021 | Peer- reviewed | Cross sectional | Canada | Ontario | 7371000 | 426967 | Ontario Breast Screening Program (OBSP) | Regional | 50–74 | Digital Mammography, MRI (High risk) | Jul - Dec 2019 vs Jul - Dec 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 3.99 | 117.01 |
| Walker et al., 2021 | Peer- reviewed | Cross sectional | Canada | Ontario | 7371000 | 605889 (2019) 284242 (2020) | Ontario Breast Screening Program (OBSP) | Regional | 50–74 | Digital Mammography | Modelled 2019 data vs Dec 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 75.74 | 117.01 |
| Doubova et al., 2021 | Peer- reviewed | Cross sectional | Mexico | 64570000 | 1431216 | Mexican Institute of Social Security (IMSS) | National | 40 - unspecified | Digital Mammography | Jan 2019 – Mar 2020 vs Apr – Dec 2020 | Yes | Yes | Yes | No | No | Yes | Yes | Yes | 2.60 | 61.12 | |
| Chen et al., 2021 | Peer- reviewed | Cross sectional | USA | 167500000 | Not specified | HealthCore Integrated Research Database | National | 50–79 years | Digital Mammography | Jul 2019 vs Jul 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 119.03 | 142.00 | |
| Amornsiripanitch et al., 2021 | Peer- reviewed | Cross sectional | USA | Massachusetts | 3537000 | 32387 | Electronic medical record (Epic, Verona, WI) - Massachusetts. One tertiary care academic center, a community hospital, a specialized cancer center, three outpatient imaging centers, one urban healthcare center, and one mobile mammography van | Regional | 40 - unspecified years | Digital Mammography | Jun – Aug 2019 vs Jun – Aug 2020 | Yes | Yes | No | No | Yes | Yes | No | No | 17.06 | 53.09 |
| Becker et al., 2021 | Peer- reviewed | Cross sectional | USA | Michigan | 5062000 | 7250080 | Women enrolled in Health Managed Organization (HMO) Blue Cross Blue Shield (BCBS) in Michigan | Regional | 40–74 | Digital Mammography | Dec 2019 vs Dec 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 147.56 | 328.94 |
| DeGroff et al., 2021 | Peer- reviewed | Cross sectional | USA | 167500000 | 630264 | Breast and Cervical Cancer Early Detection Program (NBCCEDP) Database, which provides cancer screening services to women with low income and inadequate health insurance | National | 40–74 | Digital Mammography | Jun 2019 vs Jun 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 45.46 | 103.84 | |
| Dennis et al., 2021 | Peer- reviewed | Cross sectional | USA | 167500000 | 475083 | Behavioral Risk Factor Surveillance System (BRFSS) survey database | National | 40–74 | Digital Mammography | 2014–2019 vs 2020 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | 0.00 | 460.68 | |
| Fedewa et al., 2021 | Peer- reviewed | Cross sectional | USA | 167500000 | 2019:142003 2020:150630 | Data from 32 CHCs of the American Cancer Society's Community Health Advocates Implementing Nationwide Grants for Empowerment and Equity (CHANGE) grant program to increase BCSRs and follow-up care | National | 50–74 | Digital Mammography | 2019 vs 2020 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | 0.00 | 460.68 | |
| Lehman et al., 2022 | Preprint | Cross sectional | USA | 167500000 | 29276 | Screening database over 5 facilities | National | Unspecified | Digital Mammography | 2019 vs 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 0.00 | 460.68 | |
| London et al., 2022 | Peer- reviewed | Cross sectional | USA | 167500000 | 34000000 (full study including colorectal cancers) | TriNetX Research Network | National | Unspecified | Digital Mammography | Jul – Dec 2019 vs Jul – Dec 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 74.54 | 460.68 | |
| Miller et al., 2021 | Peer- reviewed | Cross sectional | USA | Virginia | 2757460 | Not specified | Instituition Database, University of Virginia | Regional | Unspecified (45 - 70) | Digital Mammography | Jan – Nov 2019 vs Jan - Nov 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | no data | no data |
| Sprague et al., 2021 | Peer- reviewed | Cross sectional | USA | 167500000 | 461083 | 62 radiology facilities of Breast Cancer Surveillance Consortium | National | 40–79 | Digital Mammography | Jan-Jul 2019 vs Jan-Jul 2020 | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | 0.00 | 142.00 | |
| Nyante et al., 2021 | Peer- reviewed | Cross sectional | USA | North Carolina | 5099371 | 42412 | 7 academic and community breast imaging facilities in North Carolina | Regional | 40–79 | Digital Mammography | Modelled Sep 2019 data vs Sep 2020 | Yes | No | No | No | No | Yes | Yes | Yes | 80.27 | 91.26 |
England’s and Scotland’s NHS systems are devolved and, therefore, are separate national entities. However, they hold similar screening criterion where breast screening policy in the NHS (across the UK) is that all women aged 50–70 y + 364 d are invited for breast screening once every 3 y.
These infection rates were region-specific and analogous to the region the study involved. If study period was ≤1 mo, only infection data from the first and last week of the period will be collected. If study period was over the whole year of 2020, the earliest available public health data was used (e.g., study period started from January 2020 but data was only available in March, March data used as first interval of analysis). It should be noted that there is reporting bias here as testing rates may differ between countries. These infection incidence rates were based on national/regional data depending on whether the study population originated from an entire nation or a limited region within a nation. (Dipartimento della Protezione Civile, 2023a; Dipartimento della Protezione Civile, 2023b; Government of Ontario, 2023; Government of the Netherlands, 2023; Cooper et al., 2023; IARC, 2022; Mathieu, 2022; MDHHS, 2023; Medicaid.gov, 2022; NCDHHS, 2023; NHS England, 2021; OECD, 2021a; PAHO, 2020; Sciensano, the Belgian Institute for Health, 2023; SPICe, 2023; State of Michigan, 2020; State of North Carolina, 2020; The Scottish Government, 2022; UK Government, 2023; WHO, 2023; WHO, 2022; WHO, 2022; Worldometer, 2022; WHO, 2021; Yucatan Times, 2021).
Types of restrictions will include restrictions that were withdrawn at any point of the study period. Restrictions present were classified as per non-pharmacological interventions mentioned by the paper Li et al., 2021 ‘The Temporal Association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number (R) of SARS-COV-2: A modelling study across 131 countries’, The Lancet Infectious Diseases, if restrictions were introduced/withdrawn during the study period, it will still be indicated as a 'Yes', Data from Oxford COVID-19 policy tracker, devolved state-wide healthcare organization websites in Canada, the USA, and UK was used to assess this.
Data was unavailable for regions in this country, national restrictions were assessed instead.