Table 1.
Summary of screening volume (number of screening mammograms/women or screening rate, n = 35).
| Study, Country/Region | Health service setting |
Pre-pandemic |
Pandemic |
Number of screening mammograms or number of women having screening |
||
|---|---|---|---|---|---|---|
| Time period | Time period | Services suspension/lockdown | Pre-pandemic vs Pandemic (data are frequency (N) unless specified) | Relative change in outcome (unless specified) | ||
| Al-Kuwari 2021, Qatar [11] | HCS | 01/01/2019 to 31/07/2019 | 01/01/2020 to 31/07/2020 | 11/03/2020–31/07/2020 | 4854 vs 2156 | ↓55.58% |
| Amran 2021, US [13] | HCS | 01/04/2019 to 31/12/2019 | 01/04/2020 to 31/12/2020 | NR | 55,678 vs 27,522 | ↓49% |
| Bakouny 2021, US [14] | HCS | Same months 2019: 02/03/2019 to 02/06/2019; Pre-peak: 01/12/2019 to 02/03/2020. |
Peak: 02/03/2020 to 02/06/2020; After-peak: 03/06/2020 to 03/09/2020. |
NR | Same months 2019 vs Peak: 24,660 vs 5305; Pre-peak vs Peak: 29,158 vs 5305; After-peak vs Peak: 24,788 vs 5305. |
Same months 2019 vs Peak: ↓77.67%; Pre-peak vs Peak: ↓81.49%; After-peak vs Peak: ↓78.06%. |
| Bentley 2021, Canada [15] | BCSP | 01/01/2019 to 31/12/2019 | 01/01/2020 to 31/12/2020 | 18/03/2020–30/05/2020 | 265,479 vs 185,154 | ↓30.2% |
| Bessa 2021, Brazil [16] | BCSP | 01/01/2019 to 31/12/2019 | 01/01/2020 to 31/12/2020 | 17/03/2020-NR | 1,948,471 vs 1,126,688 | ↓42.18% |
| Brugel 2021, France [17] | HCS | 01/01/2019 to 31/05/2019 | 01/01/2020 to 31/05/2020 | 17/03/2020–11/05/2020 | Jan: 2541 vs 2607; Feb: 2128 vs 2203; Mar: 2316 vs 965; Apr: 2288 vs 0; May: 2089 vs 636. |
Jan: ↑2%; Feb: ↑3%; Mar: ↓58%; Apr: ↓100%; May: ↓70%. |
| Chiarelli 2021a, Canada [19] | BCSP | 01/01/2019 to 29/02/2020 | Suspension: 01/03/2020 to 31/05/2020; Resumption: 01/06/2020 to 31/03/2021. |
23/03/2020–26/05/2020 | Pre vs Suspension vs Resumption: 822,862 vs 32,408 vs 394,559 |
Pre vs Suspension: ↓96.1%; Pre vs Resumption: ↓52.1%; Suspension vs Resumption: ↑1117.5%. |
| Chou 2020, Taiwan [20] | ASI | Week 1, 2019 to Week 22, 2019 | Week 1, 2020 to Week 22, 2020 | NR | NR | ↓51%, p < 0.001 |
| Collado-Mesa 2020, US [21] | HCS | 1/04/2018–2019 to 30/04/2018–2019 | 01/04/2020 to 30/04/2020 | 20/03/2020-Mid May to early June 2020 | 2722 vs 105 | ↓96% |
| Dabkeviciene 2021, Lithuania [22] | ASI | 01/02/2019 to 31/12/2019 | 01/02/2020 to 31/12/2020 | 18/03/2020–17/06/2020; 04/11/2020–31/12/2020. | 9704 vs 3653 | ↓62% |
| de Degani 2021, Argentina [23] | BCSP | 19/03/2019 to 19/09/2019 | 19/03/2020 to 19/09/2020 | 19/03/2020–19/09/2020 | 9918 vs 2098 | ↓78.85% (95% CI: 78.03–79.65%), p < 0.0001 |
| DeGroff 2021, US [24] | BCSP | 01/01/2015–2019 to 30/06/2015–2019 | 01/01/2020 to 30/06/2020 | NR | Total: 1,112,126 vs 71,704. Apr: 19,366 vs 2607; Jun: 17,385 vs 10,626. |
Total: ↓94%. Apr: ↓97%, p < 0.001; Jun: ↓39%, p < 0.001. |
| Fedewa 2021, Italy [25] | HCS | 01/07/2019 to 31/07/2019 | 01/07/2020 to 31/07/2020 | NR | 76,430 vs 74,340 | ↓2.7% |
| Gorin 2021, US [27] | ASI | 19/03/2019 to 09/05/2019 | 19/03/2020 to 09/05/2020 | 19/03/2020–09/05/2020 | 3339 vs 6 | ↓99.8% |
| Kang 2021b, Korea [29] | HCS | 01/02/2019 to 31/07/2019 | 01/02/2020 to 31/07/2020 | NR | Total: 20,923 vs 11,982. Peak (Feb–Apr): 8837 vs 3697; After-peak (May–Jul): 12,086 vs 8285. |
Total: ↓42.7%. Peak (Feb-Apr): ↓58.2%; After-peak (May-Jul): ↓31.4%. |
| Kidwai 2022, US [30] | ASI | 01/01/2019 to 31/12/2019 | 01/01/2020 to 31/12/2020 | NR | 435 vs 382 | ↓12% |
| Labaki 2021, US [33] | HCS | Pre-peak: 01/12/2019 to 02/03/2020 | 1st peak: 02/03/2020 to 02/06/2020; Period between two peaks: 03/06/2020 to 03/09/2020; 2nd peak: 04/09/2020 to 05/12/2020. |
NR | Pre-peak vs 1st peak: 29,305 vs 5379; Pre-peak vs Period between two peaks: 29,305 vs 24,876; Pre-peak vs 2nd peak: 29,305 vs 33,282. |
Pre-peak vs 1st peak: ↓82%; Pre-peak vs Period between two peaks: ↓15%; Pre-peak vs 2nd peak: ↑14%. |
| London 2022, US [34] | HCS | 01/01/2019 to 30/04/2020 | 01/01/2020 to 30/04/2021 | 01/03/2020–30/04/2020 | NR | Apr 1–15, 2020 (lowest): ↓89%; Jun 30- Jul 14, 2020 (recovery): ↑21%; Mar 2–16, 2021 (highest): ↑64%. |
| Losurdo 2022, Italy [35] | BCSP | 01/01/2019 to 31/12/2019 | 01/01/2020 to 31/12/2020 | 09/03/2020-NR | NR | ↓37.6% |
| Miller 2021, US [36] | ASI | Week 1, 2019 to Week 47, 2019 | Week 1, 2020 to Week 47, 2020 | Weeks 11–17 | 15,339 vs 13,841 | ↓9.8% |
| Norbash 2020, US [37] | HCS | Week 1, 2019 to Week 21, 2019 | Week 1, 2020 to Week 21, 2020 | NR | Nadir: in weeks 15–16: 12,027 vs 152 | Weekly change range: Weeks 1–10: ↑3%–16%; Weeks 11–13: ↓10%–96%; Weeks 14–20: ↓95%–99% (Nadir: ↓99% in weeks 15–16); Week 21: ↓73%. |
| Peng 2020, Taiwan [39] | BCSP | 01/01/2019 to 31/05/2019 | 01/01/2020 to 31/05/2020 | No suspension | Total: 496,207 vs 358,771 |
Total: ↓27.70%. Mar: ↓35% (p < 0.0001); Apr: ↓60% (p < 0.0001); May: ↓49% (p < 0.0001). |
| Ribeiro 2022, Brazil [40] | HCS | 01/01/2019 to 31/12/2019 | 01/01/2020 to 31/12/2020 | No lockdown | Total: 3,810,427 vs 218,371. Percentage of screening mammography performed in women aged 50–69 years: 64.8% vs 64.4%. |
Total: ↓42.62%. Percentage of screening mammography performed women aged 50–69 years: ↓0.4%. |
| Shen 2022, Taiwan [41] | BCSP | 01/01/2019 to 30/04/2019 | 01/01/2020 to 30/04/2020 | No suspension | Inreach (hospital): 150,903 vs 94,796; Outreach (mobile): 242,482 vs 211,730. |
Average monthly percentage change: Inreach (hospital): ↓41.43%; Outreach (mobile): ↓23.99%. |
| Sprague 2021, US [42] | CIR | 01/01/2019 to 31/07/2019 | 01/01/2020 to 31/07/2020 | NR | 190,454 vs 126,040 | ↓33.8% (95% CI: 27.4–39.7%) |
| Sutherland 2020, Australia [43] | BCSP | 01/03/2019 to 30/06/2019 | 01/03/2020 to 30/06/2020 | 24/03/2020–18/05/2020 | NR vs 58,478 | ↓51.5% |
| Tang 2022, US [44] | HCS | 17/03/2019 to 17/05/2019 | 17/03/2020 to 17/05/2020 | 17/03/2020–17/05/2020 | 180,724 vs 1681 | ↓99.1% |
| Tsai 2020, Taiwan [45] | BCSP | 01/01/2019 to 30/04/2019 | 01/01/2020 to 30/04/2020 | No suspension | 396,371 vs 308,463 | ↓22.2%, p < 0.001 |
| Velazquez 2021, US [46] | ASI | 01/01/2019 to 31/12/2019 | 01/01/2020 to 31/12/2020 | 16/03/2020–16/05/2020 | 5662 vs 3385 | ↓40% |
| Walker 2021a, Canada [47] | BCSP | 01/03/2019 to 31/12/2019 | 01/03/2020 to 31/12/2020 | Mid 03/2020-End 05/2020 | 605,889 vs 284,242 | ↓53.1% |
| Study, Country/Region | Health service setting | Pre-pandemic | Pandemic | Screening rate or use rate of mammograms | ||
| Time period | Time period | Services suspension/lockdown | Pre-pandemic vs Pandemic (data are in proportion (%) unless specified) | Relative change in outcome (unless specified) | ||
| Chen 2021, US [18] | HIC | 01/01/2019 to 31/07/2019 | 01/01/2020 to 31/07/2020 | NR | 4133 vs 2971 screens per 100,000 enrolees | ↓28.1% |
| Fedewa 2021, US [25] | HCS | 01/07/2019 to 31/07/2019 | 01/07/2020 to 31/07/2020 | NR | 53.9% vs 49.6% | Rate ratio: 0.92 (95% CI: 0.92–0.93) |
| Jidkova 2022, Belgium [28] | BCSP | 01/01/2019 to 31/12/2019 | 01/01/2020 to 31/12/2020 | 23/03/2020–28/06/2020 | NR | Absolute change: Entire year: ↓1.0% (95% CI: 0.8%–1.3%); Before shutdown (01/01–21/03): ↓1.4% (95% CI: 1.0%–1.9%); Reopen (05/07–31/12): ↓1.0% (95% CI: 1.3%–2.0%). |
| Kim 2022, US [31] | HCS | 01/01/2020 to 03/03/2020 | Stat-at-home: 04/03/2020 to 08/05/2020; Reopen: 09/05/2020 to 08/07/2020. |
04/03/2020–08/05/2020 | Odds Ratio (95% CI)d: Stay-at-home vs Pre: 0.34 (0.31–0.37); Reopen vs Pre: 0.49 (0.45–0.53); Reopen vs Stat-at-home: 1.44 (1.31–1.58). |
Stay-at-home vs Pre: ↓66%, p < 0.001; Reopen vs Pre: ↓51%, p < 0.001; Reopen vs Stat-at-home: ↑44%, p < 0.001. |
| Koczkodaj 2021, Poland [32] | BCSP | 01/01/2019 to 30/09/2019 | 01/01/2020 to 30/09/2020 | NR | 38.15% vs 35.92% | Absolute change: ↓2.2% |
| Whaley 2020, US [48] | HIC | 01/03/2019 to 30/04/2019 | 01/03/2020 to 30/04/2020. | NR | Mar: 358.4 per 10,000 women vs NR; Apr: 378.5 per 10,000 women vs NR. |
Mar: ↓41.6%c; Apr: ↓90.4%c. |
BCSP= Breast cancer (or cancer) screening program, HCS=Healthcare (or community-based) system/network/database, ASI = A single institution or department, CIR=Cancer or imaging registry, HIC=Health insurance claims, NR=Not reported, CI=Confidence interval.
Italics: computed data (see Appendix C).
a
Screening modality includes both mammography and magnetic resonance imaging.
b
Screening modality includes both mammography and ultrasound.
c
Controls for the age categories, state, year, and month.
d
Adjusted for age, race/ethnicity, enrolment in the patient portal (MyChart), COVID-19 risk score, and provider specialty.