Did Cancer Screening Rates Rebound to Pre-Pandemic Levels?
BACKGROUND AND PURPOSE:
- Star et al. (Journal of Clinical Oncology, 2023) examined whether cancer screening prevalence in the United States during 2021 has returned to pre-pandemic levels using nationally representative data
METHODS:
- Analysis of data from a cross-sectional US nationwide household survey
- 2021 National Health Interview Survey
- Populations
- USPSTF recommendations for age-eligible screening
- Breast cancer: 50 to 74 years
- Cervical cancer: 21 to 65 years
- Prostate cancer: 55 to 69 years
- Colorectal cancer: 50 to 75 years
- USPSTF recommendations for age-eligible screening
- Exposure
- Pre-pandemic: 2019
- Pandemic: 2021
- Study design
- Adjusted prevalence ratios (aPRs) using logistic regression models
- Primary outcomes
- Past-year screening prevalence
- Prevalence ratios in 2021 vs 2019
RESULTS:
- Between 2019 and 2021, past-year screening decreased for
- Breast cancer: from 59.9% to 57.1% | aPR 0.94 (95% CI, 0.91 to 0.97)
- Cervical cancer: from 45.3% to 39.0% | aPR 0.85 (95% CI, 0.82 to 0.89)
- Prostate cancer: from 39.5% to 36.3% | aPR 0.9 (95% CI, 0.84 to 0.97)
- Declines were most notable for non-Hispanic Asian persons
- Colorectal cancer screening prevalence remained unchanged
- An increase in past-year stool testing offset a decline in colonoscopy
- Past year stool testing: from 7.0% to 10.3% | aPR 1.44 (95% CI, 1.31 to 1.58)
- Colonoscopy: from 15.5% to 13.8% | aPR 0.88 (95% CI, 0.83 to 0.95)
- An increase in past-year stool testing offset a decline in colonoscopy
- The increase in stool testing was most pronounced in non-Hispanic Black and Hispanic populations and in persons with low socioeconomic status
CONCLUSION:
- Screening rates for breast, cervical and prostate cancers in 2021 remained lower than the rates in 2019, pre-pandemic
- There was a large increase in stool testing, instead of colonoscopy, for colorectal cancer screening
- The authors state
These findings reinforce the importance of strengthening return to screening campaigns for cancer prevention and control, and the major role physicians and other health care providers should play for the success of the campaigns
Learn More – Primary Sources:
Cancer Screening in the United States During the Second Year of the COVID-19 Pandemic
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