BACKGROUND AND PURPOSE:

• Cancer screening rates declined during COVID and in the immediate aftermath, leading to increased cancer diagnoses at later stages
• Star et al. (JAMA, 2025) estimated post-pandemic cancer screening rates in 2023 relative to previously documented declines through 2021

METHODS:

• Analysis of screening trends
  • Data from National Health Interview Survey
• Population
  • Nationally representative cross-sectional cohort of noninstitutionalized US adults
• Exposures
  • Before the COVID-19 pandemic: 2019
  • During: 2021
  • After: 2023
• Study design
  • Adjustments were made for nonresponse bias
  • Screening eligibility and strategies were defined according to the USPSTF recommendations
  • Logistic regression models estimated adjusted prevalence ratios (aPRs)
    • Adjustments: was Age | Race and ethnicity | Education | Insurance | Region
• Primary outcomes
  • Self-reported breast | Cervical | Colorectal cancer screening

RESULTS:

• 2023 eligibility for screening
  • Breast cancer: 6829 | Cervical cancer: 8888 | Colorectal cancer: 13,144
• Between 2019 and 2023, reported past-year breast and colorectal cancer screening increased
  • Breast: 7% increase
    • Prevalence estimate 59.7 to 64.9%
    • aPR 1.07 (95% CI, 1.04 to 1.10)
  • Colorectal: 12%
    • Prevalence estimate: 21.2 to 24.3%
    • aPR 1.12 (95% CI, 1.06 to 1.18)
• Underlying these increases were
  • Rebounds between 2021 and 2023 in breast cancer screening
    • 56.9 to 64.9%
    • aPR 1.14 (95% CI, 1.11 to 1.18)
  • Rebounds between 2021 and 2023 in colonoscopy screening
    • 13.8 to 15.7%
    • aPR 1.13 (95% CI, 1.06 to 1.22)
  • Sustained increases in stool testing
    • 2019: 6.6%
    • 2021: 10.1%
    • 2023: 10.1%
• Reported cervical cancer screening in 2023 remained below 2019 estimates
  • 14% decrease
  • Prevalence estimate 46.8 to 40.9%
  • aPR 0.86 (95% CI, 0.82 to 0.90)
• Colorectal cancer screening increased between 2019 and 2023 for college graduates, but did not change in individuals with a high school degree or less
• Breast cancer screening met or exceeded 2019 levels across screening groups as screening rebounded between 2021 and 2023
• Cervical cancer screening rebounded between 2021 and 2023 among college graduates, but remained below 2019 levels for most education groups

CONCLUSION:

• Reported breast and colorectal cancer screening rates rebounded after pandemic-related decreases
• In 2023 screening rates were higher than pre-pandemic levels
• Cervical cancer screening remained below pre-pandemic levels
• The authors state

Cervical cancer screening rates remained below prepandemic levels, a troubling trend as early-stage diagnoses continued to decrease in 2021

The persistent decline may in part reflect longer-term declines in patient knowledge and clinician recommendation of cervical cancer screening

Learn More – Primary Sources:

Cancer Screening 3 Years After the Onset of the COVID-19 Pandemic

Related PcMed Topics:

Did Cancer Screening Rates Rebound to Pre-Pandemic Levels?

Why Have Cervical Cancer Screening Rates Decreased Over the Past Decade in the US?