TY - JOUR
T1 - Impact of the suspension and restart of the Dutch breast cancer screening program on breast cancer incidence and stage during the COVID-19 pandemic
AU - Eijkelboom, Anouk
AU - de Munck, Linda
AU - Lobbes, M.B.I.
AU - van Gils, Carla H.
AU - Wesseling, Jelle
AU - Westenend, Pieter J.
AU - Guerrero Paez, Cristina
AU - Pijnappel, Ruud M.
AU - Verkooijen, H. M.
AU - Broeders, Mireille J.M.
AU - Siesling, Sabine
PY - 2021/6/30
Y1 - 2021/6/30
N2 - The COVID-19 pandemic forced the Dutch national breast screening program to a halt in week 12, 2020. In week 26, the breast program was resumed at 40% capacity, which increased to 60% in week 34. We examined the impact of the suspension and restart of the screening program on the incidence of screen-detected and non-screen-detected breast cancer. We selected women aged 50–74, diagnosed during weeks 2–35 of 2018 (n = 7250), 2019 (n = 7302), or 2020 (n = 5306), from the Netherlands Cancer Registry. Weeks 2–35 were divided in seven periods, based on events occurring at the start of the COVID-19 pandemic. Incidence of screen-detected and non-screen-detected tumors was calculated overall and by age group, cT-stage, and cTNM-stage for each period in 2020, and compared to the incidence in the same period of 2018/2019 (averaged). The incidence of screen-detected tumors decreased during weeks 12–13, reached almost zero during weeks 14–25, and increased during weeks 26–35. Incidence of non-screen-detected tumors decreased to a lesser extent during weeks 12–16. The decrease in incidence was seen in all age groups and mainly occurred for cTis, cT1, DCIS, and stage I tumors. Due to the suspension of the breast cancer screening program, and the restart at reduced capacity, the incidence of screen-detected breast tumors decreased by 67% during weeks 9–35 2020, which equates to about 2000 potentially delayed breast cancer diagnoses. Up to August 2020 there was no indication of a shift towards higher stage breast cancers after restart of the screening.
AB - The COVID-19 pandemic forced the Dutch national breast screening program to a halt in week 12, 2020. In week 26, the breast program was resumed at 40% capacity, which increased to 60% in week 34. We examined the impact of the suspension and restart of the screening program on the incidence of screen-detected and non-screen-detected breast cancer. We selected women aged 50–74, diagnosed during weeks 2–35 of 2018 (n = 7250), 2019 (n = 7302), or 2020 (n = 5306), from the Netherlands Cancer Registry. Weeks 2–35 were divided in seven periods, based on events occurring at the start of the COVID-19 pandemic. Incidence of screen-detected and non-screen-detected tumors was calculated overall and by age group, cT-stage, and cTNM-stage for each period in 2020, and compared to the incidence in the same period of 2018/2019 (averaged). The incidence of screen-detected tumors decreased during weeks 12–13, reached almost zero during weeks 14–25, and increased during weeks 26–35. Incidence of non-screen-detected tumors decreased to a lesser extent during weeks 12–16. The decrease in incidence was seen in all age groups and mainly occurred for cTis, cT1, DCIS, and stage I tumors. Due to the suspension of the breast cancer screening program, and the restart at reduced capacity, the incidence of screen-detected breast tumors decreased by 67% during weeks 9–35 2020, which equates to about 2000 potentially delayed breast cancer diagnoses. Up to August 2020 there was no indication of a shift towards higher stage breast cancers after restart of the screening.
U2 - 10.1016/j.ypmed.2021.106602
DO - 10.1016/j.ypmed.2021.106602
M3 - Article
VL - 151
JO - Preventive medicine
JF - Preventive medicine
SN - 0091-7435
M1 - 106602
ER -