Impact of the suspension and restart of the Dutch breast cancer screening program on breast cancer incidence and stage during the COVID-19 pandemic

Anouk Eijkelboom, Linda de Munck, M.B.I. Lobbes, Carla H. van Gils, Jelle Wesseling, Pieter J. Westenend, Cristina Guerrero Paez, Ruud M. Pijnappel, H. M. Verkooijen, Mireille J.M. Broeders, Sabine Siesling

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.
Original languageEnglish
Article number106602
JournalPreventive medicine
Volume151
Early online date30 Jun 2021
DOIs
Publication statusE-pub ahead of print/First online - 30 Jun 2021

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