Barriers to breast cancer screening are worsened amidst COVID-19 pandemic: A review

Abstract

Disparities in screening mammography and barriers to accessing breast cancer screening are most prevalent among racial/ethnic minority and low-income women. The significant breast cancer mortality rates experienced in both Hispanic and African American populations are found to be connected to delayed screening. For these women to follow the screening guidelines outlined by the American College of Radiology and Society of Breast Imaging, they must successfully navigate existing barriers to screening. These barriers include differential access to care, language barriers, and lack of medical insurance. The COVID-19 Pandemic has worsened the barriers to breast cancer screening faced by these groups of women. These barriers need to be addressed or they may further exacerbate disparities.

Mortality by Education Before and During the COVID-19 Pandemic, U.S., 2017–2020

“…The pandemic brought fluctuations in health insurance coverage (by abrupt changes in employment) and health system disruptions in the U.S., adversely affecting healthcare access and quality, especially among people of color and of lower SES. 11 , 12 For example, delays in radiation therapy 13 and cancer surgery 14 occurred more often among Black individuals and people of lower SES than among other patients with cancer during the height of the pandemic. Delays in cancer screening during the pandemic are also predicted to widen disparities in cancer mortality in the coming years.…”

Patient-Reported Experiences of Breast Cancer Screening, Diagnosis, and Treatment Delay, and Telemedicine Adoption during COVID-19

“…Moreover, as we observed greater delays among individuals with Medicaid insurance, and others have found disparities in COVID-19-related changes in cancer screening among racial/ethnic minorities [ 37 ], the impact could be unevenly distributed and be more severe in vulnerable populations including patients with lower socioeconomic status. COVID-19-related delays could further exacerbate pre-existing racial and socioeconomic disparities in breast cancer early detection, diagnosis, and treatment [ 38 , 39 ]. Although the transition of care delivery to telemedicine could help mitigate the detrimental effect of COVID-19 on cancer care, we must be aware that inequity in telemedicine uptake could exist.…”

Breast Cancer in Asia: Incidence, Mortality, Early Detection, Mammography Programs, and Risk-Based Screening Initiatives

“…In high-income countries such as South Korea, Japan, Singapore, Brunei, Kuwait, and Saudi Arabia, the underutilization of mammography screening is attributed to differences in insurance coverage, the lack of awareness of mammography screening in their country, and personal beliefs [ 100 , 103 , 106 , 107 , 108 ]. Although screening is included in health insurance, mammography is made more accessible with the ease of a centralized insurance system in South Korea, as opposed to having multiple individual insurance companies in Japan [ 103 ].…”