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

Impact of the COVID-19 Pandemic on Breast Cancer Diagnoses

“…It expands prior literature, including an earlier BCSC paper, which assessed pandemic effects on mammographic utilization and suggested the possibility of longer-term screening deficits ( 5 ). The findings are also in accord with a recent Dutch study by Eijkelboom and colleagues, who reported a drop in cancer detection during the pandemic, and specifically a decrease in the number of screen-detected rather than symptomatic cancers ( 6 ). In the Dutch program, screen-detected cancers decreased by 67% compared to 2018 and 2019 averaged volumes, while non-screen detected tumors only decreased by 7%.…”

“…The organization of the Dutch national screening program likely allows for a more controlled and efficient recapture of women who missed their screens than may be possible in many practices in the United States. In fact, women in the Netherlands who had missed their screening were methodically invited to come in for screening first ( 6 ). It is therefore conceivable that the consequences and duration of impact of the pandemic on breast cancer outcomes will vary by setting.…”

Breast Biopsy Recommendations and Breast Cancers Diagnosed during the COVID-19 Pandemic

“…Our findings are consistent with the efforts of breast imaging facilities to prioritize women with symptoms of breast cancer over screening of asymptomatic women during periods of limited capacity ( 20 ) and/or may reflect women's greater reluctance to delay evaluation of breast symptoms than a screening examination. A recent study of the Dutch national breast screening program similarly found that pandemic-related shutdowns had a smaller impact on non-screen detected cancer incidence than screen-detected cancer incidence ( 21 ). In a prior analysis using breast cancer models from the Cancer Intervention and Surveillance Modeling network, delays in diagnostic evaluation of symptomatic women were more detrimental to long-term outcomes than delays in screening mammography, resulting in excess breast cancer mortality ( 16 ).…”

The impact of the COVID-19 pandemic on perceived access to health care and preferences for health care provision in individuals (being) treated for breast cancer

“…The coronavirus disease 2019 (COVID-19) pandemic and its associated restrictions led to a multitude of challenges for health care systems worldwide. In the Netherlands, the national screening program for breast cancer was halted from March 2020 and Dutch guidelines for breast cancer treatment were temporarily adapted to alleviate the burden on the health care system, resulting in postponement and cancelation of breast cancer screening, treatment, and follow-up care [ 1 – 4 ].…”

“…The Dutch national screening program for breast cancer was partially resumed from July 2020 onward [ 4 , 11 ]. Furthermore, transformations within the health care system, such as the implementation of additional safety measures and telehealth (i.e., telephone and video consultations), were paramount to continue breast cancer treatment and follow-up care as much as possible amid the COVID-19 crisis.…”