Prompt Resumption of Screening Programme Reduced the Impact of COVID-19 on New Breast Cancer Diagnoses in Northern Italy

Abstract

The aim of this study is to evaluate the real impact of COVID-19 during the entire 2020 period, compared with 2019. The data comes from a Cancer Registry in Northern Italy and we compared clinical and treatment characteristics of breast cancer by age, stage, treatment, and status screening. In 2020 there was no decrease in invasive tumours nor in in situ (513 vs. 493 and 76 vs. 73, respectively), while there was a significant decrease in surgery and increase in neoadjuvant chemotherapy (p = 0.016). In the screening range (aged 45–74), no change in stage and grading was observed. In the four periods examined there was an increase in new diagnoses during pre-lockdown, a decrease in tumours especially at age 75+ [IRR 0.45; 95%CI 0.25–0.79] during lockdown, a recovery of new diagnoses in women 45+ in the low incidence period while in the last period there was a significant increase only for ages 45–74 [IRR 1.48; 95%CI 1.11–1.98]. Screening activities were suspended from March to May, but over the summer and autumn the backlog was addressed. This suggests that a prompt resumption of programmed screening may have limited the impact of the pandemic on the delay of breast cancer diagnoses.

The impact of the COVID-19 pandemic on Italian population-based cancer screening activities and test coverage: Results from national cross-sectional repeated surveys in 2020

“…The active invitation allows to accurately plan the workload, which represented an opportunity for organized screening programs to resume post-lockdown activities in a rational way according to accurate prioritization, aiming to minimize the impact of the pandemic on cancer diagnosis delays ( Castanon et al, 2021 , Campbell et al, 2021 ). Thus, the presence of a structured and well-organized program has been recognized as a possible element favoring the resilience of health services to the pandemic disruption ( Mangone et al, 2022 ).…”

The impact of the Covid-19 pandemic on Italian population-based cancer screening activities and test coverage: results from national cross-sectional repeated surveys

“…There are large differences in the cumulated delay between macro areas and, within macro areas, between regions (Table 1) and local health authorities. 9,35 The largest delays are observed in those areas where screening programs had historical problems in extending invitations to the whole target population and participation was already low before the pandemic - particularly in Southern Italy but also in some areas of Northern Italy - where cervical cancer screening was recently implemented and coverage relied largely on opportunistic screening. 21 24 25 Northern Italy was also the most affected area by the pandemic.…”

“…7 , 8 Thus, the presence of a structured and well-organized screening program has been recognized as an element favoring the resilience of health services to the pandemic disruption. 9 In Italy, a national law included organized screening programs for breast, cervical, and colorectal cancers among the public health interventions that all the Regions must carry out [ref]. 10 The target population, the test, and the intervals used are reported in box 1.…”

“…7 , 8 Thus, the presence of a structured and well-organized screening program has been recognized as an element favoring the resilience of health services to the pandemic disruption. 9…”

A Combined Risk Score Model to Assess Prognostic Value in Patients with Soft Tissue Sarcomas

“…Due to the rare incidence rate and diverse origins of STS, precise diagnosis and prediction of its prognosis have become strikingly difficult [ 26 , 27 , 28 ]. Several therapeutic methods have been applied for STS patients, including surgical, chemotherapy, radiotherapy, and immunotherapy, but the overall survival of STS patients could not reach a satisfactory level [ 29 , 30 , 31 , 32 ].…”