Patient-reported impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment: A national survey

Introduction: The COVID-19 pandemic has altered the health care delivery system The purpose of this study wasto determine the impact of the COVID-19 pandemic on breast cancer screening, diagnosis, and treatment Methods: Potential survey respondents were identified through partnerships with breast cancer organizationsincluding Dr Susan Love Foundation for Breast Cancer Research, SHARE, Survivingbreastcancer org, SistersNetwork Inc , the African American Breast Cancer Alliance, and through ResearchMatch org Study information wasshared via social media, websites, or email Individuals were eligible for this study if they: 1) receive routine breastcancer screening, or 2) are undergoing diagnostic evaluation for breast cancer, or 3) had ever been diagnosed withbreast cancer Participants accessed and completed the 10-15-minute REDCap survey either by emailing theresearch team and receiving a private survey link or by clicking a public link The survey collected information onrespondent demographics;breast cancer screening and diagnosis;the extent to which screening, diagnosis, ortreatment had been changed, delayed, or canceled because of COVID-19;personal protective practices;extent ofworry about financial and health implications of COVID-19;and use of telemedicine We used descriptive statisticalanalyses to better understand the impact of the COVID-19 pandemic on respondents Results: There are currently 415 survey respondents, 404 of whom agreed to participate in the study 46 8%(N=189) of respondents were white, 26 7% (N=108) Black, 6 7% (N=27) Asian, and 5 5% Hispanic or Latino (N=22) Most respondents were between the ages of 50 and 69 years (52 2%, N=211) 43 3% (N=175) of respondents hadbeen diagnosed with breast cancer and, of those, 36% (N=63) were in active treatment More than a quarter ofparticipants (26 5%, N=107) reported delayed or canceled breast cancer care due to COVID-19;the most frequentlyaffected care was screening mammogram, ultrasound, or MRI (97 2%, N=104) 20 6% (N=13) of women in activetreatment reported delayed or canceled surgery, chemotherapy, or radiation visits 22 3% (N=90) of respondentsreported that an in-person visit was changed to a phone call or videoconference, and 39 1% (N=158) said they haddiscussed COVID-19 with a health care provider 29 1% (N=51) of those with breast cancer were worried or veryworried that the COVID-19 pandemic would make it harder for them to get cancer care;among those without breastcancer, 34 9% (N=80) were worried that COVID-19 would make it harder to obtain health care, including breastcancer screening and diagnosis Conclusions: The COVID-19 pandemic continues to disrupt breast cancer-related care, primarily screening Planning and coordination are necessary to ensure the timely return of these patients to care Most participantsagreed to be contacted for follow-up, allowing us to investigate the long-term effects of delayed breast cancerscreening, diagnostic evaluation, and treatment on health outcomes