Rate and reasons of missed screening mammography in the COVID-19 pandemic from Turkey

Year 2022, , 1068 - 1072, 20.07.2022

Mustafa Emre Akın

https://doi.org/10.32322/jhsm.1110424

Abstract

Aim: While screening mammography has been interrupted in many countries during the coronavirus disease (COVID-19) pandemic lockdowns, less is known about missed mammography screening and its reasons in the later periods of pandemic. In this study it was aimed to find out the rate and the reasons for missed mammography screening, and the associated factors in Turkey during the COVID-19 pandemic.
Material and Method: In this single center, cross-sectional observational study women who underwent mammography screening between September 1st to October 1st 2021 (15 months after the start of the COVID-19 pandemic) were recruited. A questionnaire developed for the purpose of this study was used to assess the participant characteristics, whether a screening mammography has been missed during pandemic and its reasons.
Results: The sample comprised of 144 women with a mean age of 50.2±8.0. Most of the sample were married and had children, 34.0% had chronic diseases. Ninety women (62.5%) misssed a screening mammography in the pandemic. Having equal or less than primary school education was associated with higher delay in mammography screening when compared to being having higher education (OR=2.26, 95%CI= 1.09- 4.69, p=0.027). Fear of COVID-19 transmission (92.2%) was the most common reason for missed mammography screening.
Conclusion: This study firstly demonstrated that most of the women delayed their screening mammography after the lockdown periods in the COVID-19 pandemic in Turkey and having equal or less than primary school education was associated with higher missed screening rates than having higher education levels. Effective solutions are needed to address the reasons for missed mammography screening to reduce breast cancer related morbidity and mortality both for this pandemic and for regular times.

Keywords

Mammography, cancer screening, breast cancer, missed mammography screening, COVID-19 pandemic

References

• Nelson HD, Fu R, Cantor A, Pappas M, Daeges M, Humphrey L. Effectiveness of breast cancer screening: systematic review and meta-analysis to update the 2009 U.S. Preventive Services Task Force Recommendation. Ann Intern Med 2016; 164: 244-55.
• Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed 2020; 91: 157-160. doi:10.23750/abm.v91i1.9397
• Prabhakar AM, Glover M 4th, Schaefer PW, Brink JA. Academic radiology departmental operational strategy related to the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Radiol 2020; 17: 730-33.
• Breast Screening Working Group (WG2) of the COVID-19 and Cancer Global Modelling Consortium, Figueroa JD, Gray E, et al. The impact of the COVID-19 pandemic on breast cancer early detection and screening. Prev Med 2021; 151: 106585.
• Norbash AM, Moore AV Jr, Recht MP, et al. Early-stage radiology volume effects and considerations with the coronavirus disease 2019 (COVID-19) pandemic: adaptations, risks, and lessons learned. J Am Coll Radiol 2020; 17: 1086-95.
• Lang M, Yeung T, Mendoza DP, et al. Imaging volume trends and recovery during the COVID-19 pandemic: a comparative analysis between a large urban academic hospital and its affiliated imaging centers. Acad Radiol 2020; 27: 1353-62.
• Shi J, Giess CS, Martin T, et al. Radiology workload changes during the COVID-19 pandemic: implications for staff redeployment. Acad Radiol 2021; 28: 1-7.
• Yong JH, Mainprize JG, Yaffe MJ, et al. The impact of episodic screening interruption: COVID-19 and population-based cancer screening in Canada. J Med Screen 2021; 28: 100-7.
• Tsai HY, Chang YL, Shen CT, Chung WS, Tsai HJ, Chen FM. Effects of the COVID-19 pandemic on breast cancer screening in Taiwan. Breast 2020; 54: 52-5.
• Nechuta S, Wallace H. Screening and diagnostic mammography utilization during the COVID-19 pandemic: public health implications and future research needs. J Natl Cancer Inst 2021; 113: 1115-7.
• Yılmaz E, Güldoğan N, Arıbal E. The effect of COVID-19 pandemic on breast imaging: a clinical observations. Diagn Interv Radiol 2020; 26: 603.
• Revision of the International Standard Classification of Education (ISCED) https://web.archive.org/web/20130124032233/http://www.uis.unesco.org/Education/Documents/isced-2011-en.pdf
• Ozmen T, Soran A, Ozmen V. Comparison of barriers against mammography screening in socioeconomically very low and very high populations. Cureus. 2016; 8: e690.
• Sabatino SA, Thompson TD, White MC, et al. Cancer screening test receipt - United States, 2018. MMWR Morb Mortal Wkly Rep 2021; 70: 29-35.
• McIntyre A, Brault MW, Sommers BD. Measuring coverage rates in a pandemic: policy and research challenges. JAMA Health Forum 2020; 1: e201278.
• Özmen T, Yüce S, Güler T, et al. Barriers against mammographic screening in a socioeconomically underdeveloped population: a population-based, cross-sectional study. J Breast Health 2016; 12: 72-7.
• Kartal M, Ozcakar N, Hatipoglu S, Tan MN, Guldal AD. Breast cancer risk perceptions of Turkish women attending primary care: a cross-sectional study. BMC Womens Health 2014; 14: 152.
• Viens L, Perin D, Senkomago V, Neri A, Saraiya M. Questions about cervical and breast cancer screening knowledge, practice, and outcomes: a review of demographic and health surveys. J Womens Health (Larchmt) 2017; 26: 403-12.
• Saei Ghare Naz M, Simbar M, Rashidi Fakari F, Ghasemi V. Effects of model-based interventions on breast cancer screening behavior of women: a systematic review. Asian Pac J Cancer Prev 2018; 19: 2031-41.