Impact of age, race, and family history on COVID-19–related changes in breast cancer screening among the Boston mammography cohort study

Purpose We studied women enrolled in the Boston Mammography Cohort Study to investigate whether subgroups defined by age, race, or family history of breast cancer experienced differences in the incidence of screening or diagnostic imaging rates during the COVID-19 lockdown and had slower rebound in the incidence of these rates during reopening. Methods We compared the incidence of monthly breast cancer screening and diagnostic imaging rates over during the pre-COVID-19 (January 2019–February 2020), lockdown (March–May 2020), and reopening periods (June–December 2020), and tested for differences in the monthly incidence within the same period by age (< 50 vs ≥ 50), race (White vs non-White), and first-degree family history of breast cancer (yes vs no). Results Overall, we observed a decline in breast cancer screening and diagnostic imaging rates over the three time periods (pre-COVID-19, lockdown, and reopening). The monthly incidence of breast cancer screening rates for women age ≥ 50 was 5% higher ( p = 0.005) in the pre-COVID-19 period (January 2019–February 2020) but was 19% lower in the reopening phase (June–December 2020) than that of women aged < 50 ( p < 0.001). White participants had 36% higher monthly incidence of breast cancer diagnostic imaging rates than non-White participants ( p = 0.018). Conclusion The rebound in screening was lower in women age ≥ 50 and lower in non-White women for diagnostic imaging. Careful attention must be paid as the COVID-19 recovery continues to ensure equitable resumption of care.