Morgan M. Millar

Changes in Breast and Cervical Cancer Incidence by Stage at Diagnosis During the COVID‐19 Pandemic in Utah

ABSTRACTPurposeThe COVID‐19 pandemic caused unprecedented disruptions in healthcare access, resulting in significant delays in breast and cervical cancer screening and diagnostic services. This study examined whether there were changes in the stage of diagnosis for breast and cervical cancers diagnosed among Utah women during the pandemic compared to years prior to the pandemic.MethodsPatients included adult females with a new breast or cervical cancer diagnosis reported to the Utah Cancer Registry, diagnosed from January 2020 to December 2021 (pandemic time period) or between January 2018 and December 2019 (pre‐COVID‐19). We calculated age‐adjusted incidence rates and incidence rate ratios (IRRs) with 95% confidence intervals (CI) to compare stage at diagnosis and sociodemographic factors between time periods.ResultsA total of 308 cervical cancer cases and 8215 breast cancer cases were diagnosed throughout the duration of the study. Overall incidence of cervical cancer was higher during the pandemic, driven primarily by distant‐stage disease incidence, which was more than three times higher than before the pandemic (IRR, 3.11; 95% CI, 1.67–5.79). Non‐Hispanic (NH) White women were significantly more likely to be diagnosed with late‐stage cervical cancer (IRR, 1.60; 95% CI, 1.12‐2.30) during the pandemic compared to pre‐pandemic. Local‐stage breast cancer incidence decreased slightly during the pandemic compared to pre‐pandemic (IRR, 0.93; 95% CI, 0.88–0.99). Hispanic women saw a slight increase in late‐stage breast cancer incidence during the pandemic compared to before the pandemic (IRR, 1.31; 95% CI, 1.03–1.67).ConclusionsWe saw a significant increase in the incidence of late‐stage cervical cancer during the pandemic compared with pre‐pandemic. Conversely, while local‐stage breast cancer incidence was slightly lower during COVID‐19 compared with pre‐COVID‐19, no difference was observed among all other stages. More time is needed to assess the full impact of COVID‐19 on breast and cervical cancer trends.

Adherence to Guideline‐Recommended cancer screening among Utah cancer survivors

AbstractBackgroundAdherence to cancer screening is important for cancer survivors because they are at high risk of subsequent cancer diagnoses or recurrence. We assessed adherence to breast, cervical, and colorectal cancer‐(CRC)‐screening guidelines and evaluated demographic disparities among a population‐based sample of survivors.MethodsA representative sample of Utah survivors diagnosed from 2012–2018 with any reportable invasive cancer was selected from central cancer registry records for a survey about survivorship needs. We estimated the proportion of eligible survivors adhering to U.S. Preventive Services Task Force screening guidelines and calculated risk ratios and 95% confidence intervals. Analyses were age‐adjusted and weighted to account for sample design and nonresponse.ResultsAnd 1421 survivors completed the survey (57.2% response rate). Screening adherence was 74.4% for breast, 69.4% for cervical, and 79.7% for CRC. Rural residents were more likely to adhere to breast cancer screening than urban residents (86.1% vs. 72.7%; adjusted RR = 1.19, CI = 1.05, 1.36). Higher educational attainment was associated with increased adherence to cervical and colorectal cancer screening. Younger age was associated with greater adherence to cervical cancer screening (p = 0.006) but lower adherence to CRC screening (p = 0.003). CRC screening adherence was lower among the uninsured and those without a primary care provider (45.6%) compared to those with a regular provider (83.0%; adjusted RR = 0.57, CI = 0.42, 0.79).ConclusionsSurveys based on samples from central cancer registries can provide population estimates to inform cancer control. Findings demonstrate work is needed to ensure all Utah cancer survivors obtain recommended cancer screenings. Efforts should focus particularly on increasing uptake of breast and cervical cancer screening and reducing demographic disparities in CRC screening.PrecisDespite high risk for subsequent cancer diagnosis, Utah cancer survivors are not all obtaining recommended breast, cervical, and colorectal cancer screenings. This presents a significant healthcare gap.