The impact of the COVID-19 pandemic on attendance and diagnostic outcomes at BreastScreen Western Sydney, Australia Impact of COVID-19 on breastscreen western sydney

Katelin Yarde (1), Tessa Hunt (2), Kerry Hitos (3), Aswin Shanmugalingam (4), Nicholas Ngui (5), Nirmala Pathmanathan (6), Meagan E Brennan (7)
(1) National School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia, Australia,
(2) National School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia, Australia,
(3) Westmead Research Centre for Evaluation of Surgical Outcomes, Department of Surgery, Westmead Hospital, Westmead, NSW, Australia; Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia, Australia,
(4) Department of Surgery, Westmead Hospital, Westmead, NSW, Australia, Australia,
(5) Department of Surgery, Blacktown/ Mt Druitt Hospitals, NSW, Australia , Australia,
(6) Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia, Australia,
(7) National School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia; Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia, Australia

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Issue
Vol. 12 No. 3 (2025): In-Press, August 2025
Keywords:
    malignant neoplasm of breast, early diagnosis of cancer, cancer screening, covid-19 pandemic, public health
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Abstract

Background: BreastScreen, Australia’s population screening program, was disrupted by the COVID-19 pandemic. This study examined the pandemic’s effect on attendance and assessment outcome data to inform service planning for the recovery period.


Methods: BreastScreen Western Sydney data from ‘pre-COVID’ (2018 and 2019) versus ‘COVID-affected’ years (2020 and 2021) were analysed. Number of screens, recall rate, sociodemographic data of clients, imaging and pathological features of malignancies analysed.


Results: During the four year study period, COVID-affected years demonstrated an 18.8% reduction in screening episodes (77,510 vs 95,467, P<0.001) and 16.3% reduction in malignancies (512 vs 612, P=0.49) compared to pre-COVID years. The cancer detection rate (cancers detected per 10,000 screens) remained similar (52.8 vs 52.3 per 10,000 screens for invasive cancer, P=0.89 and 66.1 vs 64.1 for all malignancy, P=0.62), and recall rate was lower (4.2% vs 4.8% P<0.001). Younger women and first-time screeners were less likely to attend during COVID. There was no significant difference in the proportion of DCIS vs invasive cancers (20.1% vs 18.5%, P=0.48), the mean invasive tumour size (18.7mm vs 17.8, P=0.37), or size of DCIS (46.4 vs 21.8, P=0.11) between COVID-affected and pre-COVID years.


Conclusion: There was an expected reduction in the number of screens and cancers detected during COVID, without a change in tumour size or cancer detection rate. Younger women should be targeted for catch-up screening. Services should plan for the 19% of the screening cohort that failed to attend during the pandemic as they may present with later-stage cancers.

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Authors

Katelin Yarde
National School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia
Tessa Hunt
National School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia
https://orcid.org/0009-0005-7581-8645
Kerry Hitos
Westmead Research Centre for Evaluation of Surgical Outcomes, Department of Surgery, Westmead Hospital, Westmead, NSW, Australia; Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia
https://orcid.org/0000-0002-6604-6218
Aswin Shanmugalingam
Department of Surgery, Westmead Hospital, Westmead, NSW, Australia
https://orcid.org/0000-0002-8956-873X
Nicholas Ngui
Department of Surgery, Blacktown/ Mt Druitt Hospitals, NSW, Australia
https://orcid.org/0000-0002-9674-4404
Nirmala Pathmanathan
Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia
https://orcid.org/0000-0001-9225-139X
Meagan E Brennan
National School of Medicine, The University of Notre Dame, Darlinghurst, NSW, Australia; Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia
https://orcid.org/0000-0002-3281-7643
meagan.brennan@health.nsw.gov.au (Primary Contact)
1.
Yarde K, Hunt T, Hitos K, Shanmugalingam A, Ngui N, Pathmanathan N, Brennan ME. The impact of the COVID-19 pandemic on attendance and diagnostic outcomes at BreastScreen Western Sydney, Australia : Impact of COVID-19 on breastscreen western sydney. Arch Breast Cancer [Internet]. [cited 2025 Jun. 1];12(3). Available from: https://www.archbreastcancer.com/index.php/abc/article/view/1105
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