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Trends in Breast Cancer Screening in a Safety-Net Hospital During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

National estimates project COVID-19 negatively influenced cancer screening, leading to an estimated deficit of 3.9 million breast cancer (BC) screenings among US adults.1,2 In San Francisco, California, low-income neighborhoods disproportionately affected by COVID-19 bear the burden of higher BC stage at diagnosis.3,4 We sought to evaluate the association of COVID-19 and BC screening in a safety-net hospital in San Francisco.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: June 3, 2021.

Published: August 6, 2021. doi:10.1001/jamanetworkopen.2021.19929

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Velazquez AI et al. JAMA Network Open.

Corresponding Author: Ana I. Velazquez, MD, MSc, National Clinician Scholars Program, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 290 Illinois St, Ste 7227, Box 0936, San Francisco, CA 94158 (ana.velazquezmanana@ucsf.edu).

Author Contributions: Drs Velazquez and Dixit had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Velazquez, Gregory, Dixit.

Acquisition, analysis, or interpretation of data: Velazquez, Hayward, Dixit.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Velazquez, Gregory.

Obtained funding: Dixit.

Administrative, technical, or material support: Dixit.

Supervision: Hayward, Dixit.

Conflict of Interest Disclosures: Dr Velazquez reported receiving travel funds from the American Society of Clinical Oncology outside the submitted work, and that an immediate family member is a former employee of Johnson & Johnson Innovation and has stock ownership in Portola Pharmaceuticals, Corbus Pharmaceuticals, and Midatech. Dr Dixit reported financial compensation from Bristol Myers Squibb for participation in an advisory board outside the submitted work. No other disclosures were reported.

Funding/Support: This research was funded by the University of California, San Francisco (UCSF), Helen Diller Comprehensive Cancer Center at UCSF through the San Francisco Cancer Initiative. Dr Velazquez is supported by the UCSF National Clinician Scholars Program and by the National Institute on Aging of the National Institutes of Health (NIH) under award P30AG015272.

Role of the Funder/Sponsor: The Helen Diller Comprehensive Cancer Center had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

References
1.
Mast  C , Munoz del Rio  A . Delayed cancer screenings—a second look. Epic Health Research Network. Accessed March 3, 2021. https://ehrn.org/articles/delayed-cancer-screenings-a-second-look/
2.
Chen  RC , Haynes  K , Du  S , Barron  J , Katz  AJ .  Association of cancer screening deficit in the United States with the COVID-19 pandemic.   JAMA Oncol. 2021;7(6):878-884. doi:10.1001/jamaoncol.2021.0884 PubMedGoogle ScholarCrossref
3.
Guan  A , Lichtensztajn  D , Oh  D ,  et al; San Francisco Cancer Initiative Breast Cancer Task Force.  Breast cancer in San Francisco: disentangling disparities at the neighborhood level.   Cancer Epidemiol Biomarkers Prev. 2019;28(12):1968-1976. doi:10.1158/1055-9965.EPI-19-0799 PubMedGoogle ScholarCrossref
4.
Chamie  G , Marquez  C , Crawford  E ,  et al; CLIAhub Consortium.  SARS-CoV-2 Community transmission disproportionately affects Latinx population during Shelter-in-Place in San Francisco.   Clin Infect Dis. 2020;ciaa1234. Published online August 21, 2020. doi:10.1093/cid/ciaa1234PubMedGoogle Scholar
5.
von Elm  E , Altman  DG , Egger  M , Pocock  SJ , Gøtzsche  PC , Vandenbroucke  JP ; STROBE Initiative.  The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.   Lancet. 2007;370(9596):1453-1457. doi:10.1016/S0140-6736(07)61602-X PubMedGoogle ScholarCrossref
6.
Sprague  BL , Lowry  KP , Miglioretti  DL ,  et al.  Changes in mammography utilization by women’s characteristics during the first 5 months of the COVID-19 pandemic.   J Natl Cancer Inst. 2021;djab045. doi:10.1093/jnci/djab045 PubMedGoogle Scholar
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