Breast and Cervical Cancer Screening Rates Dropped Due to the COVID-19 Pandemic

The COVID-19 pandemic was a associated with a large, but temporary decline in breast cancer screening, cervical cancer screening, sexually transmitted infection (STI) screening, long-acting reversible contraception (LARC) insertions, according to a study published in JAMA Health Forum.

In this cross-sectional study, 685,373 women aged 18 to 74 years old (61.7%) were the primary plan holder, with mean zip code per capita income of $33,708, 20.2% mean zip code non-White population, and 3.4% mean zip code non–English-speaking population. The researchers assessed the effects of the COVID-19 pandemic from 2019-2020. The primary outcomes were defined as adjusted odds ratios (AORs) of receiving breast cancer screening, cervical cancer screening, STI screening, LARC insertions, and pharmacy-obtained contraception, adjusted for month, age, county, zip code characteristics.

According to the results, for services requiring an in-person visit (breast cancer screening, cervical cancer screening, STI testing, and LARC insertions), screening use declined by 60% to 90% during the spring of 2020, with a peak period of decline in April 2020, after which utilization for all services recovered to close to 2019 levels by July 2020, the researchers noted.

“In this cross-sectional study of women enrolled in a large US commercial health maintenance organization plan, the COVID-19 pandemic was associated with large but transient declines in rates of breast cancer screening, cervical cancer screening, STI screening, and LARC insertions, and moderate persistent declines in pharmacy-obtained hormonal contraceptives. The overall odds of a woman receiving a given preventive service in 2020 was 20% to 30% lower than 2019. Further research into disparities in access to care and the health outcomes of decreased use of these key health services is warranted,” the researchers wrote in their conclusion.


“This recovery to baseline levels, but not above them, means a group of women missed these services all year. The question is, what will that mean for them over the longer term?” says Nora Becker, M.D., Ph.D., the lead author of the study and a primary care doctor at Michigan Medicine, U-M’s academic medical center via a press release. “We don’t know yet whether they have caught up in 2021, but we will need to keep looking at the data as they become available.”