Aquilina, Rachel;
Varghese, Jajini;
Vaidya, Jayant S;
(2023)
Pausing NHSBSP during COVID-19 did not increase advanced cancers and may have avoided overdiagnosis.
Presented at: Annual Scientific Meeting of the Surgical Research Society 2023, Nottingham, UK.
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BASO POSTER - During COVID-19, the NHSBSP pause in London reduced overdiagnosis, did not increase radical surgery and maintained 3-year survival at pre-COVID rates (1) copy.pdf - Submitted Version Download (382kB) | Preview |
Abstract
Introduction: We ascertained the impact of the paused NHS breast cancer screening programme (NHSBSP) during COVID-19 on number and presentation of breast cancer patients. / Methods: We analysed, breast cancer patients diagnosed across 2 large London NHS trust hospitals in sets: the referral source and numbers in all patients from 2019 to 2021 (n=3,353), and patient/tumour characteristics and treatments received during 6 selected months in 2019 and 2020 (n=318). We analysed proportions using chi-square test. / Results: Overall, there were 31% fewer patients in 2020 compared with 2019 (1281 vs 886, p=0.002). However, there was no corresponding increase in the number of patients during 2021 (n=1186). The reduction was mainly due to fewer referrals from NHSBSP rather than from GPs (53% reduction vs 13%, p<0.00001). In 2020 vs 2019, there were fewer grade 1 (35 vs 9) and node negative tumours (143 vs 72), without a corresponding increase in grade 2 or 3 (159 vs 104), or node positive cases (54 vs 49); also fewer T1 cases (84 to 37) without a corresponding increase in >T1 cases (113 vs 84); reduced breast conservations (111 vs 71) and negative sentinel nodes (114 vs 69), without increase in mastectomies (35 vs 25) or axillary clearances (32 vs 27). There were no receptor status changes. / Conclusion: The COVID-19 pause in NHSBSP avoided diagnosis of good prognosis cancers without rapid increase in worse prognosis cancers or more extensive surgery, suggesting that it may have simply avoided overdiagnosis.
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