Women now face more delays in having their abnormal screening mammogram evaluated since the COVID-19 pandemic, according to research published April 17 in Academic Radiology. 

Follow-up delays have worsened each year following the pandemic’s onset and certain women are more at risk of experiencing diagnostic delays, wrote a team led by Eniola Oluyemi, MD, from Johns Hopkins University in Baltimore.  

“Evaluation of targeted interventions to provide support to subpopulations at higher risk for persistent, delayed follow-up may be beneficial,” the Oluyemi team wrote. 

The COVID-19 pandemic forced the temporary closure of many routine health screening services, including mammography screening for breast cancer. Prior research suggests that screening mammography rates rebounded after this pause, but not as much for Asian and Hispanic women. More research showed that the decline in mammography use had not returned to pre-pandemic levels by 2021, with Asian women, older women, and facilities affiliated with academic medical centers being disproportionately affected.  

Oluyemi and colleagues studied trends in timely diagnostic evaluation for women after they receive an abnormal screening mammogram in the years following the pandemic. They compared the results to the pre-pandemic year. The researchers also explored potential associations between patient-level factors and delayed diagnostic follow-up. 

They included 15,814 mammograms with a BI-RADS 0 assessment performed between 2019 and 2023. The women included had an average age of 55 years.  

While 88.8% of women in 2019 underwent diagnostic evaluation within 30 days of an abnormal mammogram, this dipped to 55.4% in 2022. This rate increased to 63.3% in 2023 (p

The researchers also identified the following subgroups that were more at risk of not following up within 90 days of an abnormal mammogram during the study period: age of 50 to 59 years (relative risk [RR]: 1.25), being unemployed (RR: 1.18), single (RR: 1.27), Asian/Pacific Islander (RR: 1.37), Black (RR: 1.69), and women with a neighborhood area deprivation index in the highest quintile (RR: 1.29). 

The results show how continued research is needed to study effective interventions that aim to help reduce these disparities, the study authors highlighted. 

“There is a need for research evaluating the implementation of previously studied interventions particularly in the current post-pandemic era, as well as additional research investigating more cost-effective and sustainable ways of addressing disparities in diagnostic follow-up timeliness,” they added. 

Read the full study here.