Patients characteristics related to screening mammography cancellation and rescheduling rates during the COVID-19 pandemic

Purpose: To identify patient characteristics associated with screening mammography cancellations and rescheduling during the COVID-19 pandemic. Methods: Scheduled screening mammograms during three time periods were retrospectively reviewed: state mandated shutdown (3/17/2020-6/16/2020) during which screening mammography was cancelled, a period of 2 months immediately after screening mammography resumed (6/17/2020-8/16/2020), and a representative period prior to COVID-19 (6/17/2019-8/16/2019). Relative risk of cancellation before COVID-19 and after reopening was compared for age, race/ethnicity, insurance, history of chronic disease, and exam location, controlling for other collected variables. Risk of failure to reschedule was similarly compared between all 3 time periods. Results: Overall cancellation rate after reopening was higher than before shutdown (7663/16595, 46% vs 5807/ 15792, 37%; p < 0.001). Relative risk of cancellation after reopening increased with age (1.20 vs 1.27 vs 1.36 for ages at 25th, 50th, and 75th quartile or 53, 61, and 70 years, respectively, p < 0.001). Relative risk of cancellation was also higher among Medicare patients (1.41) compared to Medicaid and those with other providers (1.26 and 1.21, respectively, p < 0.001) and non-whites compared to whites (1.34 vs 1.25, p = 0.03). Rescheduling rate during shutdown was higher than before COVID-19 and after reopening for all patients (10,658/13593, 78%, 3569/5807, 61%, and 4243/7663, respectively, 55%, p < 0.001). Relative risk of failure to reschedule missed mammogram was higher in hospitals compared to outpatient settings both during shutdown and after reopening (0.62 vs 0.54, p = 0.005 and 1.29 vs 1.03, p < 0.001, respectively). Conclusion: Minority race/ethnicity, Medicare insurance, and advanced age were associated with increased risk of screening mammogram cancellation during COVID-19.

Automated summary

During the COVID-19 pandemic, patients of minority race/ethnicity, with Medicare insurance, and of advanced age were more likely to cancel screening mammograms. The risk of failing to reschedule missed mammograms was higher in hospital settings compared to outpatient settings.