Excess breast cancer deaths after COVID-19
Contraception for patients with medical conditions
Puzzling Over the Hurt Down-Under
Serious Mental Illness and Contraception
New 13-Cycle Vaginal Contraceptive System
The Future of Family Planning in Post-COVID America
New ASCCP Guidelines: Implications for FP
On the alert: mood disorders during 2020 stressors
Challenges old and new during the pandemic
Reproductive health in the time of Covid-19
Missed Pills: The Problem That Hasn’t Gone Away
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Digital Family Planning: the Future is Now
Irregular Bleeding Due to Contraceptives
Ouch! Best approaches to menstrual pain
Contraceptive efficacy: understanding how user and method characteristics play their part
Strategizing treatment for chronic heavy menstrual bleeding
Untangling the literature on obesity and contraception
High tech apps for no-tech FABM
Menstrual exacerbation of other medical conditions
From Princeton University: Thomas James Trussell (1949-2018)
The Short and Long of IUD Use Duration
Selecting a Method When Guidance Isn’t Clear-cut
Healthcare in the Time of Digital Expansion
The Scoop on Two New FDA-Approved Contraceptive Methods
Pregnancy of unknown location—meeting the challenge
Big “yes” (with caveats) to CHCs during perimenopause
The role of IUDs (LNG IUDs, too!) in emergency contraception
Combined pills’ effect on mood disorders
Abortion in the U.S.: safe, declining, and under threat
Hope for ovarian cancer screening test
Breast cancer still a small risk with some hormonal contraceptives
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PMDD: Genetic clues may lead to improved treatment
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Latest Data on Contraceptive Use in the United States
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Emergency Contraceptive Pill Efficacy and BMI/Body Weight
Handout on Unintended Pregnancy and Contraceptive Choice
Ask About Withdrawal (Really!)
Rules to Practice By: Safety First and Cleanliness is Close to. . .
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Applying the “New” Cervical Cytology Guidelines in Your Practice
Acute Excessive Uterine Bleeding: New Management Strategies
Medical indications for IUD use in teens
July 2021
Over the next 10 years, the delay in screening, in conjunction with a delay in diagnostic tests, may result in a significant 1% increase in deaths due to related cancers, NCI director Norman Shipman wrote in a recent Science editorial.[1] By 2030, according to modeling figures, we may expect an additional 10,000 deaths due to the breast and colon cancers. This figure does not account for other cancer types or added health problems due to upstaging.
CREDIT: (GRAPH) V. ALTOUNIAN/SCIENCE; (DATA) NATIONAL CANCER INSTITUTE
The pandemic especially affected screening rates in April 2020, when the CDC’s Early Detection Program showed an 87% decrease in breast cancer screening and 84% in cervical cancer screening.[2] The recommendations to stay home, fear over contracting COVID-19, and closure or suspension of screening services were posited as factors. As the year wore on, screenings ticked up some, but remained below pre-pandemic levels.
A study in Washington State compared the number of screening mammograms during April to December 2019 to the same time frame in 2020. In the study of 230 clinics and 8 hospitals, there was at an overall 49% decrease in screenings (55,678 screenings in 2019 vs 27522 in 2020).[3] More substantial declines appeared across certain racial and ethnic subgroups:
- Hispanic: 64%
- Native American/Alaska Native: 61%
- Mixed race: 56%
- Native Hawaiian/Pacific Islander: 54%
- Asian 54%
- Black 54%
- Rural 59%
- Urban 50%
The plunge in screening occurred on top of mammography screening rates were not stellar to begin with prior to the pandemic. In 2019, only 77% of women in the highest risk age category (50-74 years) reported having had a mammogram within the past 2 years. Rates dipped even lower among women in that age group who had less than a high school education (69%) or were at 200% below the poverty level (68%).[4] So when 2020 cut those mammogram screenings by half…well, you do the math.
[1] Sharpless NE. COVID-19 and cancer. Science 2020;368:1290 https://science.sciencemag.org/content/368/6497/1290
[2] Centers for Disease Control and Prevention. Sharp declines in breast andcervical cancer screening. Press release June 30, 2021. https://www.cdc.gov/media/releases/2021/p0630-cancer-screenings.html
[3] Amram O, Robison J, Amiri S, et al. Socioeconomic and racial inequities in breast cancer screening during the Covid-19 pandemic in Washington State. Research letter. JAMA NetWork Open 2021;4: e2110946. doi:10.1001 amram_2021_ld_210090_1620747010.03984
[4] National Cancer Institute. Cancer trends progress report. Data updated July 2021 https://progressreport.cancer.gov/detection/breast_cancer