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The impact of episodic screening interruption: COVID-19 and population-based cancer screening in Canada
Open accessAbstract
Background: Population-based cancer screening can reduce cancer burden but was interrupted temporarily due to the COVID-19 pandemic. We estimated the long-term clinical impact of breast and colorectal cancer screening interruptions in Canada using a validated mathematical model. Methods: We used the OncoSim breast and colorectal cancers microsimulation models to explore scenarios of primary screening stops for 3, 6, and 12 months followed by 6–24-month transition periods of reduced screening volumes. For breast cancer, we estimated changes in cancer incidence over time, additional advanced-stage cases diagnosed, and excess cancer deaths in 2020–2029. For colorectal cancer, we estimated changes in cancer incidence over time, undiagnosed advanced adenomas and colorectal cancers in 2020, and lifetime excess cancer incidence and deaths. Results: Our simulations projected a surge of cancer cases when screening resumes. For breast cancer screening, a three-month interruption could increase cases diagnosed at advanced stages (310 more) and cancer deaths (110 more) in 2020–2029. A six-month interruption could lead to 670 extra advanced cancers and 250 additional cancer deaths. For colorectal cancers, a six-month suspension of primary screening could increase cancer incidence by 2200 cases with 960 more cancer deaths over the lifetime. Longer interruptions, and reduced volumes when screening resumes, would further increase excess cancer deaths. Conclusions: Interruptions in cancer screening will lead to additional cancer deaths, additional advanced cancers diagnosed, and a surge in demand for downstream resources when screening resumes. An effective strategy is needed to minimize potential harm to people who missed their screening.
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“It is also important to note that recruitment for this study was conducted during the second and third waves of the COVID-19 pandemic [81]. Because of the impact that the pandemic had on the health care system (e.g., postponement of certain tests), this may have temporarily increased the participants’ anxiety about their medical condition [82, 83].”
From Fear of cancer recurrence in breast cancer survivors carrying a BRCA1 or 2 genetic mutation : a cross-sectional study (2024) · cites this paper as [83]
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Worthington, J., Sun, Z., Fu, R., Lew, J., Chan, K., Li, Q., Eskander, A. E., Hui, H., McLoughlin, K. G., Caruana, M., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0296945 · Cited by 10
Self-citationBarriers to Screening At-risk Populations in Canada
Cao, D. J., Alabousi, M., Farshait, N., & Patlas, M. N. (2022) · Canadian Association of Radiologists Journal · doi:10.1177/08465371221147307 · Cited by 8
Calpbinici, P., & Öztoprak, P. U. (2023) · Indian Journal of Gynecologic Oncology · doi:10.1007/s40944-023-00719-3 · Cited by 8
Achimaș-Cădariu, P. (2022) · Sustainable development goals series · doi:10.1007/978-3-030-96053-7_12 · Cited by 8
Peacock, H. M., van Walle, L., Silversmit, G., Neven, P., Han, S., & Damme, N. V. (2024) · Archives of Public Health · doi:10.1186/s13690-024-01296-3 · Cited by 7
Recovery of Screening Mammogram Cancellations During COVID-19
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Baxter, N. N., Facey, M., Ruco, A., Baker, N. A., Sorvari, A. M., Benmessaoud, A., Dube, C., Rabeneck, L., & Tinmouth, J. (2022) · BMJ Open Gastroenterology · doi:10.1136/bmjgast-2021-000826 · Cited by 9
Farah, E., Bizri, M. E., Day, R., Matai, L., Horne, F., Hanna, T. P., Armstrong, D., Marlin, S., Jérôme, O., Brenner, D. R., et al. (2022) · Current Oncology · doi:10.3390/curroncol29030143 · Cited by 8
Self-citationMoterani, N. J. W., Moterani, V. C., Moterani, L. B. B. G., Pimentel, F. F., & dos Reis, F. J. C. (2022) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.20220182 · Cited by 7
Mak, V. P., White, K. K. L., Wilkens, L. R., Cheng, I. C., Haiman, C. A., & Marchand, L. L. (2023) · eLife · doi:10.7554/elife.86562 · Cited by 7
Schiaffino, S., Pinker, K., Cozzi, A., Magni, V., Athanasiou, A., Baltzer, P., Herrero, J. C., Clauser, P., Fallenberg, E. M., Forrai, G., et al. (2023) · Insights into Imaging · doi:10.1186/s13244-023-01453-2 · Cited by 7
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Carvalho, A. V., Barroso, V. F. L., Baeta, C. C. L., Soares, A. N., & Drummond‐Lage, A. P. (2024) · Psychology Health & Medicine · doi:10.1080/13548506.2024.2422113 · Cited by 6
Mason, H. S., Friedrich, A.-K. U., Niakan, S., Jacobbe, D. L., Casaubon, J. T., & Coulter, A. M. P. (2022) · European Journal of Breast Health · doi:10.4274/ejbh.galenos.2022.2022-4-4 · Cited by 6
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Steer, K. J. D., Sun, Z., Sadowski, D. C., Yong, J. H. E., Coldman, A. J., Nemecek, N., & Yang, H. (2023) · Journal of Medical Screening · doi:10.1177/09691413231202877 · Cited by 5
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Self-citationExamining the impact of COVID-19 disruptions on population-based breast cancer screening in Ireland
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Metadata
- Authors
- Yong, J. H., Mainprize, J. G., Yaffe, M. J., Ruan, Y., Poirier, A. E., Coldman, A., Nadeau, C., Iragorri, N., Hilsden, R. J., & Brenner, D. R.
- Affiliations
- Independent Consultant, Toronto, Canada
- Sunnybrook Hospital (CA)
- University of Toronto (CA)
- Alberta Health Services (CA)
- British Columbia Cancer Research, Vancouver, Canada
- Statistics Canada (CA)
- Corresponding author
- Yaffe, Martin J
- ORCID
- Venue
- Journal of Medical Screening
- Publisher
- SAGE Publications
- Published
- 2020-11-26
- Volume
- 28
- Issue
- 2
- Pages
- 100-107
- ISSN
- 0969-1413 (ISSN-L)
- 1475-5793
- PMC
- PMC7691762
- OpenAlex
- W3108766839
- Cited by
- 187
- References
- 12
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 29 · 2023: 45 · 2022: 63 · 2021: 30 · 2020: 1
- FWCI
- 12.54
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Medical Screening (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Keywords
- COVID-19 pandemic, breast cancer screening, colorectal cancer screening, mass screening, advanced cancer, cancer incidence, cancer mortality, missed screening, Canada
- MeSH terms
- COVID-19, Breast Neoplasms, Canada, Female, Humans, Male, Colorectal Neoplasms, Incidence, Early Detection of Cancer
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.