With financial support from Pink Ribbon, Belgian Cancer Registry (BCR) in collaboration with breast cancer experts evaluated the impact of the 2020 COVID-19 pandemic on breast cancer diagnosis and treatment in Belgium.
This study used standard cancer registry data supplemented with administrative data from insurance institutions obtained by the InterMutualist Agency (IMA). In addition, BCR, together with 11 participating hospitals, manually searched pathology reports for individual data on the exact dimensions of the breast tumour and the number of affected lymph nodes.
Compared with trends from 2015 to 2019, there were 5% fewer diagnoses of invasive breast cancer in 2020 than would have been expected. This is due to a 23% decrease during the first COVID wave (March-June) followed by a 7% increase in diagnoses is July to December. The largest decreases in incidence of all breast cancers (invasive and in situ) were found in patients aged 50-69 (-4.1%) and 70+ (-8.4%). The decreases were most pronounced for stage 0 (in situ) and stage I breast cancer tumours in March-June 2020, likely mainly due to the temporary cessation of population screening for breast cancer. Reassuringly, no increase in stage II-IV tumours was found in the second half of the year.
Diagnostic and treatment procedures for breast cancer patients were largely unchanged in 2020 compared to the previous 5 years. There was no increase in average waiting time before starting treatment, even a decrease in waiting time for some treatments. There was increased use of anti-hormonal therapy prior to surgery in patients with stage I-II breast cancer, to safely delay surgery. But at the time of surgery, tumours in 2020 were not larger or with more affected lymph nodes than in the previous year. Also, the distributions of type of surgery - mastectomy or breast-conserving surgery - were not changed in 2020.
The detailed study was published in the peer-reviewed journal Archives of Public Health and is free to read . Breast cancer incidence, stage distribution, and treatment shifts during the 2020 COVID-19 pandemic: a nationwide population-level study | Archives of Public Health | Full Text (biomedcentral.com)
Peacock, H.M., van Walle, L., Silversmit, G. et al. Breast cancer incidence, stage distribution, and treatment shifts during the 2020 COVID-19 pandemic: a nationwide population-level study. Arch Public Health 82, 66 (2024). https://doi.org/10.1186/s13690-024-01296-3