Impact of the COVID-19 pandemic on breast cancer referrals and diagnoses in 2020 and 2021: a population-based study in England

Significant concerns have been raised about the impact of COVID-19 on the delivery of NHS cancer service. This report compares breast cancer service referral and treatment activity in 2020 and 2021, compared to those in 2019 (pre-pandemic). Data were extracted from the Cancer Waiting Times data set and the COVID-19 Cancer Equity Data Packs. Compared to 2019, there was 33% fewer urgent and 40% fewer routine referrals in the first half of 2020. Urgent referral activity had returned to usual level s by August 2020 and by the first half of 2021, the volume of urgent referral was 10% higher when compared to 2019. The volume of routine referrals remained 16% fewer however. Compared to 2019, there were 16% fewer first treatments for breast cancer in the first half of 2020. There were 19% fewer treatments in the second half of 2020, and only 3% fewer treatments in the first half of 2021. The monthly number of first treatments recovered by December 2020, with the slowest recovery seen in patients aged 50-69 years (population-based screening age group). This reduction in the number of first treatments suggest that there may be approximately 9500 ‘missing’ breast cancer diagnoses since the start of 2020 due to the pandemic. Half of these are likely to be due to reduced screening activity (March to September 2020), and remainder due to the reduction in the number of referral.

Classifications: Screening & Diagnosis

Keywords: COVID-19