Vaidya, Jayant;
Aquilina, Rachel;
Varghese, Jajini;
(2024)
During COVID-19, the NHSBSP pause in London reduced overdiagnosis, did not increase radical surgery and maintained 3-year survival at pre-COVID rates.
Presented at: British Association of Surgical Oncology and Association of Cancer Surgeons Annual Conference, London, UK.
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BASO POSTER - During COVID-19, the NHSBSP pause in London reduced overdiagnosis, did not increase radical surgery and maintained 3-year survival at pre-COVID rates (1) copy.pdf - Submitted Version Download (382kB) | Preview |
Abstract
Introduction: The NHS breast screening programme (NHSBSP) paused during COVID-19, potentially impacting presentation and survival. Methods: We analysed referral source of all breast cancer patients diag- nosed at two London hospitals from 2019 to 2021. Using routinely collected hospital data, we compared tumour characteristics, treatments and survival during pre-COVID and COVID era (Apr-Aug+Oct of 2019 vs 2020) using chi-square tests, and Kaplan-Meier estimates. Registered as local audit. / Results: Overall (n1⁄43353), there were 31% fewer patients in 2020 compared with 2019 (886 vs 1281, p1⁄40.002), due to fewer screen-detected (851 vs 398) rather than symptomatic cases (432 vs 459), p<0.00001); there was no corresponding increase during 2021 (n1⁄41186) In the detailed analysis (n1⁄4325), in 2020 vs 2019, there were significantly fewer grade 1 cancers (11/120 vs 37/204, p1⁄40.028) with no corresponding increase in numbers of grade 2 or 3 (109 vs 167). There were fewer T1 (41/ 121 vs 85/204) and node negative tumours (69/115 vs 123/200), but no increase in >T1 (80/121 vs 119/204) or node positive cases (46/115 vs 77/ 200), both p>0.05. There were fewer operations (113 vs 197); fewer breast conservations (81/ 113 vs 134/196) but no increase in mastectomies (32/113 vs 56/196) or axillary clearances (34/114 vs 54/174), all p>0.05. The median follow up was 3.8 years; K-M survival curves overlapped; 3-year survival: 90.5% vs 91.7%, HR1⁄41.09, p1⁄40.83. / Conclusion: During the COVID-19-induced NHSBSP pause, good-prog- nosis cancers reduced without increasing worse-prognosis cancers or more extensive surgery, and 3-year survival remained unchanged: sug- gesting that pausing NHSBSP avoided overdiagnosis without causing harm.
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