Breast cancer is the second leading cause of death for women in the United States. Yet breast cancer doesn’t impact all communities in the same way. Despite having similar rates of breast cancer, Black women in the United States are more likely than white women to die of the disease, due to a range of social, economic, political and environmental factors that contribute to an individuals’ health conditions and disparities. COVID-19 also has wreaked havoc on cancer detection and further compounded these disparities, creating a “COVID cancer effect.”
Fear of the virus kept many out of doctor’s offices and hospitals during the pandemic, leading to widespread postponement of screenings, surgeries and routine care. It is estimated that almost 10 million people skipped cancer screenings between March and May of 2020, and many more in subsequent waves. The pandemic also exacerbated factors that impact motivation or ability to seek cancer screening and treatment in underserved populations, such as limited transportation options or fear of losing a paycheck for missed work time. It is estimated that as a result of COVID-19, screenings for cancers of the breast, colon and cervix dropped by 94%, 86% and 94% respectively between Jan. 20, 2020, and April 21, 2020.
At the Brem Foundation to Defeat Breast Cancer we’re using a combination of education, access programs and advocacy in the DMV area to help women advocate for their own health and to increase access to essential screening and diagnostic services, many of which are out of reach for low-income populations. Our “Wheels for Women” partnership with Lyft is the country’s first and only free transportation program dedicated exclusively to breast cancer screening and diagnostics. Started in D.C. and now operating in Baltimore, the program opens doors for women to get the care they need and deserve — building upon close partnerships with patient navigators at local medical partners, to identify patients in need and arrange rides, so that transportation is not a barrier to care.
Through our “B-fund” program, Brem partners with local breast imaging centers and community medical providers to identify gaps and provide funding for breast diagnostic tests for women who cannot meet the costs on their own — fighting for every woman to get the care she needs and deserves, regardless of her ability to pay. Such creative, proactive efforts are needed to address the complex challenges we face in cancer screening today.
In February, as part of the reignited Cancer Moonshot, President Biden and first lady Jill Biden announced a call to action on cancer screening to jump-start progress on the 10 million missed screenings due to the pandemic, and to work to ensure that all Americans equitably benefit from existing tools to prevent, detect, and diagnose cancer. This prioritization of screening at the federal level is indeed an encouraging step. We’ve learned over the last twenty years that early detection of breast cancer, particularly when it’s small and has not spread, saves lives. It is much easier to treat successfully. Screening could substantially reduce cancer incidence and mortality rates in patients.
Proactive, creative collaboration among government, corporations, the health care community and the nonprofit sector is needed immediately. The American Cancer Society estimates that this year approximately 287,850 new cases of invasive breast cancer will be diagnosed in women, and, of these, 43,250 women will die. While we don’t know the full extent, pandemic related reductions in screening could result in thousands of additional deaths from breast cancer in the next 10 years. Just how significant the impact will be is dependent on how quickly stakeholders pivot and work across disciplines to find creative solutions to ensure patients, providers and health systems have the tools and means necessary to make up for the COVID cancer effect and make screening a top priority, particularly for our most underrepresented communities. We simply do not have time to waste.
Clare Dougherty (clare@bremfoundation.org) is CEO if the Brem Foundation to Defeat Breast Cancer, located in Silver Spring.