How did the COVID-19 Pandemic impact self-reported cancer screening rates in 12 Midwestern states?
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Abstract
Objective: In the early months of the COVID-19 pandemic, the U.S. healthcare system reallocated resources to emergency response and mitigation. This reallocation impacted essential healthcare services, including cancer screenings. Methods: To examine how the pandemic impacted cancer screenings at the population-level, this study analyzes 2018 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate the change in the proportion of eligible adults reporting a recent cancer screen (mammogram, pap smear, colon/sigmoidoscopy, blood stool test). All analyses accounted for response rates and sampling weights, then explored differences by gender and rurality across 12 Midwestern states. Results: We found that the proportion of adult women completing a mammogram declined across all states (-0.9% to -18.1%). The change in colon/sigmoidoscopies, pap smears, and blood stool tests were mixed, ranging from a 9.7% decline in pap smears to a 7.1% increase in blood stool tests. Declines varied considerably between states and within states by gender or metro/urban/rural status. Conclusions: The COVID-19 pandemic led to delayed breast, cervical, and colorectal cancer detection services. Policymakers should aim to advance cancer control efforts by implementing targeted screening initiatives.
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SciScore for 10.1101/2022.04.13.22273837: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable Subgroup analyses examine differences by gender (male, female) and region (metro, urban, rural) across each Midwestern state. Randomization Each year, BRFSS queries a random sample of adults to represent health risks and behaviors of the U.S. population. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources The analysis was performed in STATA v. 17. STATAsuggested: (Stata, RRID:SCR_012763)Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations: This study is not without its …
SciScore for 10.1101/2022.04.13.22273837: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable Subgroup analyses examine differences by gender (male, female) and region (metro, urban, rural) across each Midwestern state. Randomization Each year, BRFSS queries a random sample of adults to represent health risks and behaviors of the U.S. population. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources The analysis was performed in STATA v. 17. STATAsuggested: (Stata, RRID:SCR_012763)Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations: This study is not without its limitations. First, the experience of adults in 12 Midwestern states may not generalize to other U.S. states or census regions. Moreover, while the Midwestern states provided interesting data for examining differences by metro/urban/rural status, the region is less diverse from a racial/ethnic perspective (at least in the BRFSS data). The small sample size of adults identifying as a race or ethnicity other than non-Hispanic White would yield unstable estimates and unreliable or nonrepresentative sample weights. Future research should investigate how cancer screening rates may have differentially changed by race/ethnic identity. Another limitation stems from the outcome of interest: having complete a cancer screen in the past 12 months, and the timing of survey. Adults in the exposure group (2020-Q4) reporting a recent cancer screen could have completed the screen anytime between October 1st, 2019 to December 30th, 2020. If the screening was completed in 2019, we may be underestimating the decline in screening rates for 2020. We also have no way to know if these recent cancer screens were completed during the end of 2020 and may therefore be missing a signal of “return to screening” behavior. As new data emerge, future research should continue to survey how screening rates evolve over time. Unfortunately, among all population-based survey data, BRFSS provides the most comprehensive cancer screening data, but the cancer module is only ...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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