Breast Cancer Awareness Month: Knock-on effects of Covid pandemic on screening cannot be allowed to linger – Dr Gwenetta Curry

October is Breast Cancer Awareness Month and with it comes a reminder to everyone to see their physicians for screenings when prompted.

Breast cancer survivors highlight the importance of awareness of the symptoms (Picture: Matt Alexander/PA)

Also, it is important to see your physician if you feel you are experiencing symptoms. According to the NHS, breast cancer symptoms include: a new lump or thickening of tissue, a change in the size and shape of your breast, discharge fluid from nipples, a lump or swelling under armpit, change in the look of the skin, a rash or puckering, redness and crusting like eczema around the nipple, and change in the nipple.

The data clearly demonstrates that early detection increases your chances of survival. When breast cancer is diagnosed in its early stages, survival rates increase, with almost 98 per cent surviving for five years or more, compared to one in four people surviving when there is a late diagnosis.

Breast screening programmes were paused in March 2020 during the Covid lockdown, and it is estimated that 8,600 women who were caught up in the backlog could have been living with undetected breast cancer. Overall there was a 51 per cent decrease in breast cancer diagnosis during the pandemic. One of the main factors driving late detection was due to people’s fear of getting infected while using healthcare facilities. According to Cancer Research UK, during the first year of Covid a million fewer screening notices were sent to patients.

Breast cancer is among the most common cancers with the vast majority of people diagnosed being women. According to figures for England, among women aged 45 to 54, breast cancer made up 50.2 per cent of all cancer cases but this gradually reduces to 21.3 per cent of cancer cases for women aged 75 years and over. Black African women are almost twice as likely to be diagnosed with late-stage breast cancer compared to white women.

Although breast cancer rarely occurs in men, it is still important for them to remain vigilant and report symptoms to their physician. Among men, it usually happens to those over 60 but can occasionally affect younger men. Men make up less than one per cent of new cancer diagnosis in the UK. In the United States, Black men have the highest incidence rates of male breast cancer, with 2.7 out of every 100,000 men affected, followed by White men on 1.9 out of every 100,00. Black men with breast cancer typically have a lower chance of recovery.

A paper by Professor Jonine Figueroa and colleagues, entitled “The impact of the Covid-19 pandemic on breast cancer early detection and screening”, highlighted that breast cancer screening services and participation were globally affected during the pandemic. They stated that screening and early detection are not simply end points and that health system strengthening was needed in tandem with appropriate diagnostic, pathologic and treatment support to ensure appropriate and timely management of breast cancer.

As we move forward to the Covid recovery phase, we must continue to focus on the various inequalities highlighted by the pandemic. With new developments in cancer screening and treatment, it is imperative that the knock-on effects of the pandemic do not limit access to health services for women across the globe.

Dr Gwenetta Curry is an Edinburgh University lecturer on race, ethnicity and health