Abstract P33: Disparities in breast cancer screening and the impact of COVID-19 in Houston, Texas
Authors: Shafaee Maryam Nemati , Gilman Luke , Oluyomi Abiodun , Bondy Melissa , Ortiz-Perez Tamara , Amos Chris , Rimawi Mothaffar 
Published: March 2021

Abstract
Background: The third most populous county in the United States, the Harris Country, has some of the worst outcomes of breast cancer in the country. In this county, 27% of mammogram eligible women, ages 40-64 are uninsured, compared to about 11% the national average. Harris Health (HH) is a state funded network of SafetyNet hospitals and clinics that provide comprehensive care, including breast cancer screening to the uninsured and underinsured residents of the Harris county. The population who receives care at the HH sites is majority of racial and ethnic minorities and generally lower socioeconomic status than the county average. The number of screening mammograms abruptly dropped by 94% across the United States following the declaration of the COVID-19 national emergency. Currently there is no data on how breast cancer screening rates have been affected during the pandemic across Houston, and specifically in Harris County where health disparities gap already existed. We hypothesized that the population across HH sites have lower rates of screening mammograms following the COVID-19 pandemic declaration compared to the rest of the population across Houston who visit Baylor St. Luke’s Health- Texas (SLH) catchment area. Methods: We retrieved the monthly gross number of screening mammograms performed at all HH sites and SLH sites from February to October for both 2019 and 2020 on the PENRAD database. We then used the Independent-Samples Mann-Whitney U Test to assess differences in the distribution of percent change in mammogram between HH sites and SLH sites. First, we compared the total mammogram numbers for February to October (2020 vs. 2019). We then compared only the numbers for each month (e.g., May 2020 vs. May 2019). Beyond basic descriptive counts, statistical analysis was limited to mammogram among women ages 40 – 69. Statistical significance was set at p&lt;0.05. Results: Overall, across both health care systems, HH and SLH, and for all ages, there was a drastic drop (53.96%) in screening mammogram between 2019 (N=32,968) and 2020 (N=17,788). For women ages 40 – 69, the drop in screening mammogram at SLH sites during 2020 (February to October) was significantly less than the drop at HH sites during the same period. When screening mammogram was compared between 2019 and 2020 for each month separately, it was only in May and September that the % change in mammogram were similar for SLH and HH. For the remaining months, SLH site had significantly less drop in screening mammograms. Conclusion: The population that normally receives care at HH site had significantly lower rates of screening mammograms following the pandemic compared to the population who receives care at SLH sites. This will likely widen the already present disparity gap in breast cancer outcomes for the city of Houston.
Citation Format: Maryam Nemati Shafaee, Luke Gilman, Abiodun Oluyomi, Melissa Bondy, Tamara Ortiz-Perez, Chris Amos, Mothaffar Rimawi. Disparities in breast cancer screening and the impact of COVID-19 in Houston, Texas [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr P33.