Disproportionate Impact of COVID-19 on Breast Cancer Diagnoses in Older Hispanic Women.

Purpose This study aimed to evaluate the impact of COVID-19 pandemic on discrepancies between expected and actual breast cancer diagnosis. Methods Data on breast cancer incidence were obtained from the United States Cancer Statistics (USCS) program from 2001 to 2020. We compared actual breast cancer incidence rates in the year 2020 to estimated rates based on trends from 2001 to 2019.  Results From 2001 to 2019, there were 4,005,763 identified cases of breast cancer in the United States. Prior to the pandemic, the incidence rate of breast cancer was 162.87 per 100,000 in females with an annual increase of 1.32% (p < 0.001). A comparison between projected and observed incidences in 2020 revealed a 21,450-case discrepancy, indicating 10.1% fewer diagnosed cases than expected. Patients over 70 years old exhibited the highest discrepancy of more than 13.27% compared to younger cohorts. Hispanic patients saw the largest discrepancy with 13.4% fewer diagnoses compared to only 10.5% in White patients. Intersectional analysis showed that older Hispanic patients aged 65-69 years old residing in the Northeast observed one of the highest discrepancies at nearly 25.9% fewer cases. Conclusions The reported breast cancer cases significantly declined during the pandemic. Older age, Hispanic race and ethnicity, and those residing in the Northeast region had the greatest number of missing cases.