A steep drop in breast cancer screenings in Washington during the COVID-19 pandemic appears to have most affected women of color and those living in rural communities, according to Washington State University researchers.

After looking over clinical data of tens of thousands of Washington women both before and after the pandemic began last spring, researchers noticed sharp disparities when the data were separated by race and geographic location.

WSU assistant professor Ofer Amram, lead author on the study, said overall, they found completed mammograms in the state between April and December of 2020 fell to half the number reported in that same time the year before, but the drop was steeper among low-income, rural and nonwhite women.

For example, screenings fell by 64 percent for Hispanic women, 61 percent for American Indian and Native Alaskan women and by 59 percent for rural women. Meanwhile, screenings for white and urban women saw about the same 50 percent fall observed in Washington women generally.

While Amram said it’s logical to assume this will lead to more cases of breast cancer within these groups being caught late, more research needs to be done.

“I think, to understand the extent of the impact (of) these late diagnoses of breast cancer, we still need to do more investigation, you know, maybe two, three years into the future,” he said. “We’re hoping to do that, to really examine the impact of this delay.”


In most cases, Amram said these disparities had existed before COVID-19 but were exacerbated by the pandemic.

However, he said there is some indication that the dramatic and rapid expansion of telehealth services throughout Washington’s healthcare system may have helped to pick up the slack of some missed in-person visits. He said the next phase of research will likely address the effect this had and how some features of expanded telehealth may remain in place.

“What we are looking to investigate is how this increase in telehealth services brought up by COVID-19 can be used in the future to improve access to health services,” he said. “There’s a lot of indication that actually this increase in telehealth use will probably remain fairly high, even after COVID-19.”

While it makes sense that expanded telehealth services will help to increase healthcare access generally, Amram said it is still unclear how virtual visits compare to in-person appointments. He said with telehealth use up and promising to remain high, this may be a good time to address some of that uncertainty.

“Because of COVID-19 … health systems had to increase telehealth in order to improve access,” he said. “It’s actually a great opportunity to try to identify what telehealth is good at and what’s not, and what can be improved — so we want to capitalize on this opportunity.”