133 MISSING WOMEN: Breast Cancer Cases Going Undetected Because Of Covid-19
At least 133 women across Aotearoa New Zealand have no idea they have breast cancer right now, warns Breast Cancer Foundation NZ. The charity is gravely concerned for these women, who have missed the mammogram that would have diagnosed them during the latest Covid-19 lockdowns. The number of undetected breast cancer cases is expected to grow as both BreastScreen Aotearoa and private clinics deal with the fallout of extended lockdowns.
Data also shows that since the arrival of Covid, a higher proportion of invasive cancers have been found later than they could have been, and participation in breast screening has been set back 10 years, with younger women and vulnerable populations most affected. As a result, deaths from breast cancer could soon be on the rise and urgent action is required to reverse this alarming trend.
The 133 missing women can be attributed to the national breast screening programme being put on hold when the country went into Alert Level 4 on 18 August, and then running at reduced capacity from Level 3.
Ah-Leen Rayner, chief executive of Breast Cancer Foundation NZ, said: “We’re extremely concerned about every woman who has missed a diagnosis and is not getting the earliest possible treatment. Each year around 650 Kiwi women die from breast cancer and we have a real fear this number could be on the rise because of the steep drop in screening since Covid arrived.
“If you’ve had a mammogram cancelled, get rebooked as soon as you can. And if you’ve discovered a lump or other symptom you should see your GP straight away, no matter what Level you’re in. Every day counts when you have breast cancer – don’t let Covid stop you finding breast cancer early.”
This Breast Cancer Awareness Month (October), the charity has launched a petition urging the Government to put resource into finding the missing women and restoring New Zealand’s gold-standard screening programme. With breast cancer being the leading cause of death for Kiwi women under 65, the petition also calls for specific action needed for the health system to prioritise women.
“To the Government, our plea is to not ignore the other pressing issues that are threatening the lives of New Zealanders,” Ah-Leen Rayner said. “Preventing deaths from breast cancer should be just as much of a priority as preventing deaths from Covid-19.”
Analysis of the Breast Cancer Foundation National Register shows a 12% drop in invasive breast cancers detected by screening mammograms in 2020 compared with the previous year. This means more women were diagnosed later, which can make cancer harder to treat and more likely to come back.
According to BreastScreen Aotearoa’s two-yearly coverage report to August 2021, screening rates dropped in 2020 and 2021 to the lowest than any time since 2010. Māori, Pacific and younger women are worst affected, and all ethnicities fall short of the 70% participation required for an effective screening programme.
Overseas Covid-19 impact studies suggest that women with delayed diagnoses will need more severe treatments and some will go on to die of advanced (metastatic) breast cancer.
Breast Cancer Foundation NZ’s petition calls on Government to:
- Add breast screening participation to the new Health System Indicators that measure how well our public health system is doing
- Invest in restoring and extending the BreastScreen Aotearoa programme to the agreed target of 70% coverage of women aged 45-69, and extending to 70-74 in line with other countries
- Provide funding and resources to enable BreastScreen Aotearoa to process the entire backlog within six months
- Ensure breast screening continues to operate in Level 4 lockdown in the same way as Level 3, to help minimise future losses.
The petition can be signed at www.missingwomen.org.nz.
Breast cancer is the most common cancer for Kiwi women, with around 3,500 women being diagnosed each year. The survival rates for breast cancer are higher when breast cancer is found early, and mammograms can show changes inside a breast before they can be felt. The 10-year survival rate if breast cancer is detected by mammogram is 95%, but this falls to 85% if a woman finds a lump.
Footnote:  Provisional 2020 data from Te Rēhita Mate Ūtaetae – The Breast Cancer Foundation National Register, for Auckland, Waikato, Wellington and Christchurch, women aged 45-69
Breast Cancer Foundation NZ’s calculation of 133 missing women takes into account the average number of women aged 45-69 diagnosed with invasive breast cancer or DCIS (Ductal Carcinoma in Situ, a pre-invasive form of breast cancer) via screening mammogram each week, nationally and in regional lockdowns. This average is multiplied by the weeks in national or regional Level 4 lockdown, with a reduced multiplier applied for weeks in Level 3 (when breast screening is available at reduced capacity).
The Breast Cancer Foundation National Register collects information such as demographics, diagnosis and treatment of more than 38,000 past and present patients across New Zealand. Breast Cancer Foundation NZ has provided more than $2.5 million to the development and management of the register since it was first launched in 2000.
BreastScreen Aotearoa provides New Zealand’s free national screening programme and is part of the Ministry of Health’s National Screening Unit. Its two-yearly coverage report can be viewed at: https://minhealthnz.shinyapps.io/nsu-bsa-coverage-dhb/