LCOM & Department News

UVM Researchers Help Identify Impact of COVID-caused Delays in Breast Cancer Screening

November 23, 2021 by Jennifer Nachbur

New research from U.S. Breast Cancer Surveillance Consortium (BCSC) members, including several University of Vermont researchers, found that from March to September 2020, breast biopsies and detected cancers at U.S. BCSC facilities dropped sharply, compared with the same span a year earlier.

Pictured: Brian Sprague, Ph.D., (left); Sally Herschorn, M.D. (center); and Donald Weaver, M.D. (right).

Study highlights racial disparities in biopsies and detected breast cancers during a 2020 span when routine screenings were greatly slowed

New research from U.S. Breast Cancer Surveillance Consortium (BCSC) members, including several University of Vermont researchers, found that from March to September 2020, breast biopsies and detected cancers at U.S. BCSC facilities dropped sharply, compared with the same span a year earlier. Biopsies declined by 23 percent and detected cancers by 24 percent – findings that the research team attributes mostly to the postponement of routine screening mammograms as the COVID-19 pandemic took hold. 

The findings were published recently in Radiology. UVM Associate Professor of Surgery Brian Sprague, Ph.D., is senior author on the paper, and Professor of Radiology Sally Herschorn, M.D., and Professor of Pathology and Laboratory Medicine Donald Weaver, M.D., are coauthors. All three are also members of the UVM Cancer Center.

“The large deficit in breast cancers detected by screening during 2021 raises concern that cancers we would have hoped to detect early with screening will now present symptomatically or through delayed screening at a more advanced stage in the coming year,” said Sprague.

Weaver explains, “Breast cancers that are self-detected or cancers discovered by mammogram after missed screening exams tend to be larger and pathologically more aggressive than those detected by routine screening.”

Additionally, the research suggests that those postponed mammograms appeared to disproportionately affect women of color, as breast cancer diagnoses during the span diminished at different rates across demographic groups: Non-Hispanic white women had 17 percent fewer breast cancer diagnoses, while the year-over-year decline was 53 percent for Asian women, 43 percent for Hispanic women, and 27 percent for Black women.

“We know that prolonged delayed screening (more than a few months) will result in more cancers detected at larger sizes and later stages, making treatment more difficult,” said Hershorn. “We do not know the long-term effects of this on prognosis.”

Back on March 26, 2020, the American College of Radiology and American Society of Breast Surgeons jointly recommended that medical facilities immediately postpone all breast cancer-screening exams. Three weeks later, on April 16, the Society for Breast Imaging issued guidelines for resumption of breast cancer screening. That guidance noted, however, that the facilities’ ability to offer screening would depend on many factors, including the local COVID-19 burden, the availability of personal protective equipment, and the ability of breast surgeons and oncologists to manage newly diagnosed breast cancer patients.

Medical facilities rolled out COVID-19 safety protocols and, as October began, the American College of Radiology launched a “Return to Mammography” initiative, encouraging women who had missed a screening to return as soon as possible.

These efforts appear to have been largely successful. As early as July 2020, monthly biopsies and cancer diagnoses had returned to near-normal, even as total year-over-year cancer diagnoses remained lower. The new findings suggest, though, that breast imaging facilities may be struggling to meet demand for rescheduled examinations.

“All facilities in the BCSC were having difficulty catching up on screening backlogs,” Herschorn said. “We are seeing patients who usually screen every year coming in at 15, 18, or 24 months from their last mammogram. Some of this is access, but some may be hesitancy due to COVID-19 or other family obligations that make going for routine care difficult.”

First author Kathryn Lowry, M.D., assistant professor of radiology at the University of Washington School of Medicine, suggested that it’s likely that women of color have faced greater barriers to returning for routine mammograms based on evidence demonstrating that U.S. communities of color have borne the brunt of COVID-19’s trauma. 

“These communities have disproportionately experienced SARS-CoV-2 illness and mortality, as well as economic hardship due to job losses during the pandemic,” said Lowry. “It’s also possible that some medical facilities serving these communities have been less able to compensate for increased demand.”

Lowry noted that the researchers’ just-published results do not account for the delta variant surge, which peaked only a month ago.

“Based on our findings, particular efforts are needed to facilitate utilization of breast cancer screening among communities of color during the pandemic,” added Sprague.

The research was supported by the National Cancer Institute (R01CA248068, R50CA211115, P01CA154292, U54CA163303, P30CA014520, and P20GM103644); the Patient-Centered Outcomes Research Institute (PCS-1504-30370); the Agency for Healthcare Research and Quality (R01 HS018366-01A1); and the Breast Cancer Surveillance Consortium. The collection of SABIR data was supported by the UC Davis Comprehensive Cancer Center, the Placer County Breast Cancer Foundation, and the UC Davis Clinical and Translational Science Center.

(This article was adapted from a press release written by Brian Donohue of the University of Washington School of Medicine.)

 

Department Highlights

Congratulations! Jo Conant, M.D. has received the ‘Gender Equity in Medicine and Science Rising Star’ award. This award recognizes a woman or gender minority* faculty or staff member at the Larner College of Medicine who is in the early stage of their career, and who demonstrates excellence in contributions to students, colleagues, and/or the institution in the areas of gender equity and inclusion through service, program development, teaching, research or beyond. The awardee also shows the promise for future contributions and leadership in their field as well as in achieving goals for the advancement of diversity, equity, and inclusion. (02/2022)

LCOM class of 2024 Foundations Awards, Winners and nominees from our Department: Dr. Rebecca Wilcox- nominated for the AMWA Gender Equity Award | nominated for the Foundations Teaching Award; Dr. Pam Gibson– awarded the Silver Stethoscope Award | nominated for the Foundations Teaching Award | nominated for the Dean Warshaw Integration Award; Dr. Jo Conant– nominated for the Silver Stethoscope Award | nominated for the Dean Warshaw Integration Award; Medical Student Matt Hodd-Wells awarded the Ephraim Woll Award for Excellence in General Pathology (01/2022)

Congratulations! Dr. Rebecca Wilcox, M.D. has been appointed Associate Dean for Faculty Affairs at the Larner College of Medicine. Read her story. (01/2022)

Congratulations! Dr. Yvonne Janssen-Heininger, Ph.D.– Dean’s Research Laureate Award (Professor) Dr. Yvonne Janssen-Heininger was presented the Dean’s Research Laureate Award on 10/27/2021 at the LCOM State of Research Address and Awards. Please see the PDF slide that was presented at the program. (10/2021)

Heading to clinical trials..."UVM researchers celebrate ‘first-of-its-kind’ mesothelioma treatment headed to clinical trials" – My Champlain Valley News.  University of Vermont researchers have made a breakthrough in their study of possible treatments for malignant mesothelioma, a rare and aggressive cancer linked to asbestos exposure. (10/2021)

Terri Messier, research analyst and lab manager for the Cunniff lab, has been highlighted in the "Meet the Staff" section of the the Larner College of Medicine Dean's Newsletter, October 20, 2021 | Volume III, Issue 20. (10/2021)

Congratulations! Albert van der Vliet, Ph.D. has been named a 2021 Fellow of the Society for Redox Biology and Medicine. SfRBM annually confers the special title of Fellow to members who have made outstanding contributions to the association as well as in the field of free radical chemistry, redox biology and antioxidants. (09/2021)

Well done! Christina Wojewoda, M.D., associate professor of pathology and laboratory medicine, has received, along with her colleague Daniel Rhoads, M.D., of the Cleveland Clinic, the 2021 College of American Pathologists (CAP) Laboratory Improvement Programs Service Award. The award honors an individual(s) serving within the ranks of the CAP Council on Scientific Affairs who has demonstrated exceptional service. The two pathologists serve as chair and vice chair, respectively, of the CAP microbiology committee. (08/2021)

Congratulations to Dr. Yvonne Janssen-Heininger, Dr. Albert van der Vliet, Dr. David Seward and their team members for this outstanding acknowledgement (see pdf) from the The American Physiological Society; "your article has been selected for APSselect  (http://apsselect.physiology.org/),  a collection from the APS that showcases some of the best recently published articles in physiological research." (7/2021)

2020-2021 Teaching Award This award is nominated for and voted by medical resdients for idividuals going above and beyond for resident education. Nominees this year: Dr. Agnes Balla, Dr. Kelly Butnor, Dr. Rebecca Wilcox and Dr. Bronwyn Bryant. The winner this year is Dr. Agnes Balla. (06/2021)

Dr. Joanna Conant has become a member of The Teaching Academy at Robert Larner, M.D. College of Medicine at the University of Vermont. The Teaching Academy sustains and supports an interdisciplinary community of educators who value the scholarship of teaching and learning while facilitating educator development; improve the efficiency and quality of medical education through collaboration and scholarship; and promote an academic environment that increases the value and impact of educators locally, regionally, and nationally.Congrats to Jo on this achievement! (06/2021)

Congratulations to Dr. Arti Shukla on receiving the SAASCR 2021 Outstanding Achievement Award for her seminal contributions to the field of cancer research. Well done Arti!! (5/2021)

SAASCR award 2021

Congratulations!  To Pam Gibson, M.D. who has been awarded 2021 Gender Equity Champion Award which honors Larner College of Medicine community members (faculty, staff or students) who have demonstrated outstanding commitment and service to the advancement of women and those with underrepresented gender identities beyond the scope of their job, area of research, or training. Also, to Joanna Conant, M.D. on her nomination for 2021 The Rising Star Emerging Professional Award which honors a Larner College of Medicine woman or gender minority faculty or staff member who is in the early stage of their career, and who demonstrates excellence in contributions to students, colleagues, and/or the institution in the areas of gender equity and inclusion through service, program development, teaching, research or beyond. (02/2021)

LCOM Foundations Awards: Congratulations to Ron Bryant, M.D. on receiving the Foundations Teaching Award which recognizes the faculty member who provided the most outstanding teaching activities within the foundations curriculum. Also, congratulations to award nominees: Pam Gibson, M.D. for both the Above and Beyond Award and the AMWA Gender Equity Award; Andrew Goodwin, M.D. and Christina Wojewoda, M.D. for the Silver Stethoscope Award and Rebecca Wilcox, M.D. for the Dean Warshaw Integration Award. (01/2021)

LCOM Teaching Academy Recognition for P&LM faculty: Deborah Cook, M.D. and Anne Stowman, M.D. were inducted as Master Teachers and Rebecca Wilcox, M.D. was inducted as a Distinguished Educator. (01/2021)

Mark Fung, M.D., Professor, Pathology and Laboratory Medicine, has been elected as a new Trustee of the American Board of Pathology. His 3-year term will begin January 2021. Read about it here. (12/2020)

Sarah A. Nowak, PhD, Assistant Professor, Department of Pathology and Laboratory Medicine, Larner College of Medicine was named the inaugural Blodwen S. Huber Early Career Green and Gold Professor in Pathology and Laboratory Medicine. (12/2020)

David J. Seward, MD, PhD, Assistant Professor, Department of Pathology and Laboratory Medicine, Larner College of Medicine was named the inaugural Elmer R. Huber Early Career Green and Gold Professor in Pathology and Laboratory Medicine. (12/2020)

Terri Messier, Research Analyst and Lab Manager of the Cunniff lab was recently awarded a Dean's Excellence in Research Award from the Larner College of Medicine. Terri has served the UVM community for over 25 years both as a scientist and steward of professionalism. Congratulations Terri!! (11/2020)

Congratulations to Dr. Yvonne Janssen-Heininger, Ph.D. on her selection as a new Fellow of the Society for Redox Biology and Medicine (SfRBM) in recognition of her outstanding contributions in the field of redox biology and to SfRBM. (09/2020)

Congratulations to Dr. Joanna Conant, M.D. on her acceptance into the Teaching Academy's Medical Education Fellowship Program. Only 8-10 faculty from across the Larner College of Medicine are selected for participation in the program. Well done, Jo! (08/2020)

Associate Professor, Dr. Laura Greene, MD, has been appointed Interim Assistant Dean for Admissions for the Larner College of Medicine. (08/2020)

Congratulations to Bei Zhang, MD, PhD, Associate Professor, the newest graduate of the Medical Education Fellowship Program. The cohort style program is for Larner College of Medicine educators who seek additional preparation for teaching across the medical education continuum. (07/2020)

UVM Health Network’s Genomic Medicine Program is highlighted in the recent issue of Vermont Medicine Magazine, read it here. (05/2020)

Department efforts in COVID-19 research & testing are ongoing at UVM LCOM and the UVM Medical Center. The Rutland Herald/Times Argus ran the following story on these efforts. Teamwork & Testing (04/2020)

DLaward

LCOM Gender Equity Awards Department Chair, Dr. Debra Leonard received the Polaris Award for Outstanding Mentorship. Additionally, Dr. Pam Gibson was nominated for the Gender Equity Champion Award; Dr. Rebecca Wilcox was nominated for the Gender Equity Outstanding Achievement in Medicine and Science Award and Dr. Christi Wojewoda was nominated for the Rising Star Emerging Professional Award. (03/2020)

Excellence in Education The department was well represented at the Class of 2022 Foundation Awards. Rebecca Wilcox, M.D. received the AWMA Gender Equity Award, the Above & Beyond Award, the Foundations Course Director Award and the Foundations Teaching Award. Well done, Dr. Wilcox. Additional department nominees were Dr. Pam Gibson and Dr. Christi Wojewoda for the AWMA Gender Equity Award and Dr. Pam Gibson and Dr. Rebecca Wilcox for the Dean Warshaw Integration Award. Congratulations to our outstanding faculty for nominations and awards! (1/2020)

Dr. Bei Zhang, Associate Professor on the Education Scholar Pathway has been inducted into the Teaching Academy at the Larner College of Medicine at the Master Teacher level. Congratulations, Dr. Zhang! (1/2020)

Dr. Debra Leonard, M.D., Ph. D., our department chairand the Genomic Medicine Team announce the start of the Genomic Population Health Initiative. A pilot project offering Genomic DNA Testing is now underway within the University of Vermont Health Network. Read more here... (2019)

Dr. William Pendlebury, M.D., professor emeritus of Pathology & Laboratory Medicine, has been selected to receive the 2019 Vermont Medical Society’s (VMS) Founders’ Award. The award recognizes Pendlebury’s leadership role and advocacy in “the fight for the diagnosis and treatment of dementia in Vermont for the past 35 years.” He will receive the award November 2 at the VMS 206th Annual Meeting in Stowe, Vt.(2019)

Yvone Janssen-Heininger, Ph.D., Jos van der Velden, Ph.D. (both Pathology & Laboratory Medicine faculty) and senior author, Charles Irvin, Ph.D. (Medicine), published "The Effect of Flavored E-cigarettes on Murine Allergic Airways Disease" in Nature Scientific Reports. The study has been cited in stories by several news outlets: U.S. News & World Report/HealthDay; American Journal of Managed Care; Medical News Bulletin; and  Medical Daily. (2019)

Dr. Mark Fung, M.D, Ph.D., professor and vice chair for Population Health, was recently named to the board of directors for the Project Santa Fe Foundation, which “focuses on demonstrating the power of longitudinal clinical laboratory data to proactively augment population health in a value-based healthcare environment.” (2019)

Dr. Bronwyn Bryant, M.D. was named a 2019 Frymoyer Scholar for her project, “Validating Entrustable Professional Activity-Based Assessment to Determine On-Call Competency in Pathology Residents”. (2019)

Dr. Rebecca Wilcox, M.DDr. Rebecca Wilcox, M.D. was selected, by the Larner College of Medicine Class of 2019, to be the commencement keynote speaker. Read more... [Photo credit: Andy Duback 2019] (2019)