Uneven US Cancer Screening Recovery Post-COVID: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On March 12, 2025, we reported on a study published in JAMA that examined post–COVID-19 pandemic cancer screening rates in 2023 relative to previously documented declines through 2021 in the US.

The study

Researchers analyzed data from the National Health Interview Survey, a nationally representative cross-sectional survey of noninstitutionalized adults. They assessed self-reported screening rates for breast, cervical, and colorectal cancer in 2019 (pre-pandemic), 2021 (during the pandemic), and 2023 (post-pandemic). Screening eligibility and strategies were based on the US Preventive Services Task Force recommendations put in effect in 2019. Logistic regression models estimated adjusted prevalence ratios (aPRs) comparing cancer screening rates between 2019 to 2023 and 2021 to 2023, adjusted for age, race and ethnicity, education, insurance, and region, and stratified by education and health insurance.

The findings

Changes in reported past-year cancer screening before, during, and after the pandemic were as follows:

• Breast cancer screening (women aged 50-74 years) increased from 59.7% in 2019 to 64.9% in 2023 (aPR, 1.07; 95% CI, 1.04-1.10).

• Colorectal cancer screening (adults aged 50-75 years) rose from 21.2% in 2019 to 24.3% in 2023 (aPR, 1.12; 95% CI, 1.06-1.18). Colonoscopy rates rebounded between 2021 and 2023 (aPR, 1.13; 95% CI, 1.06-1.22), and stool-based testing remained higher than in 2019.

• Cervical cancer screening (women aged 21-65 years without hysterectomy) dropped from 46.8% in 2019 to 40.9% in 2023 (aPR, 0.86; 95% CI, 0.82-0.90), with no significant change from 2021.

While breast cancer screening rebounded across education levels, increases in colorectal cancer screening were mainly observed in individuals with higher education, private insurance, or Medicare. Cervical cancer screening remained below pre-pandemic levels for most groups, despite an 8% rebound between 2021 and 2023 among college graduates.

Authors' comments

"To prevent further shifts toward later-stage diagnoses, efforts must address declines in cervical cancer screening and disparities by socioeconomic status in all 3 screening types. Health systems and health care professionals could play a major role by improving screening communications and providing patient navigators to help address structural and cost barriers."

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