Racial Disparities in Cancer Screening Utilization before and after the COVID-19 Pandemic

Cancer screening services such as mammograms, pap smears, and colonoscopies have allowed doctors to mitigate the mortality of breast cancer, cervical cancer, and colorectal cancer, respectively, by enabling early detection. However, as with many preventative care services, cancer screening has various racial and ethnic disparities. During the COVID-19 pandemic, the utilization of critical preventative care services such as cancer screening dramatically decreased. This paper studies the changes in cancer screening utilization based on race during the COVID-19 pandemic using survey data from the 2018, 2020, and 2022 Behavioral Risk Factor Surveillance System (BRFSS). This paper finds that total utilization of mammograms and colonoscopies decreased in 2020, but returned to pre-pandemic levels in 2022; however, pap smears decreased significantly in 2020, and continued to decrease through 2022. Using a probit model, this paper finds that racial disparities for breast and colorectal cancer screening were largely unchanged, while disparities in cervical cancer screening for Blacks and Hispanics were exacerbated during the pandemic. In addition, young Hispanic women had a greater decrease in cervical cancer screening compared to older Hispanic women during the pandemic. Policymakers should emphasize the importance of and prioritize improving access to pap smears for Black and Hispanic populations.