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Geographic Examination of COVID-19 Test Percent Positivity and Proportional Change in Cancer Screening Volume, National Breast and Cervical Cancer Early Detection Program

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Proportional change in breast cancer screening volume values were divided into 3 categories: large decrease (less than −20%), medium decrease (−20% to −5%), and a minimal change (more than −5%). COVID-19 test percent positivity values were also divided into 3 categories: low (less than 5.00%), moderate (5.00% to 7.99%) and high (8.00% or more). Each state is represented by a single bivariate combination of 1 of 3 COVID-19 test percent positivity categories and 1 of 3 proportional change in breast cancer screening volume categories, resulting in 9 possible bivariate relationships.

Figure 1.
Bivariate visualization of the association between state-level proportional change in NBCCEDP breast cancer screening volume and COVID-19 test percent positivity for each month from July through December 2020. Breast cancer screening volume was based on NBCCEDP minimal data elements submitted in April 2021. Data for the District of Columbia, Massachusetts, and North Carolina and are not displayed because 2020 breast cancer screening data were missing. The change in cancer screening volume was calculated as the difference between the volume during July–December 2020 and the previous 5-year average for those months. Abbreviation: NBCCEDP, National Breast and Cervical Cancer Early Detection Program.

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Proportional change in cervical cancer screening volume values were divided into 3 categories: large decrease (less than −20%), medium decrease (−20% to −5%), and a minimal change (more than −5%). COVID-19 test percent positivity values were also divided into 3 categories: low (less than 5.00%), moderate (5.00% to 7.99%) and high (8.00% or more). Each state is represented by a single bivariate combination of 1 of 3 COVID-19 test percent positivity categories and 1 of 3 proportional changes in cervical cancer screening volume categories, resulting in 9 possible bivariate relationships.

Figure 2.
Bivariate visualization of the association between state-level proportional change in NBCCEDP cervical cancer screening volume and COVID-19 test percent positivity for each month from July through December 2020. Cervical cancer screening volume was based on NBCCEDP minimal data elements submitted in April 2021. Data for the District of Columbia, Massachusetts, and North Carolina and are not displayed because 2020 cervical cancer screening data were missing. The change in cancer screening volume was calculated as the difference between the volume during July–December 2020 and the previous 5-year average for those months. Abbreviation: NBCCEDP, National Breast and Cervical Cancer Early Detection Program.

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