COVID-19 大流行突然中断了乳腺癌筛查，这是初级保健中一项重要的预防服务。我们的目的是使用真实世界的健康记录数据来评估这一流行病对整体和后续乳腺癌筛查的影响。我们回顾性分析了2017年1月1日至2022年2月28日研究期间符合乳腺癌筛查条件的一组女性使用 TriNetX 研究网络数据。我们检查了整个研究期间每月筛查量的时间趋势，并比较了在前一次筛查后 24 个月内进行后续筛查的坚持率（当后续筛查应在新冠疫情之前期间与新冠疫情期间进行）。为了解释纵向数据中的多次筛查，我们应用了逻辑回归模型，该模型使用广义估计方程并调整了个体水平的协变量。在 1,186,669 名符合筛查资格的女性中，从 2020 年 2 月到 4 月，每月筛查量暂时减少了 80.6%，并且然后到 2020 年 6 月反弹至接近新冠疫情前的水平。然而，后续筛查率从新冠疫情前的 78.9%（95% CI，78.8%-79.0%）下降至 77.7%（95% CI，新冠疫情期间为 77.6%-77.8%）。多元回归分析还显示，新冠肺炎期间随访筛查的依从性较低（比值比 = 0.86；0.86-0.87），并且 65 岁及以上女性和非西班牙裔“其他”种族女性的流行病影响更大（亚洲人、美洲印第安人或阿拉斯加原住民、夏威夷原住民或其他太平洋岛民）。COVID-19 大流行对总体乳腺癌筛查产生了短暂的负面影响，并对后续筛查产生了长期的负面影响。它还加剧了坚持随访筛查的差距，特别是在某些弱势群体中，需要创新策略来解决初级保健中潜在的健康差异。© 2024 年家庭医学年鉴，公司。

The COVID-19 pandemic abruptly interrupted breast cancer screening, an essential preventive service in primary care. We aimed to evaluate the pandemic's impact on overall and follow-up breast cancer screening using real-world health records data.We retrospectively analyzed a cohort of women eligible for breast cancer screening through the study period from January 1, 2017 to February 28, 2022 using TriNetX Research Network data. We examined the temporal trend of monthly screening volume throughout the study period and compared the rate of adherence to follow-up screening within 24 months after the previous screening when the follow-up screening was due in the pre-COVID period vs the COVID period. To account for multiple screenings in the longitudinal data, we applied a logistic regression model using generalized estimating equations with adjustment for individual-level covariates.Among 1,186,669 screening-eligible women, the monthly screening volume temporarily decreased by 80.6% from February to April 2020 and then rebounded to close to pre-COVID levels by June 2020. Yet, the follow-up screening rate decreased from 78.9% (95% CI, 78.8%-79.0%) in the pre-COVID period to 77.7% (95% CI, 77.6%-77.8%) in the COVID period. Multivariate regression analysis also showed a lower adherence to follow-up screening during the COVID period (odds ratio = 0.86; 0.86-0.87) and a greater pandemic impact among women aged 65 years and older and women of non-Hispanic "other" race (Asian, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander).The COVID-19 pandemic had a transient negative effect on breast cancer screening overall and a prolonged negative effect on follow-up screening. It also exacerbated gaps in adherence to follow-up screening, especially among certain vulnerable groups, requiring innovative strategies to address potential health disparities in primary care.© 2024 Annals of Family Medicine, Inc.