Population-level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures.
Population-level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures.
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DOI：
10.1002/cncr.33460
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发表时间：
2021-06-15
期刊：
影响因子：
6.2
通讯作者：
Henderson LM
中科院分区：
文献类型：
--
作者：
Nyante SJ;Benefield TS;Kuzmiak CM;Earnhardt K;Pritchard M;Henderson LM
为了了解医疗保健延误可能如何影响乳腺癌的检测，作者量化了2019年冠状病毒病(新冠肺炎)大流行期间与乳房相关的预防和诊断护理的变化。符合条件的女性(N=39,444)年龄为18岁，于2019年1月1日至2020年9月30日期间在北卡罗来纳州的7个学术和社区乳房成像设施接受筛查乳房X光检查、诊断性乳房X光检查或乳房活检。评估了2020年3月3日(北卡罗来纳州第一例新冠肺炎诊断)之后乳房X光检查或乳腺活检检查次数的变化，并根据2019年1月1日至2020年3月2日的趋势将其与预期次数进行了比较。使用中断的时间序列模型估计预测的月平均检查次数的变化。使用最小二乘均值回归检验患者特征的差异。大流行开始后，接受的检查比预期的要少。筛查乳房X光检查(−85.1%；95%CI，−100.0%，−70.0%)和诊断性乳房X光检查(−48.9%；95%CI，−71.7%，−26.2%)和活检(−40.9%；95%CI，−57.6%，−24.3%)的最大降幅出现在2020年3月。赤字逐渐减少，到2020年7月(诊断性乳房X光检查)和2020年8月(筛查乳房X光检查和活检)时，观察到的数字与预期的数字没有显著差异。在疫情爆发几个月后，与流行前期人群相比，接受护理的女性预测的乳腺癌风险(筛查乳房X光检查，P<；.001)更高，而且更常见地缺乏保险(诊断乳房X光检查，P<；.001；活组织检查，P<；.001)。随着时间的推移，与大流行相关的乳房检查数量赤字有所减少。利用情况因乳腺癌风险和保险状况而异，但不因年龄或种族/民族而异。需要长期的研究来澄清这些趋势对乳腺癌差异的贡献。在这项观察性研究中，筛查乳房X光检查、诊断性乳房X光检查和乳房活检的使用率显著低于北卡罗来纳州新冠肺炎大流行开始后的预期，但随着时间的推移，缺陷有所减少。健康保险状况和预测的乳腺癌风险被确定为大流行期间乳房X光检查和活检收据的预测因子。
To understand how health care delays may affect breast cancer detection, the authors quantified changes in breast‐related preventive and diagnostic care during the coronavirus disease 2019 (COVID‐19) pandemic. Eligible women (N = 39,444) were aged ≥18 years and received a screening mammogram, diagnostic mammogram, or breast biopsy between January 1, 2019 and September 30, 2020, at 7 academic and community breast imaging facilities in North Carolina. Changes in the number of mammography or breast biopsy examinations after March 3, 2020 (the first COVID‐19 diagnosis in North Carolina) were evaluated and compared with the expected numbers based on trends between January 1, 2019 and March 2, 2020. Changes in the predicted mean monthly number of examinations were estimated using interrupted time series models. Differences in patient characteristics were tested using least squares means regression. Fewer examinations than expected were received after the pandemic's onset. Maximum reductions occurred in March 2020 for screening mammography (−85.1%; 95% CI, −100.0%, −70.0%) and diagnostic mammography (−48.9%; 95% CI, −71.7%, −26.2%) and in May 2020 for biopsies (−40.9%; 95% CI, −57.6%, −24.3%). The deficit decreased gradually, with no significant difference between observed and expected numbers by July 2020 (diagnostic mammography) and August 2020 (screening mammography and biopsy). Several months after the pandemic's onset, women who were receiving care had higher predicted breast cancer risk (screening mammography, P < .001) and more commonly lacked insurance (diagnostic mammography, P < .001; biopsy, P < .001) compared with the prepandemic population. Pandemic‐associated deficits in the number of breast examinations decreased over time. Utilization differed by breast cancer risk and insurance status, but not by age or race/ethnicity. Long‐term studies are needed to clarify the contribution of these trends to breast cancer disparities. In this observational study, the use of screening mammography, diagnostic mammography, and breast biopsy is significantly lower than expected after the onset of the COVID‐19 pandemic in North Carolina, but the deficits decrease over time. Health insurance status and predicted breast cancer risk are identified as predictors of mammography and biopsy receipt during the pandemic.
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影响因子：
19.7
作者：
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通讯作者：
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DOI：
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影响因子：
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通讯作者：
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作者：
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DOI：
10.3390/ijerph17124322
发表时间：
2020-06-01
影响因子：
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通讯作者：
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