Model-Based Estimation of Colorectal Cancer Screening and Outcomes During the COVID-19 Pandemic.
Model-Based Estimation of Colorectal Cancer Screening and Outcomes During the COVID-19 Pandemic.
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DOI：
10.1001/jamanetworkopen.2021.6454
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发表时间：
2021-04-01
影响因子：
13.8
通讯作者：
Roth J
中科院分区：
文献类型：
--
作者：
Issaka RB;Taylor P;Baxi A;Inadomi JM;Ramsey SD;Roth J
在COVID-19大流行期间，扩大基于粪便免疫化学检测（FIT）的结直肠癌筛查参与与哪些3年临床结局相关？在这项建模研究中，在3年期间将FIT的使用率从15%增加到22%，以抵消结肠镜检查筛查中COVID-19相关的下降，这与额外的655825例结直肠癌筛查和2715例结直肠癌诊断相关，其中72%为早期。这些发现表明，在COVID-19大流行期间，增加FIT用于结直肠癌筛查可能会减轻大流行导致的结直肠癌筛查率下降的后果。这项建模研究估计了结直肠癌筛查率和相关结果的COVID-19相关变化，并估计了扩大粪便免疫化学检测可能减轻这些结果的程度。COVID-19减少了结直肠癌筛查。评估COVID-19大流行期间扩大基于粪便免疫化学检测的结直肠癌筛查参与与临床结局的相关程度。采用先前开发的模拟模型来估计COVID-19可能对结直肠癌结果的贡献。该模型包括美国癌症协会估计已完成COVID-19前结直肠癌筛查的美国人口。该模型旨在估计2020年至2023年之间的结直肠癌结局。该分析于二零二零年七月至十二月期间完成。成人结直肠癌筛查和结直肠癌病例分期检测。4种情况下的结直肠癌结局估计：（1）9个月的50%结直肠癌筛查，随后21个月的75%结直肠癌筛查;（2）18个月的50%筛查，随后12个月的75%筛查;（3）增加粪便免疫化学检测的情况1;（4）情景2，粪便免疫化学试验的使用增加。在我们的模拟模型中，2020年至2023年期间，COVID-19相关的护理利用减少导致结直肠癌筛查估计减少1 176 942至2 014 164例，结直肠癌诊断减少8346至12 894例，早期结直肠癌诊断减少6113至9301例。随着结直肠癌筛查减少的时间缩短，粪便免疫化学检测使用的增加与估计额外的588844次结直肠癌筛查和2836例结直肠癌诊断相关，其中1953例（68.9%）为早期。如果长期减少结直肠癌筛查，增加粪便免疫化学试验的使用与估计额外的655825次结直肠癌筛查和2715次结直肠癌诊断相关，其中1944次（71.6%）为早期。这些结果表明，COVID-19大流行期间粪便免疫化学检测的使用增加与结直肠癌筛查参与率增加和早期结直肠癌诊断增加有关。如果我们的估计在现实世界的临床实践中得到证实，在COVID-19大流行期间增加基于粪便免疫化学检测的结直肠癌筛查参与率可能会减轻大流行期间结直肠癌筛查率下降的后果。
What 3-year clinical outcomes are associated with expanding fecal immunochemical test (FIT)–based colorectal cancer screening participation during the COVID-19 pandemic? In this modeling study, increasing FIT use from 15% to 22% over a 3-year period to offset COVID-19–related declines in colonoscopy screening was associated with an additional 655 825 colorectal cancer screenings and 2715 colorectal cancer diagnoses, of which 72% were early stage. These findings suggest that increasing FIT use for colorectal cancer screening during the COVID-19 pandemic may mitigate the consequences of reduced screening rates caused by the pandemic for colorectal cancer outcomes. This modeling study estimates COVID-19–related changes in rates of colorectal cancer screenings and associated outcomes and estimates the degree to which expanded fecal immunochemical testing could potentially mitigate these outcomes. COVID-19 has decreased colorectal cancer screenings. To estimate the degree to which expanding fecal immunochemical test–based colorectal cancer screening participation during the COVID-19 pandemic is associated with clinical outcomes. A previously developed simulation model was adopted to estimate how much COVID-19 may have contributed to colorectal cancer outcomes. The model included the US population estimated to have completed colorectal cancer screening pre–COVID-19 according the American Cancer Society. The model was designed to estimate colorectal cancer outcomes between 2020 and 2023. This analysis was completed between July and December 2020. Adults screened for colorectal cancer and colorectal cancer cases detected by stage. Estimates of colorectal cancer outcomes across 4 scenarios: (1) 9 months of 50% colorectal cancer screenings followed by 21 months of 75% colorectal cancer screenings; (2) 18 months of 50% screening followed by 12 months of 75% screening; (3) scenario 1 with increased use of fecal immunochemical tests; and (4) scenario 2 with increased use of fecal immunochemical tests. In our simulation model, COVID-19–related reductions in care utilization resulted in an estimated 1 176 942 to 2 014 164 fewer colorectal cancer screenings, 8346 to 12 894 fewer colorectal cancer diagnoses, and 6113 to 9301 fewer early-stage colorectal cancer diagnoses between 2020 and 2023. With an abbreviated period of reduced colorectal cancer screenings, increasing fecal immunochemical test use was associated with an estimated additional 588 844 colorectal cancer screenings and 2836 colorectal cancer diagnoses, of which 1953 (68.9%) were early stage. In the event of a prolonged period of reduced colorectal cancer screenings, increasing fecal immunochemical test use was associated with an estimated additional 655 825 colorectal cancer screenings and 2715 colorectal cancer diagnoses, of which 1944 (71.6%) were early stage. These results suggest that the increased use of fecal immunochemical tests during the COVID-19 pandemic was associated with increased colorectal cancer screening participation and more colorectal cancer diagnoses at earlier stages. If our estimates are borne out in real-world clinical practice, increasing fecal immunochemical test–based colorectal cancer screening participation during the COVID-19 pandemic could mitigate the consequences of reduced screening rates during the pandemic for colorectal cancer outcomes.
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影响因子：
--
作者：
Inadomi, John M.;Vijan, Sandeep;Janz, Nancy K.;Fagerlin, Angela;Thomas, Jennifer P.;Lin, Yunghui V.;Munoz, Roxana;Lau, Chim;Somsouk, Ma;El-Nachef, Najwa;Hayward, Rodney A.
通讯作者：
Hayward, Rodney A.
DOI：
10.1158/1055-9965.epi-15-0470
发表时间：
2016-02
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Chubak J;Garcia MP;Burnett-Hartman AN;Zheng Y;Corley DA;Halm EA;Singal AG;Klabunde CN;Doubeni CA;Kamineni A;Levin TR;Schottinger JE;Green BB;Quinn VP;Rutter CM;PROSPR consortium
通讯作者：
PROSPR consortium
影响因子：
24.5
作者：
Church TR;Wandell M;Lofton-Day C;Mongin SJ;Burger M;Payne SR;Castaños-Vélez E;Blumenstein BA;Rösch T;Osborn N;Snover D;Day RW;Ransohoff DF;PRESEPT Clinical Study Steering Committee, Investigators and Study Team
通讯作者：
PRESEPT Clinical Study Steering Committee, Investigators and Study Team
影响因子：
15.8
作者：
Heitman SJ;Hilsden RJ;Au F;Dowden S;Manns BJ
通讯作者：
Manns BJ
影响因子：
120.7
作者：
Frazier, AL;Colditz, GA;Kuntz, KM
通讯作者：
Kuntz, KM