Impact of the COVID-19 Pandemic on Fecal Immunochemical Testing, Colonoscopy Services, and Colorectal Neoplasia Detection in a Large United States Community-based Population.
Impact of the COVID-19 Pandemic on Fecal Immunochemical Testing, Colonoscopy Services, and Colorectal Neoplasia Detection in a Large United States Community-based Population.
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DOI：
10.1053/j.gastro.2022.05.014
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发表时间：
2022-09
期刊：
影响因子：
29.4
通讯作者：
中科院分区：
文献类型：
--
作者：
2019冠状病毒病大流行影响了全球的临床服务，包括结直肠癌筛查和诊断检测。我们在一家大型综合医疗机构的21个医疗中心调查了大流行对粪便免疫化学试验（FIT）筛查、结肠镜检查使用和结直肠肿瘤检测的影响。我们在2019年和2020年对北加州凯撒医疗机构18至89岁的患者进行了一项回顾性队列研究，并测量了邮寄、完成和阳性fit数量的变化；结肠镜检查;以及2020年和2019年结肠镜检查发现的结直肠肿瘤病例数。FIT套件的邮寄在2020年3月中旬至4月停止，但随后反弹，与2019年相比，邮寄的套件增加了8.7%。随着FIT试剂盒的后期邮寄，与2019年相比，2020年完成的FIT减少了9.0%，阳性检测减少了10.1%。与2019年4月相比，2020年4月结肠镜检查量下降了79.4%，但在9月至12月恢复到接近大流行前的水平，导致2020年结肠镜检查总量下降了26.9%。2020年与2019年相比，结肠镜检查诊断为结直肠癌和晚期腺瘤的患者数量分别下降了8.7%和26.9%。与2019年相比，大流行导致2020年FIT筛查和结肠镜检查减少；然而，在取消就地安置命令后，FIT筛查超过了预期，结肠镜检查量几乎达到了2019年同期的水平。总体而言，2020年结肠镜检查诊断的结直肠癌病例减少了8.7%。这些数据可能有助于在未来国家突发事件期间制定CRC筛查和诊断检测战略。与2019年相比，2019冠状病毒病大流行导致2020年结肠镜检查量下降，结直肠癌和晚期腺瘤病例数也有所下降。
The COVID-19 pandemic has affected clinical services globally, including colorectal cancer (CRC) screening and diagnostic testing. We investigated the pandemic’s impact on fecal immunochemical test (FIT) screening, colonoscopy utilization, and colorectal neoplasia detection across 21 medical centers in a large integrated health care organization. We performed a retrospective cohort study in Kaiser Permanente Northern California patients ages 18 to 89 years in 2019 and 2020 and measured changes in the numbers of mailed, completed, and positive FITs; colonoscopies; and cases of colorectal neoplasia detected by colonoscopy in 2020 vs 2019. FIT kit mailings ceased in mid-March through April 2020 but then rebounded and there was an 8.7% increase in kits mailed compared with 2019. With the later mailing of FIT kits, there were 9.0% fewer FITs completed and 10.1% fewer positive tests in 2020 vs 2019. Colonoscopy volumes declined 79.4% in April 2020 compared with April 2019 but recovered to near pre-pandemic volumes in September through December, resulting in a 26.9% decline in total colonoscopies performed in 2020. The number of patients diagnosed by colonoscopy with CRC and advanced adenoma declined by 8.7% and 26.9%, respectively, in 2020 vs 2019. The pandemic led to fewer FIT screenings and colonoscopies in 2020 vs 2019; however, after the lifting of shelter-in-place orders, FIT screenings exceeded, and colonoscopy volumes nearly reached numbers from those same months in 2019. Overall, there was an 8.7% reduction in CRC cases diagnosed by colonoscopy in 2020. These data may help inform the development of strategies for CRC screening and diagnostic testing during future national emergencies. The COVID-19 pandemic led to declines in colonoscopy volumes and the number of colorectal cancer and advanced adenoma cases detected in 2020 compared with 2019.
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影响因子：
29.4
作者：
National Cancer Institute’s PROSPR Consortium;Corley DA;Sedki M;Ritzwoller DP;Greenlee RT;Neslund-Dudas C;Rendle KA;Honda SA;Schottinger JE;Udaltsova N;Vachani A;Kobrin S;Li CI;Haas JS
通讯作者：
Haas JS
影响因子：
9.3
作者：
Lantinga, Marten A.;Theunissen, Felix;Siersema, Peter D.
通讯作者：
Siersema, Peter D.
影响因子：
24.5
作者：
Rutter, Matthew D.;Brookes, Matthew;Sharp, Linda
通讯作者：
Sharp, Linda
影响因子：
2.8
作者：
Meyer A;Drouin J;Zureik M;Weill A;Dray-Spira R
通讯作者：
Dray-Spira R
影响因子：
5.2
作者：
Ruiz-Medina S;Gil S;Jimenez B;Rodriguez-Brazzarola P;Diaz-Redondo T;Cazorla M;Muñoz-Ayllon M;Ramos I;Reyna C;Bermejo MJ;Godoy A;Torres E;Cobo M;Galvez L;Rueda A;Alba E;Ribelles N
通讯作者：
Ribelles N