Effects of the COVID-19 Pandemic on Cancer-Related Patient Encounters
Effects of the COVID-19 Pandemic on Cancer-Related Patient Encounters
复制标题
DOI：
10.1200/cci.20.00068
复制
发表时间：
2020-07-27
影响因子：
4.2
通讯作者：
McNair, Christopher
中科院分区：
文献类型：
--
作者：
London, Jack W.;Fazio-Eynullayeva, Elnara;McNair, Christopher
目的研究新冠肺炎疫情对癌症患者护理的直接影响，但很少有关于疫情控制对癌症诊疗过程的影响的定量报道。方法我们利用TriNetX平台分析了20家拥有相关最新遭遇数据的医疗机构。使用这个COVID和癌症研究网络(CCRN)，我们比较了通过查询COVID前(2019年1月至2019年4月)和当前(2020年1月至2020年4月)遭遇数据确定的癌症队列。所有肿瘤患者(恶性、良性、原位和行为不明)、新发肿瘤(初诊)、完全恶性肿瘤和新发恶性肿瘤患者均生成队列。一家英国机构的数据也进行了类似的分析。对选定的癌症患者以及进行过癌症筛查的患者进行了额外的分析。结果确定了明显的趋势，表明目前研究的所有队列中都有显著下降，2020年4月显示出遇到癌症患者数量的最大降幅。在所分析的癌症类型中，与2019年4月相比，2020年4月肺癌、结直肠癌和血液病队列的规模下降幅度较小(分别为-39.1%、-39.9%和-39.1%)，而乳腺癌、前列腺癌和黑色素瘤的队列规模下降(分别为-47.7%、-49.1%和-51.8%)。此外，癌症筛查大幅下降，乳腺癌筛查下降了89.2%，结直肠癌筛查下降了84.5%。结论CCRN的趋势清楚地表明，由于大流行，所有与癌症相关的患者就诊人数都显著减少。癌症筛查和癌症新发病率患者的急剧减少表明，未来最初被诊断为晚期癌症的患者可能会增加，而且随着推迟测试的重新安排，对癌症筛查程序的需求也会增加。(C)2020年美国临床肿瘤学会
PURPOSE While there are studies under way to characterize the direct effects of the COVID-19 pandemic on the care of patients with cancer, there have been few quantitative reports of the impact that efforts to control the pandemic have had on the normal course of cancer diagnosis and treatment encounters.METHODS We used the TriNetX platform to analyze 20 health care institutions that have relevant, up-to-date encounter data. Using this COVID and Cancer Research Network (CCRN), we compared cancer cohorts identified by querying encounter data pre-COVID (January 2019-April 2019) and current (January 2020-April 2020). Cohorts were generated for all patients with neoplasms (malignant, benign, in situ, and of unspecified behavior), with new incidence neoplasms (first encounter), with exclusively malignant neoplasms, and with new incidence malignant neoplasms. Data from a UK institution were similarly analyzed. Additional analyses were performed on patients with selected cancers, as well as on those having had cancer screening.RESULTS Clear trends were identified that suggest a significant decline in all current cohorts explored, with April 2020 displaying the largest decrease in the number of patients with cancer having encounters. Of the cancer types analyzed, lung, colorectal, and hematologic cancer cohorts exhibited smaller decreases in size in April 2020 versus 2019 (-39.1%, -39.9%, -39.1%, respectively) compared with cohort size decreases for breast cancer, prostate cancer, and melanoma (-47.7%, -49.1%, -51.8%, respectively). In addition, cancer screenings declined drastically, with breast cancer screenings dropping by -89.2% and colorectal cancer screenings by -84.5%.CONCLUSION Trends seen in the CCRN clearly suggest a significant decrease in all cancer-related patient encounters as a result of the pandemic. The steep decreases in cancer screening and patients with a new incidence of cancer suggest the possibility of a future increase in patients with later-stage cancer being seen initially as well as an increased demand for cancer screening procedures as delayed tests are rescheduled. (c) 2020 by American Society of Clinical Oncology