Effects of cancer screening restart strategies after COVID-19 disruption.
Effects of cancer screening restart strategies after COVID-19 disruption.
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DOI：
10.1038/s41416-021-01261-9
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发表时间：
2021-04
影响因子：
8.8
通讯作者：
de Kok IMCM
中科院分区：
文献类型：
--
作者：
Kregting LM;Kaljouw S;de Jonge L;Jansen EEL;Peterse EFP;Heijnsdijk EAM;van Ravesteyn NT;Lansdorp-Vogelaar I;de Kok IMCM
由于COVID-19大流行，许多乳腺癌、宫颈癌和结直肠癌筛查项目中断。本研究旨在评估中断后五种重启策略对所需筛查能力和癌症负担的影响。微观模拟模型模拟了乳腺癌、宫颈癌和结直肠癌筛查的五种重启策略。这些模型估计了中断6个月后所需的筛查能力、癌症发病率和癌症特异性死亡率。重启策略的不同在于屏幕是否被赶上，如果是，立即或延迟，以及年龄上限是否增加。筛查计划的中断而没有赶上错过的筛查，导致乳腺癌、宫颈癌和结直肠癌在10年内每10万人中分别增加了2.0、0.3和2.5例癌症死亡。立即弥补错过的屏幕最大限度地减少了中断的影响，但需要在筛选能力激增。延迟筛查，但仍然提供所有筛查轮次，在所需容量、发病率和死亡率之间取得了最佳平衡。对健康影响损失最小的策略也是筛查组织负担最重的策略。哪种战略是首选取决于组织和国家的可用能力。
Many breast, cervical, and colorectal cancer screening programmes were disrupted due to the COVID-19 pandemic. This study aimed to estimate the effects of five restart strategies after the disruption on required screening capacity and cancer burden. Microsimulation models simulated five restart strategies for breast, cervical, and colorectal cancer screening. The models estimated required screening capacity, cancer incidence, and cancer-specific mortality after a disruption of 6 months. The restart strategies varied in whether screens were caught up or not and, if so, immediately or delayed, and whether the upper age limit was increased. The disruption in screening programmes without catch-up of missed screens led to an increase of 2.0, 0.3, and 2.5 cancer deaths per 100 000 individuals in 10 years in breast, cervical, and colorectal cancer, respectively. Immediately catching-up missed screens minimised the impact of the disruption but required a surge in screening capacity. Delaying screening, but still offering all screening rounds gave the best balance between required capacity, incidence, and mortality. Strategies with the smallest loss in health effects were also the most burdensome for the screening organisations. Which strategy is preferred depends on the organisation and available capacity in a country.
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影响因子：
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通讯作者：
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