Measuring the impact of the COVID-19 pandemic on organized cancer screening and diagnostic follow-up care in Ontario, Canada: A provincial, population-based study.
Measuring the impact of the COVID-19 pandemic on organized cancer screening and diagnostic follow-up care in Ontario, Canada: A provincial, population-based study.
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衡量199年大流行对加拿大安大略省有组织的癌症筛查和诊断随访护理的影响：一项基于人群的省级研究。
DOI：
10.1016/j.ypmed.2021.106586
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发表时间：
2021-10
影响因子：
5.1
通讯作者：
Rabeneck, Linda
中科院分区：
文献类型：
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作者：
Walker, Meghan J;Meggetto, Olivia;Gao, Julia;Espino-Hernandez, Gabriela;Jembere, Nathaniel;Bravo, Caroline A;Rey, Michelle;Aslam, Usman;Sheppard, Amanda J;Lofters, Aisha K;Tammemagi, Martin C;Tinmouth, Jill;Kupets, Rachel;Chiarelli, Anna M;Rabeneck, Linda
必须量化 COVID-19 大流行对癌症筛查（包括对弱势群体）的影响，以便为制定基于证据的、有针对性的大流行恢复策略提供信息。我们在加拿大安大略省进行了一项基于人群的回顾性观察研究，以评估大流行对有组织的癌症筛查和诊断服务的影响，并评估大流行期间不同人群的癌症筛查服务使用和诊断延迟模式是否存在差异。省级健康数据库用于识别在 2019 年 1 月 1 日至 2020 年 12 月 31 日期间参加安大略省一项或多项乳腺癌、宫颈癌、结直肠癌和肺癌筛查计划的符合年龄条件的个人。安大略省的筛查计划在 2020 年比 2019 年减少了 951,000 次 (−41%) 筛查测试，并且大多数计划的数量到 2019 年底仍比历史水平低 20% 以上。 2020 年。与 2019 年相比，大流行期间宫颈筛查参与者年龄较大（50-59 岁和 60-69 岁）的比例较小。大流行期间，年龄最大的群体和低收入社区的个体在乳腺癌、宫颈癌或结直肠癌筛查测试异常后更有可能出现诊断延迟，而生活在原住民保护区的可能性较高的个体在粪便测试异常后出现诊断延迟的可能性明显更大。必须继续对积压工作进行持续监控和管理。需要进一步评估，以确定哪些人群获得癌症筛查和诊断护理受到了不成比例的影响，并量化这些服务中断对癌症发病率、分期和死亡率的影响。这些信息对于旨在实现公平和及时获得癌症筛查相关护理的大流行恢复工作至关重要。
It is essential to quantify the impacts of the COVID-19 pandemic on cancer screening, including for vulnerable sub-populations, to inform the development of evidence-based, targeted pandemic recovery strategies. We undertook a population-based retrospective observational study in Ontario, Canada to assess the impact of the pandemic on organized cancer screening and diagnostic services, and assess whether patterns of cancer screening service use and diagnostic delay differ across population sub-groups during the pandemic. Provincial health databases were used to identify age-eligible individuals who participated in one or more of Ontario's breast, cervical, colorectal, and lung cancer screening programs from January 1, 2019–December 31, 2020. Ontario's screening programs delivered 951,000 (−41%) fewer screening tests in 2020 than in 2019 and volumes for most programs remained more than 20% below historical levels by the end of 2020. A smaller percentage of cervical screening participants were older (50–59 and 60–69 years) during the pandemic when compared with 2019. Individuals in the oldest age groups and in lower-income neighborhoods were significantly more likely to experience diagnostic delay following an abnormal breast, cervical, or colorectal cancer screening test during the pandemic, and individuals with a high probability of living on a First Nation reserve were significantly more likely to experience diagnostic delay following an abnormal fecal test. Ongoing monitoring and management of backlogs must continue. Further evaluation is required to identify populations for whom access to cancer screening and diagnostic care has been disproportionately impacted and quantify impacts of these service disruptions on cancer incidence, stage, and mortality. This information is critical to pandemic recovery efforts that are aimed at achieving equitable and timely access to cancer screening-related care.