A national quality improvement study identifying and addressing cancer screening deficits due to the COVID-19 pandemic.
A national quality improvement study identifying and addressing cancer screening deficits due to the COVID-19 pandemic.
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DOI：
10.1002/cncr.34157
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发表时间：
2022-06-01
期刊：
影响因子：
6.2
通讯作者：
Cance, William G.
中科院分区：
文献类型：
--
作者：
Joung, Rachel H.;Nelson, Heidi;Mullett, Timothy W.;Kurtzman, Scott H.;Shafir, Sarah;Harris, James B.;Yao, Katharine A.;Brajcich, Brian C.;Bilimoria, Karl Y.;Cance, William G.
关键词：
由于与COVID-19大流行相关的癌症筛查不足，预计未来十年的癌症相关死亡人数将增加。虽然国家赤字已经量化，但尚未广泛采取结构性对策来确定和解决地方赤字。我们的目标是在不同的环境中分享关于乳腺癌，结直肠癌，肺癌和宫颈癌每月筛查缺陷的初步数据，并提供来自国家质量改进（QI）研究的在线材料，以帮助其他机构解决当地筛查缺陷。这项关于重返筛查的前瞻性国家QI研究于2021年4月至6月在美国招募了748个经认可的癌症项目。使用当地大流行前和大流行期间的每月筛查检测量（MTV）计算MTV的相对百分比变化，以描述每月筛查缺口。大多数机构报告了每月筛查缺陷（结直肠，80.6%（n=104/129）;宫颈，69.0%（n=20/29）;乳腺，55.3%（n=241/436）;肺，44.6%（n=98/220））。总体而言，MTV的中位相对百分比变化范围为：结直肠为-17.7%（IQR，-33.6%至2.8%），宫颈为-6.8%（IQR，-29.4%至1.7%），乳腺为-1.6%（IQR，-9.6%至7.0%），肺为1.2%（IQR，-16.9%至19.0%）。未观察到地域差异。结直肠癌筛查机构类型之间MTV的百分比变化存在统计学显著差异（p= 0.02）。癌症筛查仍然需要紧急关注，在线提供的筛查资源可以帮助设施缩小关键差距，并解决2020年错过的筛查问题。一项包括748家癌症机构的全国重返筛查质量改进研究发现，由于COVID-19大流行，大多数机构都存在局部筛查不足，尤其是结直肠癌。癌症筛查仍然需要紧急关注，在线提供的筛查资源可能有助于缩小关键差距并解决2020年错过的筛查。
Cancer-related deaths over the next decade are expected to increase due to cancer screening deficits associated with the COVID-19 pandemic. While national deficits have been quantified, structured response to identifying and addressing local deficits has not been widely available. Our objectives are to share preliminary data on monthly screening deficits in breast, colorectal, lung, and cervical cancers across diverse settings and provide online materials from a national quality improvement (QI) study to help other institutions address local screening deficits. This prospective national QI study on Return-to-Screening enrolled 748 accredited cancer programs in the US from April through June 2021. Local pre-pandemic and during-pandemic monthly screening test volumes (MTV) were used to calculate relative percent change in MTV to describe monthly screening gap. The majority of facilities reported monthly screening deficits (colorectal, 80.6% (n=104/129); cervical, 69.0% (n=20/29); breast, 55.3% (n=241/436); lung, 44.6% (n=98/220)). Overall, the median relative percent change in MTV ranged from −17.7% (IQR, −33.6% to −2.8%) in colorectal, −6.8% (IQR, −29.4% to 1.7%) in cervical, −1.6% (IQR, −9.6% to 7.0%) in breast, and 1.2% (IQR, −16.9% to 19.0%) in lung. Geographic differences were not observed. There was statistically significant differences in percent change in MTV between institution types for colorectal cancer screening (p=.02). Cancer screening is still in need of urgent attention and the screening resources made available online may help facilities close critical gaps and address 2020 missed screenings. A national Return-to-Screening quality improvement study including 748 cancer facilities found that the majority have local screening deficits due to the COVID-19 pandemic, most notably in colorectal cancer. Cancer screening is still in need of urgent attention and the screening resources made available online may help close critical gaps and address 2020 missed screenings.
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