COVID-19 Pandemic Had Minimal Impact on Colonoscopy Completion After Colorectal Cancer Red Flag Sign or Symptoms in US Veterans.
COVID-19 Pandemic Had Minimal Impact on Colonoscopy Completion After Colorectal Cancer Red Flag Sign or Symptoms in US Veterans.
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DOI：
10.1007/s10620-022-07685-4
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发表时间：
2023-04
影响因子：
3.1
通讯作者：
Gupta, Samir
中科院分区：
文献类型：
--
作者：
Demb, Joshua;Liu, Lin;Bustamante, Ranier;Dominitz, Jason A.;Earles, Ashley;Shah, Shailja C.;Gawron, Andrew J.;Martinez, Maria Elena;Gupta, Samir
在COVID-19大流行期间，结肠镜检查中结肠直肠癌（CRC）危险体征或症状的延误尚未得到很好的表征。在COVID-19大流行之前和期间，检查红旗诊断后结肠镜检查的接受情况和结肠镜检查的时间。对2019年4月至2020年12月接受退伍军人健康管理局（VHA）护理的50-75岁缺铁性贫血（IDA）、便血或粪血检查异常的成年人进行队列研究。指数日期是第一个红旗诊断日期，分为优先诊断程序的“前”（2019年4月至12月）和“内”（2020年4月至12月）政策实施，允许三个月的“洗脱期”（2020年1月至3月）。结果是结肠镜检查完成情况和结肠镜检查时间，使用具有风险比（aHRs）和95%置信区间（CIs）的多变量Cox模型进行检查。共有52,539名成年人出现危险迹象或症状（covid前：25,154；洗脱期：7527；covid内：19,858）。完成结肠镜检查的比例在covid -19前与covid -19内相似（27.0% vs 26.5%; p = 0.24）。结肠镜检查完成者在covid -19前和covid -19内结肠镜检查的中位时间相似（46天和42天），但IDA患者的中位时间更长（60天和49天）。时间和结肠镜检查完成度之间没有关联（aHR: 0.99, 95% CI 0.95-1.03）。在COVID-19大流行期间，VHA没有延迟结肠镜检查CRC红旗体征和症状，这可能是由于VHA支持优先级和完成的政策。需要进一步开展工作，了解COVID-19筛查和监测政策如何影响crc相关结果，以及如何优化红旗诊断后结肠镜检查的完成情况。在线版本包含补充材料，可在10.1007/s10620- 022-076885 -4获得。
Delays in colonoscopy work-up for red flag signs or symptoms of colorectal cancer (CRC) during the COVID-19 pandemic are not well characterized. To examine colonoscopy uptake and time to colonoscopy after red flag diagnosis, before and during the COVID-19 pandemic. Cohort study of adults ages 50–75 with iron deficiency anemia (IDA), hematochezia, or abnormal stool blood test receiving Veterans Health Administration (VHA) care from April 2019 to December 2020. Index date was first red flag diagnosis date, categorized into “pre” (April–December 2019) and “intra” (April–December 2020) policy implementation prioritizing diagnostic procedures, allowing for a 3-month “washout” (January–March 2020) period. Outcomes were colonoscopy completion and time to colonoscopy pre- vs. intra-COVID-19, examined using multivariable Cox models with hazard ratios (aHRs) and 95% confidence intervals (CIs). There were 52,539 adults with red flag signs or symptoms (pre-COVID: 25,154; washout: 7527; intra-COVID: 19,858). Proportion completing colonoscopy was similar pre- vs. intra-COVID-19 (27.0% vs. 26.5%; p = 0.24). Median time to colonoscopy among colonoscopy completers was similar for pre- vs. intra-COVID-19 (46 vs. 42 days), but longer for individuals with IDA (60 vs. 49 days). There was no association between time period and colonoscopy completion (aHR: 0.99, 95% CI 0.95–1.03). Colonoscopy work-up of CRC red flag signs and symptoms was not delayed within VHA during the COVID-19 pandemic, possibly due to VHA policies supporting prioritization and completion. Further work is needed to understand how COVID-19 policies on screening and surveillance impact CRC-related outcomes, and how to optimize colonoscopy completion after a red flag diagnosis. The online version contains supplementary material available at 10.1007/s10620-022-07685-4.
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DOI：
10.3322/caac.21452
发表时间：
2018-05
期刊：
CA: a cancer journal for clinicians
影响因子：
--
作者：
Doubeni CA;Gabler NB;Wheeler CM;McCarthy AM;Castle PE;Halm EA;Schnall MD;Skinner CS;Tosteson ANA;Weaver DL;Vachani A;Mehta SJ;Rendle KA;Fedewa SA;Corley DA;Armstrong K
通讯作者：
Armstrong K
影响因子：
4.5
作者：
Semprini, Jason;Olopade, Olufunmilayo
通讯作者：
Olopade, Olufunmilayo
影响因子：
29.4
作者：
Rockey, Don C.;Altayar, Osama;Kalmaz, Denise
通讯作者：
Kalmaz, Denise
影响因子：
29.4
作者：
San Miguel Y;Demb J;Martinez ME;Gupta S;May FP
通讯作者：
May FP
影响因子：
4.7
作者：
McGinnis, Kathleen A.;Brandt, Cynthia A.;Crothers, Kristina
通讯作者：
Crothers, Kristina