Incident Cancer Detection During the COVID-19 Pandemic
Incident Cancer Detection During the COVID-19 Pandemic
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DOI：
10.6004/jnccn.2021.7114
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发表时间：
2022-03-01
影响因子：
13.4
通讯作者：
Sutradhar, Rinku
中科院分区：
文献类型：
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作者：
Eskander, Antoine;Li, Qing;Sutradhar, Rinku
背景：许多司法管辖区都制定了资源限制措施，以在 COVID-19 大流行期间维持卫生系统的能力。医疗保健服务中断可能会影响早期癌症检测。这项研究的目的是评估大流行对每周报告的癌症发病率的影响。患者和方法：这是一项基于人群的研究，涉及2016年9月25日至2020年9月26日在加拿大安大略省被诊断患有癌症的个体。使用分段负二项式回归模型检查每周癌症发病率计数。大流行期间每周的估计积压是通过从该周的预计/预期数量中减去观察到的数量来计算的。结果：该队列由 358,487 名成年癌症患者组成。在大流行开始时，估计的平均癌症发病率立即下降了 34.3%（相对率，0.66；95% CI，0.57-0.75），随后每周癌症发病率增加 1%（相对率，1.009；95% CI，1.001-1.017）。在筛查和非筛查癌症中也发现了类似的趋势。黑色素瘤、宫颈癌、内分泌癌和前列腺癌的直接下降幅度最大。 COVID-19 期间，肝胆癌和肺癌的发病率每周持续下降。 2020 年 3 月 15 日至 9 月 26 日期间，被诊断患有癌症的人数减少了 12,601 人，估计每周积压 450 人。 结论：我们估计，有大量与 COVID-19 大流行相关的癌症病例未被发现。发病率尚未恢复到大流行前的水平。
Background: Resource restrictions were established in many jurisdictions to maintain health system capacity during the COVID-19 pandemic. Disrupted healthcare access likely impacted early cancer detection. The objective of this study was to assess the impact of the pandemic on weekly reported cancer incidence. Patients and Methods: This was a population-based study involving individuals diagnosed with cancer from September 25, 2016, to September 26, 2020, in Ontario, Canada. Weekly cancer incidence counts were examined using segmented negative binomial regression models. The weekly estimated backlog during the pandemic was calculated by subtracting the observed volume from the projected/expected volume in that week. Results: The cohort consisted of 358,487 adult patients with cancer. At the start of the pandemic, there was an immediate 34.3% decline in the estimated mean cancer incidence volume (relative rate, 0.66; 95% CI, 0.57-0.75), followed by a 1% increase in cancer incidence volume in each subsequent week (relative rate, 1.009; 95% CI, 1.001-1.017). Similar trends were found for both screening and nonscreening cancers. The largest immediate declines were seen for melanoma and cervical, endocrinologic, and prostate cancers. For hepatobiliary and lung cancers, there continued to be a weekly decline in incidence during the COVID-19 period. Between March 15 and September 26, 2020, 12,601 fewer individuals were diagnosed with cancer, with an estimated weekly backlog of 450. Conclusions: We estimate that there is a large volume of undetected cancer cases related to the COVID-19 pandemic. Incidence rates have not yet returned to prepandemic levels.