Assessing the long-term impacts of the COVID-19 pandemic on disparities in cancer screening and follow-up

评估 COVID-19 大流行对癌症筛查和随访差异的长期影响

• 批准号: 10673630
• 负责人: GLORIA D CORONADO
• 金额: $ 59.82万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10673630
• 关键词: Adult; American Cancer Society; Authorization documentation; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 pandemic effects; Cancer Intervention and Surveillance Modeling Network; Caring; Centers for Population Health; Cessation of life; Clinic; Clinical; Collaborations; Colonoscopy; Colorectal Cancer; Communities; Data; Data Sources; Disparity; Drops; Electronic Health Record; Eligibility Determination; Ensure; Equity; Ethnic Origin; Federally Qualified Health Center; Fright; Future; Gastroenterology; Goals; Health Services; Health Services Accessibility; Health system; Hospitalization; Incidence; Income; Individual; Insurance Coverage; Interruption; Intervention; Interview; Job loss; Language; Latinx; Latinx population; Life; Long-Term Care; Long-Term Effects; Low income; Malignant Neoplasms; Mammography; Medical; Methods; Modeling; Natural Disasters; Neighborhood Health Center; Outcome; Pap smear; Patients; Pattern; Persons; Preventive care; Primary Care; Protocols documentation; Provider; Race; Recommendation; Recovery; Recovery Support; Reduce health disparities; Research; Resources; SARS-CoV-2 infection; Screening for cancer; Services; Site; United States; Visit; Vulnerable Populations; authority; cancer diagnosis; cancer health disparity; cancer prevention; care delivery; coronavirus disease; disparity reduction; economic impact; experience; federal poverty level; follow-up; health assessment; health disparity populations; improved; infection rate; innovation; long term consequences of COVID-19; medical specialties; models and simulation; pandemic disease; pandemic impact; patient-level barriers; post-COVID-19; post-pandemic; pre-pandemic; preference; prevent; screening; screening services; service delivery; sex; telehealth; trend; uptake

PROJECT SUMMARY/ABSTRACT: The COVID-19 pandemic has led to dramatic reductions in cancer screening and follow-up services. During the early months of the pandemic, national organizations recommended postponing all routine cancer screening, resulting in dramatic reductions in adult primary care and specialty care visits; current rates remain far below pre-pandemic levels. Modeling suggests that these reductions will result in over 57,000 missed cancer diagnoses and 10,000 excess deaths over the next decade. However, these models are largely informed by data sources made up predominantly of insured patients and lacking race/ethnicity information. Thus, more information is needed to understand the strategies and resources need to support the recovery of health systems and communities that have been most impacted by COVID-19. The effects of the pandemic on cancer screening uptake may be particularly profound for patients served by resource-limited federally qualified health centers (FQHCs), which deliver services a large share of patients with incomes below the federal poverty level and who are Latinx. Latinx populations already have some of the lowest rates of cancer screening and follow-up care in the United States and are likely to experience the largest reductions in care and slower return to normal following COVID-19. This is, in part, because their communities have been hit particularly hard by COVID-19 (e.g. high rates of COVID-19 infections and hospitalizations and job loss) and they may fear returning for preventive care even when medical authorities have deemed it safe. Our proposed mixed-methods study will estimate the impact of the COVID-19 pandemic on rates of cancer screening and follow-up in patients served by a large, diverse FQHC (Aim 1), and estimate impacts on cancer outcomes (e.g. changes in life years gained, cancers prevented, and late-stage cancer incidence) in the FQHC population building on models developed by the CRC-SPN Cancer Intervention and Surveillance Modeling Network (Aim 2). Finally, we will gather qualitative data from clinic staff and patients to identify opportunities to improve post-pandemic cancer preventive care delivery for adults served by FQHCs (Aim 3). There is a critical need to understand the long-term impacts of COVID-19-care reductions on vulnerable populations and identify opportunities to meet the ongoing cancer prevention needs of patients served by FQHCs. We will collaborate with national stakeholders to develop FQHC-specific guidance to inform future interventions to support recovery from COVID-like care disruptions Thus, our findings will support access to care and reduction of health disparities for communities most impacted by COVID-19.

项目摘要/摘要：COVID-19大流行导致癌症的急剧减少 筛选和后续服务。在大流行的早期，国家组织 建议推迟所有常规癌症筛查，从而导致成人初级保健的大幅减少 和专业护理访问；目前的速度仍然远低于大频前水平。建模表明这些 减少将导致超过57,000多个癌症诊断和10,000多次死亡。 十年。但是，这些模型主要由被保险人组成的数据源告知 患者和缺乏种族/民族信息。因此，需要更多信息来了解 策略和资源需要支持卫生系统和社区的恢复 受到19号的影响最大。大流行对癌症筛查摄取的影响尤其是 对于由资源有限的联邦合格卫生中心（FQHC）服务的患者，该患者提供 为收入低于联邦贫困水平和拉丁裔的大量患者提供服务。拉丁文 人口的癌症筛查率最低，曼联的随访护理 州并且很可能会体验最大的护理减少和较慢的恢复正常之后 新冠肺炎。这部分是因为Covid-19的社区受到了特别严重的打击（例如 共同199的感染和住院和失业的高率），他们可能会担心返回 即使医疗当局认为安全，预防保健也是如此。我们提出的混合方法研究将 估计Covid-19-19的影响对患者癌症筛查率和随访的影响 由大型，多样化的FQHC（AIM 1）服务，并估计对癌症结果的影响（例如，生活的变化 在FQHC人口建设中获得的几年，癌症预防和晚期癌症发生率） 由CRC-SPN癌症干预和监视建模网络开发的模型（AIM 2）。最后， 我们将从诊所工作人员和患者那里收集定性数据，以确定改善大流行的机会 FQHC服务的成年人的癌症预防治疗（AIM 3）。迫切需要了解 COVID-19-Care减少对弱势群体的长期影响，并确定机会 满足FQHC服务患者的持续预防癌症需求。我们将与国家合作 利益相关者开发FQHC特定指导，以告知未来干预措施，以支持从 因此，类似于共同的护理中断，我们的发现将支持获得护理和减少健康差异的机会 对于受到Covid-19的影响最大的社区。