Division of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Natl Cancer Inst. 2021 Jun 1;113(6):662-664. doi: 10.1093/jnci/djaa089.
These past months of the coronavirus disease-2019 (COVID-2019) pandemic have given us ample opportunity to reflect on the US health-care system. Despite overwhelming tragedy, it is an opportunity for us to learn and to change. As we postpone routine visits because of the pandemic, we worry about risks for patients who delay cancer screening. We use cervical cancer screening and prevention as an example of how we can use some "lessons learned" from the pandemic to prevent "collateral losses," such as an increase in cancers. COVID-2019-related health-system changes, like the more rapid evaluation of diagnostic tests and vaccines, the transition to compensated virtual care for most counseling and education visits, and broadened access to home services, offer potential benefits to the delivery of cervical cancer screening and prevention. While we detail the case for cervical cancer prevention, many of the issues discussed are generalizable to other preventative measures. It would be a tragedy if the morbidity and mortality of COVID-2019 are multiplied because of additional suffering caused by delayed or deferred cancer screening and diagnostic evaluation-but maybe with creativity and reflection, we can use this pandemic to improve care.
过去几个月的 2019 冠状病毒病（COVID-19）大流行让我们有充分的机会反思美国的医疗保健系统。尽管发生了巨大的悲剧，但这也是我们学习和改变的机会。由于大流行，我们推迟了常规就诊，担心那些推迟癌症筛查的患者会有风险。我们以宫颈癌筛查和预防为例，说明我们如何利用大流行中的一些“经验教训”来预防“附带损失”，如癌症发病率的增加。与 COVID-19 相关的卫生系统变化，如更快速地评估诊断测试和疫苗，向大多数咨询和教育访问过渡到有补偿的虚拟护理，以及更广泛地获得家庭服务，为宫颈癌筛查和预防提供了潜在的好处。虽然我们详细说明了宫颈癌预防的情况，但所讨论的许多问题都可以推广到其他预防措施。如果 COVID-19 的发病率和死亡率因癌症筛查和诊断评估的延迟或推迟而导致更多的痛苦而增加，那将是一场悲剧——但也许通过创造力和反思，我们可以利用这场大流行来改善医疗服务。
