Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium.
Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
Pathobiology. 2021;88(1):46-55. doi: 10.1159/000509546. Epub 2020 Jul 7.
The severe acute respiratory syndrome coronavirus 2 caused a pandemic of coronavirus disease 2019 (COVID-19). Unprecedented public health actions were introduced, including social distancing, travel restrictions and quarantine. The Belgian government announced a national emergency plan, thereby postponing all non-urgent medical consultations and operations. This report analyses the impact of these measures on cancer screening, through assessment of the workload of a laboratory for histopathology and cytopathology.
Data on monthly numbers of histological and cytological samples, immunohistochemistry and molecular tests were extracted from the laboratory information management system.
The global histopathological and cytological workload was substantially reduced. The impact on oncology-related surgical procedures was rather limited. The anti-COVID-19 measures significantly diminished all screening-related samples, such as colon biopsies, breast biopsies and cervical cytology, and strongly reduced the number of samples related to "functional" pathology, such as thyroidectomies and gastric biopsies.
Since many health care interventions are reflected in the workload of a pathology laboratory, this study enabled us to identify areas for "deconfinement" health care actions. Our findings indicate that various areas in medicine were affected, but the impact seemed largest for cancer screening. Health care professionals should assure that consultations related to cancer screening are postponed instead of cancelled.
严重急性呼吸系统综合征冠状病毒 2 导致了 2019 年冠状病毒病(COVID-19)的大流行。为应对这一情况,前所未有的公共卫生措施被提上日程,包括社交距离、旅行限制和隔离。比利时政府宣布了国家紧急计划,从而推迟了所有非紧急的医疗咨询和手术。本报告通过分析组织病理学和细胞病理学实验室的工作量,分析了这些措施对癌症筛查的影响。
从实验室信息管理系统中提取了每月组织学和细胞学样本、免疫组织化学和分子检测的数据。
全球组织病理学和细胞学工作量大幅减少。对肿瘤相关手术的影响相当有限。抗 COVID-19 措施显著减少了所有与筛查相关的样本,如结肠活检、乳腺活检和宫颈细胞学检查,并大大减少了与“功能”病理学相关的样本数量,如甲状腺切除术和胃活检。
由于许多医疗干预措施都反映在病理实验室的工作量中,因此本研究使我们能够确定“解除隔离”医疗行动的领域。我们的研究结果表明,医学的各个领域都受到了影响,但对癌症筛查的影响似乎最大。医疗保健专业人员应确保推迟与癌症筛查相关的咨询,而不是取消。