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新冠疫情时代的癌症预防差距。

Disparities in Cancer Prevention in the COVID-19 Era.

机构信息

Departments of Internal Medicine and Human Genetics and Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan.

American Association for Cancer Research, Philadelphia, Pennsylvania.

出版信息

Cancer Prev Res (Phila). 2020 Nov;13(11):893-896. doi: 10.1158/1940-6207.CAPR-20-0447. Epub 2020 Sep 17.

Abstract

Screening for cancer is a proven and recommended approach to prevent deaths from cancer; screening can locate precursor lesions and/or cancer at early stages when it is potentially curable. Racial and ethnic minorities and other medically underserved populations exhibit lower uptake of cancer screening than nonminorities in the United States. The COVID-19 pandemic, which disproportionately affected minority communities, has curtailed preventive services including cancer screening to preserve personal protective equipment and prevent spread of infection. While there is evidence for a rebound from the pandemic-driven reduction in cancer screening nationally, the return may not be even across all populations, with minority population screening that was already behind becoming further behind as a result of the community ravages from COVID-19. Fear of contracting COVID-19, limited access to safety-net clinics, and personal factors like, financial, employment, and transportation issues are concerns that are intensified in medically underserved communities. Prolonged delays in cancer screening will increase cancer in the overall population from pre-COVID-19 trajectories, and elevate the cancer disparity in minority populations. Knowing the overall benefit of cancer screening versus the risk of acquiring COVID-19, utilizing at-home screening tests and keeping the COVID-19-induced delay in screening to a minimum might slow the growth of disparity.

摘要

癌症筛查是预防癌症死亡的经过验证和推荐的方法;筛查可以在癌症处于早期、具有潜在可治愈性的时候发现癌前病变和/或癌症。在美国,少数民族和其他医疗服务不足的人群接受癌症筛查的比例低于非少数民族。新冠疫情对少数族裔社区的影响不成比例,已经减少了包括癌症筛查在内的预防服务,以保护个人防护设备并防止感染的传播。尽管有证据表明,全国范围内因疫情而减少的癌症筛查有所反弹,但这种反弹可能并不均衡,少数族裔人口的筛查已经落后,因为新冠疫情对社区造成了严重破坏。对感染新冠病毒的恐惧、获得安全网诊所的机会有限以及经济、就业和交通等个人因素,这些在医疗服务不足的社区中更为严重。癌症筛查的持续延迟将使总体人口中的癌症发病率从新冠疫情前的轨迹上升,并加剧少数族裔人群中的癌症差异。了解癌症筛查的总体益处与感染新冠病毒的风险,利用家庭癌症筛查测试并将因新冠疫情而导致的筛查延迟降到最低,可能会减缓差距的扩大。

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