Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Thoracic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
J Am Coll Surg. 2021 Apr;232(4):600-605. doi: 10.1016/j.jamcollsurg.2020.12.002. Epub 2020 Dec 17.
Low-dose CT (LDCT) screening reduces lung cancer mortality by at least 20%. The COVID-19 pandemic required an unprecedented shutdown in our institutional LDCT program. The purpose of this study was to examine the impact of COVID-19 on lung cancer screening and subsequent cancer diagnosis.
We analyzed our prospective institutional LDCT screening database, which began in 2012. In all, 2,153 patients have participated. Monthly mean number of LDCTs were compared between baseline (January 2017 to February 2020) and COVID-19 periods (March 2020 to July 2020).
LDCT was suspended on March 13, 2020 and 818 screening visits were cancelled. Phased reopening began on May 5, 2020 and full opening on June 1, 2020. Total monthly mean ± SD LDCTs (146 ± 31 vs 39 ± 40; p < 0.01) and new patient monthly LDCTs (56 ± 14 vs 15 ± 17; p < 0.01) were significantly decreased during the COVID-19 period. New patient monthly LDCTs have remained low despite resuming full operations. Three- and 6-month interval follow-up LDCTs were prioritized and were significantly increased compared with baseline (11 ± 4 vs 30 ± 4; p < 0.01). The "no-show" rate was significantly increased from baseline (15% vs 40%; p < 0.04). Most concerning, the percentage of patients with lung nodules suspicious for malignancy (Lung-RADS 4) were significantly increased after screenings resumed (8% vs 29%; p < 0.01).
COVID-19 caused significant disruption in lung cancer screening, leading to a decrease in new patients screened and an increased proportion of nodules suspicious for malignancy once screening resumed. Using lung cancer and the LDCT screening program as a model, this early analysis showed the unrecognized consequences related to the pandemic for screening programs and cancer care.
低剂量 CT（LDCT）筛查可使肺癌死亡率降低至少 20%。COVID-19 大流行导致我们的机构 LDCT 计划前所未有地关闭。本研究的目的是研究 COVID-19 对肺癌筛查和随后癌症诊断的影响。
我们分析了我们的前瞻性机构 LDCT 筛查数据库，该数据库始于 2012 年。共有 2153 名患者参与。将基线（2017 年 1 月至 2020 年 2 月）和 COVID-19 期间（2020 年 3 月至 2020 年 7 月）的每月平均 LDCT 数量进行比较。
LDCT 于 2020 年 3 月 13 日暂停，取消了 818 次筛查访问。分阶段重新开放于 2020 年 5 月 5 日开始，全面开放于 2020 年 6 月 1 日开始。COVID-19 期间，每月平均 LDCT（146 ± 31 与 39 ± 40；p < 0.01）和新患者每月 LDCT（56 ± 14 与 15 ± 17；p < 0.01）显著减少。尽管恢复了全面运作，但新患者每月的 LDCT 仍保持较低水平。3 个月和 6 个月间隔的后续 LDCT 被优先考虑，与基线相比（11 ± 4 与 30 ± 4；p < 0.01）显著增加。“失约”率从基线开始（15% 与 40%；p < 0.04）显著增加。最令人担忧的是，筛查恢复后，怀疑恶性肿瘤的肺结节（Lung-RADS 4）患者的比例显著增加（8% 与 29%；p < 0.01）。
COVID-19 对肺癌筛查造成了严重干扰，导致新筛查患者减少，筛查恢复后怀疑恶性肿瘤的结节比例增加。使用肺癌和 LDCT 筛查计划作为模型，这项早期分析显示了与大流行相关的筛查计划和癌症护理的未被认识的后果。
