Division of Cancer Control and Population Sciences, National Cancer Institute, USA.
The Permanente Medical Group, Kaiser Permanente, Northern California, USA.
Prev Med. 2021 Oct;151:106595. doi: 10.1016/j.ypmed.2021.106595. Epub 2021 Jun 30.
COVID-19 has proved enormously disruptive to the provision of cancer screening, which does not just represent an initial test but an entire process, including risk detection, diagnostic follow-up, and treatment. Successful delivery of services at all points in the process has been negatively affected by the pandemic. There is a void in empirical high-quality evidence to support a specific strategy for administering cancer screening during a pandemic and its resolution phase, but several pragmatic considerations can help guide prioritization efforts. Targeting guideline-eligible people who have never been screened, or those who are significantly out of date with screening, has the potential to maximize benefits now and into the future. Disruptions to care due to the pandemic could represent an unparalleled opportunity to reassess early detection programs towards an explicit, thoughtful, and just prioritization of populations historically experiencing cancer disparities. By focusing screening services on populations that have the most to gain, and by careful and deliberate planning for the period following the pandemic, we can positively affect cancer outcomes for all.
COVID-19 极大地扰乱了癌症筛查的提供，这不仅代表了初始检测，而且代表了整个过程，包括风险检测、诊断随访和治疗。整个过程中服务的成功交付都受到了疫情的负面影响。目前还没有高质量的实证证据来支持在大流行及其解决阶段实施癌症筛查的具体策略，但一些务实的考虑因素可以帮助指导优先事项。针对从未接受过筛查或明显超出筛查时间的符合指南标准的人进行靶向治疗，有可能在现在和未来实现最大效益。由于疫情导致的护理中断可能是一个前所未有的机会，可以重新评估早期检测计划，明确、深思熟虑地将历史上癌症发病率较高的人群作为优先考虑对象。通过将筛查服务集中在获益最大的人群，并在大流行结束后进行精心和慎重的规划，我们可以积极影响所有人的癌症结果。
