Quest Diagnostics, Secaucus, NJ.
JCO Clin Cancer Inform. 2021 Sep;5:1028-1033. doi: 10.1200/CCI.21.00074.
This study examined changes in prostate disease screening (prostatic-specific antigen [PSA] testing), prostate biopsy testing, and prostate cancer diagnoses during the COVID-19 pandemic through December 2020.
This analysis included test results from men ≥ 40 years, without prior International Classification of Diseases-10 record of prostate cancer since January 2016, who received PSA or prostate biopsy testing at Quest Diagnostics during January 2018-December 2020. Monthly trends were evaluated for three periods: prepandemic (January 2018-February 2020), early-pandemic (March-May 2020), and late-pandemic (June-December 2020).
Meeting inclusion criteria were 16,365,833 PSA and 48,819 prostate biopsy results. The average monthly number of PSA tests declined from 465,187 prepandemic to 295,786 early-pandemic (36.4% decrease; = .01) before rebounding to 483,374 (3.9% increase; = .23) late-pandemic. The monthly average number of PSA results ≥ 50 ng/mL (23,356; 0.14% of all PSA results) dipped from 659 prepandemic to 506 early-pandemic (23.2% decrease; = .02) and rebounded to 674 late-pandemic (2.3% increase; = .65). The average monthly number of prostate biopsy results decreased from 1,453 prepandemic to 903 early-pandemic (37.9% decrease; = .01) before rebounding to 1,190 late-pandemic (18.1% decrease; = .01). The average monthly number for Gleason score ≥ 8 (6,241; 12.8% of all prostate biopsies) declined from 182 prepandemic to 130 early-pandemic (28.6% decrease; = .02) and decreased to 161 late-pandemic (11.5% decrease; = .02).
The findings suggest that a substantial number of prostate screening opportunities and cancer diagnoses have been missed. Efforts are needed to bring such patients back for screening and diagnostic testing and to restore appropriate care for non-COVID-19-related medical conditions.
本研究通过截至 2020 年 12 月的数据分析，探讨了 COVID-19 大流行期间前列腺疾病筛查（前列腺特异性抗原 [PSA] 检测）、前列腺活检检测和前列腺癌诊断的变化。
本分析纳入了 2016 年 1 月以来无国际疾病分类第 10 版前列腺癌病史且年龄≥40 岁的男性患者的 PSA 或前列腺活检检测结果，这些患者在 Quest Diagnostics 接受检测。评估了三个时期的每月趋势：流行前（2018 年 1 月至 2020 年 2 月）、早期流行期（2020 年 3 月至 5 月）和晚期流行期（2020 年 6 月至 12 月）。
符合纳入标准的 PSA 和前列腺活检结果分别为 16365833 项和 48819 项。流行前每月 PSA 检测平均数量为 465187 项，流行早期减少至 295786 项（减少 36.4%； =.01），随后反弹至 483374 项（增加 3.9%； =.23）。流行前每月 PSA 检测结果≥50ng/mL（占所有 PSA 检测结果的 0.14%）的平均数量从 659 项降至流行早期的 506 项（减少 23.2%； =.02），随后反弹至流行晚期的 674 项（增加 2.3%； =.65）。流行前每月前列腺活检结果平均数量从 1453 项降至流行早期的 903 项（减少 37.9%； =.01），随后反弹至流行晚期的 1190 项（减少 18.1%； =.01）。流行前每月 Gleason 评分≥8 （占所有前列腺活检的 12.8%）的平均数量从 182 项降至流行早期的 130 项（减少 28.6%； =.02），随后降至流行晚期的 161 项（减少 11.5%； =.02）。
研究结果表明，错过了大量的前列腺筛查机会和癌症诊断机会。需要努力让这些患者回来进行筛查和诊断检测，并恢复对非 COVID-19 相关医疗状况的适当治疗。
