Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
UK National Screening Committee, Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, SW1H 0EU, UK.
Br J Cancer. 2022 May;126(9):1355-1361. doi: 10.1038/s41416-022-01714-9. Epub 2022 Feb 2.
Population breast screening services in England were suspended in March 2020 due to the COVID-19 pandemic. Here, we estimate the number of breast cancers whose detection may be delayed because of the suspension, and the potential impact on cancer deaths over 10 years.
We estimated the number and length of screening delays from observed NHS Breast Screening System data. We then estimated additional breast cancer deaths from three routes: asymptomatic tumours progressing to symptomatically diagnosed disease, invasive tumours which remain screen-detected but at a later date, and ductal carcinoma in situ (DCIS) progressing to invasive disease by detection. We took progression rates, prognostic characteristics, and survival rates from published sources.
We estimated that 1,489,237 women had screening delayed by around 2-7 months between July 2020 and June 2021, leaving 745,277 outstanding screens. Depending on how quickly this backlog is cleared, around 2500-4100 cancers would shift from screen-detected to symptomatic cancers, resulting in 148-452 additional breast cancer deaths. There would be an additional 164-222 screen-detected tumour deaths, and 71-97 deaths from DCIS that progresses to invasive cancer.
An estimated 148-687 additional breast cancer deaths may occur as a result of the pandemic-related disruptions. The impact depends on how quickly screening services catch up with delays.
由于 COVID-19 大流行，2020 年 3 月英国停止了人群乳腺筛查服务。在这里，我们估计由于暂停服务而可能延迟发现的乳腺癌数量，以及对 10 年内癌症死亡的潜在影响。
我们根据 NHS 乳腺筛查系统观察到的数据估计了筛查延迟的数量和时长。然后，我们通过三种途径估计了额外的乳腺癌死亡人数：无症状肿瘤进展为有症状诊断疾病、仍然在筛查中但在较晚时期发现的侵袭性肿瘤，以及导管原位癌 (DCIS) 通过检测进展为侵袭性疾病。我们从已发表的资料中获取进展率、预后特征和生存率。
我们估计，2020 年 7 月至 2021 年 6 月期间，大约有 1489237 名女性的筛查被延迟了大约 2-7 个月，还剩下 745277 个未完成的筛查。根据积压筛查的清除速度，大约有 2500-4100 例癌症将从筛查中发现的癌症转移为症状性癌症，导致 148-452 例额外的乳腺癌死亡。还将有 164-222 例筛查发现的肿瘤死亡，以及 71-97 例从进展为侵袭性癌症的 DCIS 死亡。
由于与大流行相关的干扰，预计会有 148-687 例额外的乳腺癌死亡。影响取决于筛查服务追赶延迟的速度。
