Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Cancer Programs, American College of Surgeons, Chicago, Illinois.
Cancer. 2022 Jun 1;128(11):2119-2125. doi: 10.1002/cncr.34157. Epub 2022 Mar 21.
Cancer-related deaths over the next decade are expected to increase due to cancer screening deficits associated with the coronavirus disease 2019 (COVID-19) pandemic. Although national deficits have been quantified, a structured response to identifying and addressing local deficits has not been widely available. The objectives of this report are to share preliminary data on monthly screening deficits in breast, colorectal, lung, and cervical cancers across diverse settings and to provide online materials from a national quality improvement (QI) study to help other institutions to address local screening deficits.
This prospective, national QI study on Return-to-Screening enrolled 748 accredited cancer programs in the United States from April through June 2021. Local prepandemic and pandemic monthly screening test volumes (MTVs) were used to calculate the relative percent change in MTV to describe the monthly screening gap.
The majority of facilities reported monthly screening deficits (colorectal cancer, 80.6% [n = 104/129]; cervical cancer, 69.0% [n = 20/29]; breast cancer, 55.3% [n = 241/436]; lung cancer, 44.6% [n = 98/220]). Overall, the median relative percent change in MTV ranged from -17.7% for colorectal cancer (interquartile range [IQR], -33.6% to -2.8%), -6.8% for cervical cancer (IQR, -29.4% to 1.7%), -1.6% for breast cancer (IQR, -9.6% to 7.0%), and 1.2% for lung cancer (IQR, -16.9% to 19.0%). Geographic differences were not observed. There were statistically significant differences in the percent change in MTV between institution types for colorectal cancer screening (P = .02).
Cancer screening is still in need of urgent attention, and the screening resources made available online may help facilities to close critical gaps and address screenings missed in 2020.
Question: How can the effects of the coronavirus disease 2019 pandemic on cancer screening be mitigated?
When national resources were provided, including methods to calculate local screening deficits, 748 cancer programs promptly enrolled in a national Return-to-Screening study, and the majority identified local screening deficits, most notably in colorectal cancer. Using these results, 814 quality improvement projects were initiated with the potential to add 70,000 screening tests in 2021. Meaning: Cancer screening is still in need of urgent attention, and the online resources that we provide may help to close critical screening deficits.
由于与 2019 年冠状病毒病（COVID-19）大流行相关的癌症筛查不足，预计未来十年癌症相关死亡人数将会增加。尽管已经量化了全国范围内的不足，但尚未广泛提供针对确定和解决地方不足的结构化应对措施。本报告的目的是分享乳腺癌、结直肠癌、肺癌和宫颈癌在不同环境下每月筛查不足的初步数据，并提供来自国家质量改进（QI）研究的在线材料，以帮助其他机构解决当地筛查不足的问题。
本项前瞻性、全国性的 Return-to-Screening 质量改进研究纳入了美国 748 家认证癌症项目，时间为 2021 年 4 月至 6 月。使用当地大流行前和大流行期间的每月筛查测试量（MTV）来计算 MTV 的相对百分比变化，以描述每月筛查差距。
大多数机构报告存在每月筛查不足的情况（结直肠癌，80.6%[n=104/129]；宫颈癌，69.0%[n=20/29]；乳腺癌，55.3%[n=241/436]；肺癌，44.6%[n=98/220]）。总体而言，MTV 的中位数相对百分比变化范围为结直肠癌的-17.7%（四分位距[IQR]，-33.6%至-2.8%）、宫颈癌的-6.8%（IQR，-29.4%至 1.7%）、乳腺癌的-1.6%（IQR，-9.6%至 7.0%）和肺癌的 1.2%（IQR，-16.9%至 19.0%）。未观察到地理差异。结直肠癌筛查机构类型之间 MTV 百分比变化存在统计学差异（P=.02）。
癌症筛查仍然需要紧急关注，并且在线提供的筛查资源可能有助于机构缩小关键差距，并解决 2020 年错过的筛查。
问题：如何减轻 2019 年冠状病毒病大流行对癌症筛查的影响？
当提供国家资源时，包括计算地方筛查不足的方法，748 个癌症项目立即参与了国家 Return-to-Screening 研究，并且大多数项目都确定了地方筛查不足的情况，其中最明显的是结直肠癌。利用这些结果，启动了 814 项质量改进项目，有可能在 2021 年增加 70000 次筛查。
癌症筛查仍然需要紧急关注，我们提供的在线资源可能有助于缩小关键的筛查差距。
