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解决 COVID-19 大流行前后与多模态乳房成像服务获取相关的差异。

Addressing Disparities Related to Access of Multimodality Breast Imaging Services Before and During the COVID-19 Pandemic.

机构信息

Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

Acad Radiol. 2022 Dec;29(12):1852-1860. doi: 10.1016/j.acra.2022.03.017. Epub 2022 Mar 25.

Abstract

Despite technological advancements focused on reducing breast cancer mortality through early detection, there have been reported disparities in the access to these imaging services with underserved patient populations (including racial minority groups and patients of low socioeconomic status) showing underutilization compared to other patient groups. These underserved populations tend to have more advanced breast cancer presentations, in part due to delays in diagnosis resulting in later stage of disease presentation. To make matters worse, the COVID-19 pandemic declared in March 2020 has resulted in significant healthcare disruptions leading to extensive delays in breast imaging services which are expected to negatively impact breast cancer mortality long-term. Given the worsening disparity in breast cancer mortality among racial/ethnic minorities and financially disadvantaged groups, it is vital to address these disparity gaps with the goal of reducing the barriers to timely breast cancer diagnosis and addressing breast cancer mortality differences among breast cancer patients. Therefore, this review aims to provide a discussion highlighting the disparities related to breast imaging access, the effects of the COVID-19 pandemic on these disparities, current targeted interventions implemented in breast imaging practices to reduce these disparities, and future directions on the journey to reducing disparity gaps for breast imaging patients. Tackling the root cause factors of the persistent breast cancer-related disparities is critical to meeting the needs of patients who are disadvantaged and can lead to continued improvement in the quality of individualized care for patients who have higher breast cancer morbidity and mortality risks.

摘要

尽管专注于通过早期检测降低乳腺癌死亡率的技术取得了进展,但在获得这些影像学服务方面,仍存在报告的差异,服务不足的患者群体(包括少数族裔群体和社会经济地位较低的患者)与其他患者群体相比利用率较低。这些服务不足的人群往往表现出更晚期的乳腺癌,部分原因是诊断延迟导致疾病表现更晚。更糟糕的是,2020 年 3 月宣布的 COVID-19 大流行导致医疗保健严重中断,导致乳房成像服务广泛延迟,预计这将对长期的乳腺癌死亡率产生负面影响。鉴于少数族裔和经济弱势群体之间乳腺癌死亡率的差距不断扩大,必须解决这些差距,目标是减少及时进行乳腺癌诊断的障碍,并解决乳腺癌患者之间的乳腺癌死亡率差异。因此,本综述旨在提供一个讨论,重点介绍与乳房成像获取相关的差异、COVID-19 大流行对这些差异的影响、乳房成像实践中为减少这些差异而实施的当前针对性干预措施,以及减少乳房成像患者差异差距的未来方向。解决持续存在的乳腺癌相关差异的根本原因因素对于满足处于不利地位的患者的需求至关重要,并可以继续提高对乳腺癌发病率和死亡率较高的患者的个性化护理质量。

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