Department of Medical Records, Office for DRGs (Diagnosis Related Groups), Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Front Public Health. 2022 May 24;10:881718. doi: 10.3389/fpubh.2022.881718. eCollection 2022.
OBJECTIVE: To investigate the possible impact of lockdown policies on the diagnosis and treatment of cancer patients in Henan, China. DESIGN SETTING AND PARTICIPANTS: We collected data from the Henan Cancer Hospital, affiliated with Zhengzhou University. The monthly numbers of inpatient admissions from January 2014 to December 2019 were used to forecast the number of inpatient admissions in 2020, which was then compared to the actual number of patients admitted during the pandemic to evaluate how the actual number diverges from this forecast. We conducted an interrupted time series analysis using the autoregressive integrated moving average (ARIMA) model. MAIN OUTCOMES AND MEASURES: For specific diagnoses, treatment modalities, and age groups, we compared the changes in monthly admissions after the pandemic with the forecasted changes from the model. RESULTS: The observed overall monthly number of inpatient admissions decreased by 20.2% [95% confidence interval (CI), 11.7-27.2%], 78.9% (95% CI, 77.3-80.4%), and 40.9% (95% CI, 35.6-45.5%) in January, February, and March 2020, respectively, as compared with those predicted using the ARIMA model. After the lockdown, visits for all treatment modalities decreased sharply. However, apparent compensation and recovery of the backlog appeared in later surgeries. As a result, the number of patients who underwent surgery in 2020 (30,478) was close to the number forecasted by the ARIMA model (30,185). In the same period, patients who received other treatments or underwent examinations were 106,074 and 36,968, respectively; the respective numbers that were forecasted by ARIMA were 127,775 and 60,025, respectively. These findings depict a decrease of 16.9 and 38.4% in patients who received other treatments or underwent examinations only, respectively. Regarding diagnosis, the reported incidence of various cancers decreased dramatically in February, with varying extent and speed of recovery. CONCLUSION AND RELEVANCE: The COVID-19 pandemic has significantly delayed the diagnosis and treatment of cancer in Henan, China. Long-term research should be conducted to assess the future effects of lockdown policies.
目的：调查中国河南省 lockdown 政策对癌症患者诊断和治疗的可能影响。
设计、设置和参与者：我们从郑州大学附属河南省肿瘤医院收集数据。使用 2014 年 1 月至 2019 年 12 月的每月住院人数来预测 2020 年的住院人数，然后将实际住院人数与疫情期间的预测人数进行比较，以评估实际人数与预测人数的偏差。我们使用自回归积分移动平均 (ARIMA) 模型进行了中断时间序列分析。
主要结果和措施：对于特定的诊断、治疗方式和年龄组，我们比较了疫情后每月住院人数的变化与模型预测的变化。
结果：与 ARIMA 模型预测相比，2020 年 1 月、2 月和 3 月的实际每月住院总人数分别下降了 20.2%（95%置信区间，11.7-27.2%）、78.9%（95%置信区间，77.3-80.4%）和 40.9%（95%置信区间，35.6-45.5%）。封锁后，所有治疗方式的就诊人数都急剧下降。然而，明显的积压和恢复出现在后期手术中。因此，2020 年接受手术的患者人数（30478 人）接近 ARIMA 模型预测的人数（30185 人）。同期，接受其他治疗或检查的患者分别为 106074 人和 36968 人；ARIMA 预测的人数分别为 127775 人和 60025 人。这些发现表明，仅接受其他治疗或接受检查的患者人数分别减少了 16.9%和 38.4%。就诊断而言，2 月份各种癌症的报告发病率急剧下降，恢复速度和程度各不相同。
结论和相关性：COVID-19 大流行显著延迟了中国河南省癌症的诊断和治疗。应进行长期研究，以评估 lockdown 政策的未来影响。
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