Department of Epidemiology and Evaluation,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Preventive Medicine and Public Health Training Unit PSMar-ASPB-UPF, Barcelona, Spain.
Elife. 2022 Jun 10;11:e77434. doi: 10.7554/eLife.77434.
To assess the effect of the COVID-19 pandemic on performance indicators in the population-based breast cancer screening program of Parc de Salut Mar (PSMAR), Barcelona, Spain.
We conducted a before-and-after, study to evaluate participation, recall, false positives, the cancer detection rate, and cancer characteristics in our screening population from March 2020 to March 2021 compared with the four previous rounds (2012-2019). Using multilevel logistic regression models, we estimated the adjusted odds ratios (aORs) of each of the performance indicators for the COVID-19 period, controlling by type of screening (prevalent or incident), socioeconomic index, family history of breast cancer, and menopausal status. We analyzed 144,779 invitations from 47,571women.
During the COVID-19 period, the odds of participation were lower in first-time invitees (aOR = 0.90 [95% CI = 0.84-0.96]) and in those who had previously participated regularly and irregularly (aOR = 0.63 [95% CI = 0.59-0.67] and aOR = 0.95 [95% CI = 0.86-1.05], respectively). Participation showed a modest increase in women not attending any of the previous rounds (aOR = 1.10 [95% CI = 1.01-1.20]). The recall rate decreased in both prevalent and incident screening (aOR = 0.74 [95% CI = 0.56-0.99] and aOR = 0.80 [95% CI = 0.68-0.95], respectively). False positives also decreased in both groups (prevalent aOR = 0.92 [95% CI = 0.66-1.28] and incident aOR = 0.72 [95% CI = 0.59-0.88]). No significant differences were observed in compliance with recall (OR = 1.26, 95% CI = 0.76-2.23), cancer detection rate (aOR = 0.91 [95% CI = 0.69-1.18]), or cancer stages.
The COVID-19 pandemic negatively affected screening attendance, especially in previous participants and newcomers. We found a reduction in recall and false positives and no marked differences in cancer detection, indicating the robustness of the program. There is a need for further evaluations of interval cancers and potential diagnostic delays.
This study has received funding by grants PI19/00007 and PI21/00058, funded by Instituto de Salud Carlos III (ISCIII) and cofunded by the European Union and Grant RD21/0016/0020 funded by Instituto de Salud Carlos III and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia (MRR).
评估 COVID-19 大流行对西班牙巴塞罗那 Parc de Salut Mar (PSMAR) 基于人群的乳腺癌筛查项目中绩效指标的影响。
我们进行了一项前后对比研究，以评估 2020 年 3 月至 2021 年 3 月期间我们的筛查人群的参与率、召回率、假阳性率、癌症检出率和癌症特征与前四轮（2012-2019 年）相比的变化。使用多水平逻辑回归模型，我们控制了筛查类型（现患或新发）、社会经济指数、乳腺癌家族史和绝经状态，估计了每个绩效指标在 COVID-19 期间的调整优势比（aOR）。我们分析了来自 47571 名女性的 144779 份邀请。
在 COVID-19 期间，首次受邀者的参与率较低（aOR=0.90 [95%CI=0.84-0.96]），而之前定期和不定期参与的人（aOR=0.63 [95%CI=0.59-0.67]和 aOR=0.95 [95%CI=0.86-1.05]）的参与率也较低。在没有参加之前任何一轮的女性中，参与率略有增加（aOR=1.10 [95%CI=1.01-1.20]）。在现患和新发筛查中，召回率均下降（aOR=0.74 [95%CI=0.56-0.99]和 aOR=0.80 [95%CI=0.68-0.95]）。两组的假阳性率也均下降（现患 aOR=0.92 [95%CI=0.66-1.28]和新发 aOR=0.72 [95%CI=0.59-0.88]）。召回的依从性（OR=1.26，95%CI=0.76-2.23）、癌症检出率（aOR=0.91 [95%CI=0.69-1.18]）或癌症分期均无显著差异。
COVID-19 大流行对筛查参与率产生了负面影响，尤其是对之前的参与者和新参与者。我们发现召回率和假阳性率降低，而癌症检出率没有明显变化，表明该项目具有稳健性。需要进一步评估间隔期癌症和潜在的诊断延迟。
本研究得到了 PI19/00007 和 PI21/00058 拨款的资助，这些拨款由西班牙卡洛斯三世健康研究所（ISCIII）提供，由欧盟共同资助，并得到了 PI21/00058 拨款的资助。 RD21/0016/0020 由西班牙卡洛斯三世健康研究所（ISCIII）和欧盟的 NextGenerationEU、复苏和弹性机制（MRR）共同提供。
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