Tokode Olukayode M, Rastall Sarah
Oncoplastic Breast Surgery, Princess Royal University Hospital, Telford, GBR.
Clinical Anatomy, University of Hull, Hull, GBR.
Cureus. 2022 Jun 17;14(6):e26038. doi: 10.7759/cureus.26038. eCollection 2022 Jun.
Background Recommendations to balance cancer care with patient and hospital staff safety have been issued to hospitals during the coronavirus disease (COVID-19) pandemic. Concerns have been raised that service restrictions could jeopardize effective cancer management. Thus, this study aimed to conduct an audit to verify this proposition. Methods We conducted an audit comparing two-week wait (2ww) breast cancer referrals in our center between May and July 2019 and 2020. The primary endpoints were changes in the overall referral rates, differences in the waiting time, and breast cancer diagnosis rates between the two cohorts. Group differences were evaluated using the chi-square test (χ). A p-value of <0.05 at 95% CI was considered significant. Results The 2ww referrals decreased by 442 (28.3%) in 2020 (2019 N=1564 vs. 2020, N=1122). Referrals in 2020 were associated with a higher rate of two-week specialist consultation than referrals in 2019 (p<0.05). The 2020 patient cohort was associated with a higher rate of breast cancer diagnosis than the 2019 cohort (6.9% vs. 4.9%, p<0.05). Of the 521 patients who had telephone consultations, 29.2% were discharged, and 367 (70.4%) had post-telephone one-stop clinic visits, of which 9.0% had breast cancer. Conclusions The audit provided evidence of effective breast cancer services during the COVID-19 pandemic restrictions. The study results could inform patients and the general public at large that the waiting time and breast cancer diagnosis are not compromised during COVID-19 pandemic management. The high rates of post-telephone one-stop clinic visits and cancer diagnosis may indicate weakness in triage and difficulties in diagnosing nonspecific presentation of cancer over the telephone.
背景 在冠状病毒病（COVID-19）大流行期间，已向医院发布了关于平衡癌症护理与患者及医院工作人员安全的建议。有人担心服务限制可能会危及有效的癌症管理。因此，本研究旨在进行一项审计以验证这一观点。方法 我们进行了一项审计，比较了2019年5月至7月与2020年我们中心两周等待（2ww）乳腺癌转诊情况。主要终点是两个队列之间总体转诊率的变化、等待时间的差异以及乳腺癌诊断率。使用卡方检验（χ）评估组间差异。在95%置信区间时，p值<0.05被认为具有统计学意义。结果 2020年2ww转诊减少了442例（28.3%）（2019年N = 1564例，2020年N = 1122例）。2020年的转诊与两周专科会诊率高于2019年的转诊相关（p<0.05）。2020年患者队列的乳腺癌诊断率高于2019年队列（6.9%对4.9%，p<0.05）。在521例进行电话咨询的患者中，29.2%出院，367例（70.4%）进行了电话后一站式门诊就诊，其中9.0%患有乳腺癌。结论 该审计提供了COVID-19大流行限制期间有效乳腺癌服务的证据。研究结果可以告知患者和广大公众，在COVID-19大流行管理期间，等待时间和乳腺癌诊断并未受到影响。电话后一站式门诊就诊率和癌症诊断率较高可能表明分诊存在缺陷，以及通过电话诊断癌症非特异性表现存在困难。
