Tari Daniele Ugo, Santonastaso Rosalinda, Pinto Fabio
Department of Diagnostic Senology, District 12, Caserta Local Health Authority, 81100 Caserta, Italy.
Department of Economics, University of Campania "Luigi Vanvitelli", 81043 Capua, Italy.
Explor Target Antitumor Ther. 2022;3(4):414-422. doi: 10.37349/etat.2022.00091. Epub 2022 Jul 29.
To evaluate the local impact of the coronavirus disease 2019 (COVID-19) pandemic on breast cancer (BC) care, with particular attention to the economical and psychological consequences of the possible delay of new diagnoses and treatments.
Three years' activity (from 2019 to 2021) has been compared. The number of BCs diagnosed from the total amount of mammographic and ultrasound (US) examinations performed in women aged more than 40 years old has been considered. A Pearson's chi-squared test was performed to verify differences between results. Statistical significance was set at ≤ 0.01.
A statistically significant difference was found in the number of BC diagnosed between screening and ambulatory care patients in both the 2019-2020 (χ = 24.93, < 0.01) and 2019-2021 (χ = 29.93, < 0.01) comparisons. No statistically significant difference was found in the data recorded between 2020 and 2021 (χ = 2.35, > 0.01). By evaluating the specific age groups for each year, a statistically significant difference ( < 0.01) was found in the number of BC diagnosed in screening patients aged 50-69 years old in both 2019-2020 and 2019-2021 comparisons. The percentages of early BC diagnosed in 2019, 2020, and 2021 were 80.9%, 91.7%, and 89.8%, respectively. The adherence rates to screening in 2019, 2020, and 2021 were 67.5%, 45.2%, and 56.9%, respectively.
Results showed a reduction of new diagnoses in the screening range during the pandemic in comparison with the previous period. The high percentage of early BC would seem to have prevented worsening outcomes. Nevertheless, women who have not undergone screening could present a more advanced stage disease in the following years. Consequently, the evaluation of possible solutions to guarantee an essential level of care with the purpose to avoid worsening patients' outcomes and the increase in healthcare costs is mandatory.
评估2019年冠状病毒病(COVID-19)大流行对乳腺癌(BC)护理的局部影响,尤其关注新诊断和治疗可能延迟所带来的经济和心理后果。
比较了三年(2019年至2021年)的活动情况。考虑了40岁以上女性进行的乳腺钼靶和超声(US)检查总数中诊断出的BC病例数。进行了Pearson卡方检验以验证结果之间的差异。统计学显著性设定为≤0.01。
在2019 - 2020年(χ = 24.93,< 0.01)和2019 - 2021年(χ = 29.93,< 0.01)的比较中,筛查患者和门诊护理患者诊断出的BC病例数存在统计学显著差异。2020年和2021年记录的数据之间未发现统计学显著差异(χ = 2.35,> 0.01)。通过评估每年的特定年龄组,在2019 - 2020年和2019 - 2021年的比较中,50 - 69岁筛查患者诊断出的BC病例数存在统计学显著差异(< 0.01)。2019年、2020年和2021年诊断出的早期BC百分比分别为80.9%、91.7%和89.8%。2019年、2020年和2021年的筛查依从率分别为67.5%、45.2%和56.9%。
结果显示,与前一时期相比,大流行期间筛查范围内的新诊断病例有所减少。早期BC的高比例似乎避免了结果恶化。然而,未接受筛查的女性在接下来的几年中可能会出现更晚期的疾病。因此,必须评估可能的解决方案,以确保基本的护理水平,目的是避免患者结果恶化和医疗成本增加。