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与美国乳腺癌高风险女性在新冠疫情期间医疗保健中断相关的特征。

Characteristics associated with healthcare disruptions during the COVID-19 pandemic for women in the United States at high risk for breast cancer.

作者信息

Conley Claire C, Rodriguez Jennifer D, Brownstein Naomi C, O'Neill Suzanne C, Vadaparampil Susan T

机构信息

Georgetown University, Department of Oncology, Washington, DC, USA.

Medical University of South Carolina, Department of Public Health Sciences, Charleston, SC, USA.

出版信息

Prev Med Rep. 2022 Dec;30:101975. doi: 10.1016/j.pmedr.2022.101975. Epub 2022 Sep 6.

Abstract

Delays in healthcare, including breast cancer screening, were documented during the coronavirus disease 2019 (COVID-19) pandemic. However, no studies have examined the impact of COVID-19 on healthcare among women at high (≥20 % lifetime) risk for breast cancer. This study fills that gap. Between August 2020 and January 2021, high-risk women (N = 225) living in the United States (US) completed an online survey assessing COVID-related healthcare disruptions. Descriptive statistics characterized the frequency of breast cancer screening (mammogram and breast magnetic resonance imaging [MRI]) since the beginning of the COVID-19 pandemic. Multivariable linear regression analysis with backward selection examined demographic characteristics associated with COVID-related healthcare disruptions. Since March 2020, 40 % of participants had received a mammogram and 12 % had received a screening breast MRI. On average, participants reported low levels of COVID-related healthcare disruptions ( = 1.97 on a 0-4 scale, higher = more disruptions). Participants who were younger (β = -0.21,  = 0.002) and not working (β = 0.18,  = 0.009) reported more COVID-related healthcare disruptions. Compared to non-Hispanic White participants, those from any other racial or ethnic group reported fewer COVID-related healthcare disruptions (β = -0.15,  = 0.020). Although few high-risk women received breast cancer screening after the declaration of the COVID-19 pandemic, they reported overall low levels of COVID-related healthcare disruptions. Results identify subgroups of high-risk women whose healthcare may have been more affected by the pandemic. Efforts to encourage US women at high risk for breast cancer to return to routine preventive care (including breast cancer screening) may need to be targeted towards women who are younger, not working, and non-Hispanic White.

摘要

在2019冠状病毒病(COVID-19)大流行期间,包括乳腺癌筛查在内的医疗保健出现了延误情况。然而,尚无研究考察COVID-19对乳腺癌高风险(终生风险≥20%)女性医疗保健的影响。本研究填补了这一空白。在2020年8月至2021年1月期间,居住在美国的高风险女性(N = 225)完成了一项在线调查,评估与COVID-19相关的医疗保健中断情况。描述性统计描述了自COVID-19大流行开始以来乳腺癌筛查(乳房X线摄影和乳腺磁共振成像[MRI])的频率。采用向后选择的多变量线性回归分析考察了与COVID-19相关医疗保健中断相关的人口统计学特征。自2020年3月以来,40%的参与者接受了乳房X线摄影,12%的参与者接受了乳腺筛查MRI。平均而言,参与者报告的与COVID-19相关的医疗保健中断水平较低(在0至4分的量表上为1.97分,分数越高表示中断越多)。年龄较小(β = -0.21,P = 0.002)且未工作的参与者(β = 0.18,P = 0.009)报告的与COVID-19相关的医疗保健中断更多。与非西班牙裔白人参与者相比,来自任何其他种族或族裔群体的参与者报告的与COVID-19相关的医疗保健中断较少(β = -0.15,P = 0.020)。尽管在宣布COVID-19大流行后很少有高风险女性接受乳腺癌筛查,但她们报告的与COVID-19相关的医疗保健中断总体水平较低。研究结果确定了医疗保健可能受大流行影响更大的高风险女性亚组。鼓励美国乳腺癌高风险女性恢复常规预防性护理(包括乳腺癌筛查)的努力可能需要针对年龄较小、未工作且为非西班牙裔白人的女性。

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