丹麦在 COVID-19 大流行期间基于 FIT 的全国结直肠癌筛查参与情况：一项观察性研究。
Nationwide participation in FIT-based colorectal cancer screening in Denmark during the COVID-19 pandemic: An observational study.
机构信息
The Danish Clinical Quality Program - National Clinical Registries (RKKP), Aarhus, Denmark.
University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Aarhus, Denmark.
出版信息
Elife. 2023 Jan 25;12:e81808. doi: 10.7554/eLife.81808.
BACKGROUND
Worldwide, most colorectal cancer screening programmes were paused at the start of the COVID-19 pandemic, while the Danish faecal immunochemical test (FIT)-based programme continued without pausing. We examined colorectal cancer screening participation and compliance with subsequent colonoscopy in Denmark throughout the pandemic.
METHODS
We used data from the Danish Colorectal Cancer Screening Database among individuals aged 50-74 years old invited to participate in colorectal cancer screening from 2018 to 2021 combined with population-wide registries. Using a generalised linear model, we estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) of colorectal cancer screening participation within 90 days since invitation and compliance with colonoscopy within 60 days since a positive FIT test during the pandemic in comparison with the previous years adjusting for age, month and year of invitation.
RESULTS
Altogether, 3,133,947 invitations were sent out to 1,928,725 individuals and there were 94,373 positive FIT tests (in 92,848 individuals) during the study period. Before the pandemic, 60.7% participated in screening within 90 days. A minor reduction in participation was observed at the start of the pandemic (PR = 0.95; 95% CI: 0.94-0.96 in pre-lockdown and PR = 0.85; 95% CI: 0.85-0.86 in first lockdown) corresponding to a participation rate of 54.9% during pre-lockdown and 53.0% during first lockdown. This was followed by a 5-10% increased participation in screening corresponding to a participation rate of up to 64.9%. The largest increase in participation was observed among 55-59 years old and among immigrants. The compliance with colonoscopy within 60 days was 89.9% before the pandemic. A slight reduction was observed during first lockdown (PR = 0.96; 95% CI: 0.93-0.98), where after it resumed to normal levels.
CONCLUSIONS
Participation in the Danish FIT-based colorectal cancer screening programme and subsequent compliance to colonoscopy after a positive FIT result was only slightly affected by the COVID-19 pandemic.
FUNDING
The study was funded by the Danish Cancer Society Scientific Committee (Grant number R321-A17417) and the Danish regions.
背景
在全球范围内，大多数结直肠癌筛查计划在 COVID-19 大流行开始时暂停，而丹麦基于粪便免疫化学测试（FIT）的计划则继续进行而没有暂停。我们在整个大流行期间检查了丹麦的结直肠癌筛查参与情况和随后接受结肠镜检查的情况。
方法
我们使用了 2018 年至 2021 年期间邀请参加结直肠癌筛查的 50-74 岁人群的丹麦结直肠癌筛查数据库中的数据，并结合了全人群登记处的数据。使用广义线性模型，我们在调整年龄、邀请月份和年份后，估计了大流行期间与前几年相比，邀请后 90 天内进行结直肠癌筛查的流行率比（PR）和 95%置信区间（CI），以及阳性 FIT 检测后 60 天内进行结肠镜检查的合规性。
结果
共发出 3133947 份邀请，邀请了 1928725 人，研究期间有 94373 份阳性 FIT 检测（92848 人）。在大流行之前，有 60.7%的人在 90 天内参加了筛查。在大流行开始时，参与率略有下降（预封锁时 PR = 0.95；95%CI：0.94-0.96，第一次封锁时 PR = 0.85；95%CI：0.85-0.86），对应于预封锁时的参与率为 54.9%，第一次封锁时的参与率为 53.0%。之后，筛查的参与率增加了 5-10%，最高可达 64.9%。最大的参与率增加发生在 55-59 岁人群和移民中。在大流行之前，结肠镜检查的 60 天内完成率为 89.9%。第一次封锁期间略有下降（PR = 0.96；95%CI：0.93-0.98），之后恢复到正常水平。
结论
丹麦基于 FIT 的结直肠癌筛查计划的参与率以及阳性 FIT 结果后接受结肠镜检查的比例仅受到 COVID-19 大流行的轻微影响。
经费
本研究由丹麦癌症协会科学委员会（赠款号 R321-A17417）和丹麦地区资助。
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