Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Azienda Unità Sanitaria Locale Di Modena, Modena, Italy.
Elife. 2023 Feb 3;12:e81804. doi: 10.7554/eLife.81804.
In Italy, regions have the mandate to implement population-based screening programs for breast, cervical, and colorectal cancer. From March to May 2020, a severe lockdown was imposed due to the COVID-19 pandemic by the Italian Ministry of Health, with the suspension of screening programs. This paper describes the impact of the pandemic on Italian screening activities and test coverage in 2020 overall and by socioeconomic characteristics.
The regional number of subjects invited and of screening tests performed in 2020 were compared with those in 2019. Invitation and examination coverage were also calculated. PASSI surveillance system, through telephone interviews, collects information about screening test uptake by test provider (public screening and private opportunistic). Test coverage and test uptake in the last year were computed by educational attainment, perceived economic difficulties, and citizenship.
A reduction of subjects invited and tests performed, with differences between periods and geographical macro areas, was observed in 2020 vs. 2019. The reduction in examination coverage was larger than that in invitation coverage for all screening programs. From the second half of 2020, the trend for test coverage showed a decrease in all the macro areas for all the screening programs. Compared with the pre-pandemic period, there was a greater difference according to the level of education in the odds of having had a test last year vs. never having been screened or not being up to date with screening tests.
The lockdown and the ongoing COVID-19 emergency caused an important delay in screening activities. This increased the preexisting individual and geographical inequalities in access. The opportunistic screening did not mitigate the impact of the pandemic.
This study was partially supported by Italian Ministry of Health - Ricerca Corrente Annual Program 2023 and by the Emilian Region DGR 839/22.
在意大利，各地区负责实施针对乳腺癌、宫颈癌和结直肠癌的基于人群的筛查计划。由于意大利卫生部实施了 COVID-19 大流行的严重封锁措施，筛查计划暂停。本文描述了大流行对意大利 2020 年筛查活动和检测覆盖率的总体影响，以及按社会经济特征的影响。
比较了 2020 年和 2019 年邀请的研究对象人数和进行的筛查检测数量。还计算了邀请和检查的覆盖率。PASSI 监测系统通过电话访谈收集有关测试提供者（公共筛查和私人机会性筛查）进行的筛查测试接受情况的信息。根据教育程度、经济困难感知和公民身份计算了过去一年的检测覆盖率和检测利用率。
与 2019 年相比，2020 年观察到被邀请人数和进行的检测数量减少，且存在时期和地理大区差异。所有筛查计划的检查覆盖率下降幅度大于邀请覆盖率。自 2020 年下半年以来，所有筛查计划在所有大区的检测覆盖率呈下降趋势。与大流行前时期相比，根据教育程度，去年接受过检测的可能性与从未接受过筛查或未及时进行筛查的可能性存在更大差异。
封锁和持续的 COVID-19 紧急情况导致筛查活动严重延迟。这增加了先前存在的获得机会的个体和地理不平等。机会性筛查并未减轻大流行的影响。
本研究部分得到意大利卫生部 2023 年年度研究计划 Ricerca Corrente 和艾米利亚大区 DGR 839/22 的支持。
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