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COVID-19 大流行对癌症筛查延误的影响。

Impact of the COVID-19 Pandemic on Cancer Screening Delays.

机构信息

Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University, Columbus, OH.

Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH.

出版信息

J Clin Oncol. 2023 Jun 10;41(17):3194-3202. doi: 10.1200/JCO.22.01704. Epub 2023 Feb 3.

Abstract

PURPOSE

To examine delays in cancer screenings during the COVID-19 pandemic.

METHODS

Participants from previous studies (N = 32,989) with permissions to be recontacted were invited to complete a survey between June and November 2020. Participants (n = 7,115) who met the age range for cancer screenings were included. Participants were asked if they planned to have and then if they postponed a scheduled mammogram, Pap test, stool blood test, colonoscopy, or human papillomavirus (HPV) test. Logistic regression was used to determine the factors associated with cancer screening delays for each planned test.

RESULTS

The average age was 57.3 years, 75% were female, 89% were non-Hispanic White, 14% had public insurance, and 34% lived in rural counties. Those who planned cancer screenings (n = 4,266, 60%) were younger, more likely to be female, with higher education, had private insurance, and lived in rural counties. Specifically, 24% delayed a mammogram (n = 732/2,986), 27% delayed a Pap test (n = 448/1,651), 27% delayed an HPV test (n = 59/220), 11% delayed a stool blood test (n = 44/388), and 36% delayed a colonoscopy (n = 304/840). Age, race/ethnicity, education, and health insurance were associated with delays in cancer screenings (all < .05). Compared with non-Hispanic White women, non-Hispanic Black women had lower odds of delaying a mammogram (odds ratio [OR], 0.60; 95% CI, 0.39 to 0.94), Hispanic women had higher odds of delaying Pap test (OR, 2.46; 95% CI, 1.34 to 4.55), and women with other race/ethnicity had higher odds of delaying both Pap test (OR, 2.38; 95% CI, 1.41 to 4.02) and HPV test (OR, 5.37; 95% CI, 1.44 to 19.97).

CONCLUSION

Our findings highlighted the urgency for health care providers to address the significant delays in cancer screenings in those most likely to delay. Strategies and resources are needed to help those with barriers to receiving guideline-appropriate cancer screening.

摘要

目的

研究 COVID-19 大流行期间癌症筛查的延迟情况。

方法

邀请之前研究的参与者(N=32989 人,允许重新联系)在 2020 年 6 月至 11 月之间完成一项调查。符合癌症筛查年龄范围的(n=7115)参与者被纳入研究。参与者被问及他们是否计划进行并随后推迟了计划好的乳房 X 光检查、巴氏试验、粪便潜血检查、结肠镜检查或人乳头瘤病毒(HPV)检查。使用逻辑回归确定了与每种计划检查的癌症筛查延迟相关的因素。

结果

平均年龄为 57.3 岁,75%为女性,89%为非西班牙裔白人,14%有公共保险,34%居住在农村县。那些计划进行癌症筛查的人(n=4266,60%)年龄较小,更可能是女性,受教育程度更高,有私人保险,并且居住在农村县。具体来说,24%的人推迟了乳房 X 光检查(n=732/2986),27%的人推迟了巴氏试验(n=448/1651),27%的人推迟了 HPV 检查(n=59/220),11%的人推迟了粪便潜血检查(n=44/388),36%的人推迟了结肠镜检查(n=304/840)。年龄、种族/族裔、教育程度和医疗保险与癌症筛查的延迟有关(均<0.05)。与非西班牙裔白人女性相比,非西班牙裔黑人女性进行乳房 X 光检查的可能性更低(比值比[OR],0.60;95%置信区间[CI],0.39 至 0.94),西班牙裔女性进行巴氏试验的可能性更高(OR,2.46;95% CI,1.34 至 4.55),而其他种族/族裔的女性进行巴氏试验(OR,2.38;95% CI,1.41 至 4.02)和 HPV 试验(OR,5.37;95% CI,1.44 至 19.97)的可能性更高。

结论

我们的研究结果强调了医疗保健提供者解决最有可能推迟癌症筛查的重大延迟问题的紧迫性。需要制定策略和资源,以帮助那些在接受指南规定的癌症筛查方面存在障碍的人。

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