Harvard Medical School, Boston, Massachusetts, USA.
Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Cancer Med. 2023 Apr;12(8):9902-9911. doi: 10.1002/cam4.5678. Epub 2023 Feb 12.
This study examines the impact that the COVID-19 pandemic has had on computed tomography (CT)-based oncologic imaging utilization.
We retrospectively analyzed cancer-related CT scans during four time periods: pre-COVID (1/5/20-3/14/20), COVID peak (3/15/20-5/2/20), post-COVID peak (5/3/20-12/19/20), and vaccination period (12/20/20-10/30/21). We analyzed CTs by imaging indication, setting, and hospital type. Using percentage decrease computation and Student's t-test, we calculated the change in mean number of weekly cancer-related CTs for all periods compared to the baseline pre-COVID period. This study was performed at a single academic medical center and three affiliated hospitals.
During the COVID peak, mean CTs decreased (-43.0%, p < 0.001), with CTs for (1) cancer screening, (2) initial workup, (3) cancer follow-up, and (4) scheduled surveillance of previously treated cancer dropping by 81.8%, 56.3%, 31.7%, and 45.8%, respectively (p < 0.001). During the post-COVID peak period, cancer screenings and initial workup CTs did not return to prepandemic imaging volumes (-11.4%, p = 0.028; -20.9%, p = 0.024). The ED saw increases in weekly CTs compared to prepandemic levels (+31.9%, p = 0.008), driven by increases in cancer follow-up CTs (+56.3%, p < 0.001). In the vaccination period, cancer screening CTs did not recover to baseline (-13.5%, p = 0.002) and initial cancer workup CTs doubled (+100.0%, p < 0.001). The ED experienced increased cancer-related CTs (+75.9%, p < 0.001), driven by cancer follow-up CTs (+143.2%, p < 0.001) and initial workups (+46.9%, p = 0.007).
The pandemic continues to impact cancer care. We observed significant declines in cancer screening CTs through the end of 2021. Concurrently, we observed a 2× increase in initial cancer workup CTs and a 2.4× increase in cancer follow-up CTs in the ED during the vaccination period, suggesting a boom of new cancers and more cancer examinations associated with emergency level acute care.
本研究旨在探讨 COVID-19 大流行对基于计算机断层扫描（CT）的肿瘤影像学应用的影响。
我们回顾性分析了四个时间段的癌症相关 CT 扫描：新冠大流行前（1/5/20-3/14/20）、新冠大流行高峰期（3/15/20-5/2/20）、新冠大流行高峰期后（5/3/20-12/19/20）和疫苗接种期（12/20/20-10/30/21）。我们根据成像指征、设置和医院类型分析 CT。使用百分比下降计算和学生 t 检验，我们计算了与新冠大流行前基线期相比，所有时期每周癌症相关 CT 的平均数量变化。本研究在一家学术医疗中心和三家附属医院进行。
在新冠大流行高峰期，CT 数量平均减少（-43.0%，p<0.001），（1）癌症筛查、（2）初始检查、（3）癌症随访和（4）先前治疗癌症的定期监测 CT 分别减少 81.8%、56.3%、31.7%和 45.8%（p<0.001）。在新冠大流行高峰期后，癌症筛查和初始检查 CT 未恢复到大流行前的影像学水平（-11.4%，p=0.028；-20.9%，p=0.024）。ED 的每周 CT 检查量与大流行前水平相比增加（+31.9%，p=0.008），这是由癌症随访 CT 检查的增加（+56.3%，p<0.001）推动的。在疫苗接种期，癌症筛查 CT 未恢复到基线水平（-13.5%，p=0.002），而初始癌症检查 CT 增加了一倍（+100.0%，p<0.001）。ED 中癌症相关 CT 检查增加（+75.9%，p<0.001），这是由癌症随访 CT 检查（+143.2%，p<0.001）和初始检查（+46.9%，p=0.007）的增加推动的。
大流行仍在继续影响癌症治疗。我们观察到 2021 年底癌症筛查 CT 数量显著下降。同时，我们观察到在疫苗接种期间 ED 中初始癌症检查 CT 增加了两倍，癌症随访 CT 增加了 2.4 倍，这表明新癌症的发病率增加，与急诊水平急性护理相关的癌症检查也增加。
