Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461, United States of America.
Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210th St, Department of Radiology, Bronx, NY 10467, United States of America.
Clin Imaging. 2023 Aug;100:1-6. doi: 10.1016/j.clinimag.2023.04.011. Epub 2023 Apr 25.
The COVID-19 pandemic led to the national shutdown and subsequent reopening of cancer screening programs. Our diverse inner-city lung cancer screening program serves patients in the Bronx NY, which was severely affected by COVID-19, with the highest mortality in New York State in the spring of 2020. Staffing redeployment, quarantine protocols, increased safety measures, and changes in follow up resulted. The purpose of this study is to analyze the effect of the pandemic on lung cancer screening volumes during the first year of the pandemic.
Retrospective cohort comprised of all patients enrolled in our Bronx, NY lung cancer screening program from March 2019 to March 2021 who underwent LDCT or appropriate follow-up imaging. The pre-pandemic and pandemic period were defined as 3/28/2019 to 3/21/2020 and 3/22/2020 to 3/17/2021, respectively, dichotomized by the New York State lockdown.
1218 exams were performed in the pre-pandemic period and 857 in the pandemic period, a 29.6% decrease. The percentage of exams performed on newly enrolled patients decreased from 32.7% to 13.8% (p < 0.001). Patients in the pre-pandemic period and pandemic period respectively had the following demographic breakdown: mean age 66.9 ± 5.9 vs 66.5 ± 6.0, women 51.9% vs 51.6%, White 20.7% vs 20.3%, Hispanic/Latino 42.0% vs 36.3%. There was no significant difference in Lung-RADS scores for pre-pandemic and pandemic exams (p > 0.05). In the pandemic period, exam volume followed an inverted parabolic pattern, reflecting Covid surges for the cohort and all demographic subgroups.
The COVID-19 pandemic significantly decreased lung cancer screening volume and new enrollment in our urban inner-city program. Screening volumes demonstrated a parabolic curve reflecting pandemic surges following the initial wave, unlike other reports. The combination of the impact of COVID on our population and lack of staffing redundancy in the screening program, in the face of typical COVID isolation and quarantine absences, impeded early pandemic rebound of our lung cancer screening program. This highlights the necessity of fostering resilience by developing robust programmatic resources.
COVID-19 大流行导致全国性关闭和随后重新开放癌症筛查计划。我们的多元化城市内肺癌筛查计划为纽约州布朗克斯区的患者提供服务，该地区在 2020 年春季受到 COVID-19 的严重影响，是纽约州死亡率最高的地区。工作人员重新部署、检疫协议、增加安全措施和随访变化随之而来。本研究的目的是分析大流行对大流行第一年肺癌筛查量的影响。
回顾性队列包括 2019 年 3 月至 2021 年 3 月在我们位于纽约州布朗克斯区的肺癌筛查计划中接受 LDCT 或适当随访成像的所有患者。将大流行前和大流行期间分别定义为 2019 年 3 月 28 日至 2020 年 3 月 21 日和 2020 年 3 月 22 日至 2021 年 3 月 17 日，纽约州封锁将其分为两个阶段。
在大流行前期间进行了 1218 次检查，在大流行期间进行了 857 次检查，减少了 29.6%。新入组患者的检查比例从 32.7%下降到 13.8%（p<0.001）。大流行前和大流行期间的患者分别具有以下人口统计学分布：平均年龄 66.9±5.9 岁与 66.5±6.0 岁，女性 51.9%与 51.6%，白人 20.7%与 20.3%，西班牙裔/拉丁裔 42.0%与 36.3%。大流行前和大流行期间的肺-RADS 评分无显著差异（p>0.05）。在大流行期间，检查量遵循倒抛物线模式，反映了队列和所有人口统计学亚组的 COVID 激增。
COVID-19 大流行显著降低了我们城市内城区的肺癌筛查量和新入组人数。筛查量呈抛物线曲线，反映了最初浪潮后的大流行激增，与其他报告不同。COVID 对我们人群的影响以及筛查计划中人员配置冗余的缺乏，加上典型的 COVID 隔离和缺勤，阻碍了我们肺癌筛查计划在大流行初期的反弹。这突出了通过开发强大的计划资源来培养弹性的必要性。
