探讨在联邦合格健康中心执业的临床医生中，COVID-19 大流行对宫颈癌筛查实践的感知影响：一项混合方法研究。
Examining the perceived impact of the COVID-19 pandemic on cervical cancer screening practices among clinicians practicing in Federally Qualified Health Centers: A mixed methods study.
机构信息
H. Lee Moffitt Cancer Center & Research Institute, Health Outcomes and Behavior, Tampa, United States.
Medical University of South Carolina, Public Health Sciences, Charleston, United States.
出版信息
Elife. 2023 Sep 4;12:e86358. doi: 10.7554/eLife.86358.
BACKGROUND
The COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed methods study we explored perceived pandemic-related practice changes to cervical cancer screenings in federally qualified health centers (FQHCs).
METHODS
Between October 2021 and June 2022, we conducted a national web survey of clinicians (physicians and advanced practice providers) who performed cervical cancer screening in FQHCs in the United States during the post-acute phase of the COVID-19 pandemic, along with a sub-set of qualitative interviews via video conference, to examine perceived changes in cervical cancer screening practices during the pandemic.
RESULTS
A total of 148 clinicians completed surveys; a subset (n=13) completed qualitative interviews. Most (86%) reported reduced cervical cancer screening early in the pandemic, and 28% reported continued reduction in services at the time of survey completion (October 2021- July 2022). Nearly half (45%) reported staff shortages impacting their ability to screen or track patients. Compared to clinicians in Obstetrics/Gynecology/Women's health, those in family medicine and other specialties more often reported reduced screening compared to pre-pandemic. Most (92%) felt that screening using HPV self-sampling would be very or somewhat helpful to address screening backlogs. Qualitative interviews highlighted the impacts of staff shortages and strategies for improvement.
CONCLUSIONS
Findings highlight that in late 2021 and early 2022, many clinicians in FQHCs reported reduced cervical cancer screening and of pandemic-related staffing shortages impacting screening and follow-up. If not addressed, reduced screenings among underserved populations could worsen cervical cancer disparities in the future.
FUNDING
This study was funded by the American Cancer Society, who had no role in the study's design, conduct, or reporting.
背景
COVID-19 大流行导致宫颈癌筛查和阴道镜检查减少。因此，在这项混合方法研究中，我们探讨了在联邦合格的健康中心 (FQHC) 中，人们对与 COVID-19 大流行相关的宫颈癌筛查实践变化的看法。
方法
在 COVID-19 大流行的急性后期，我们于 2021 年 10 月至 2022 年 6 月间，对在美国的 FQHC 中进行宫颈癌筛查的临床医生（医生和高级执业医师）进行了全国性的网络调查，并通过视频会议进行了一小部分定性访谈，以研究大流行期间宫颈癌筛查实践的变化。
结果
共有 148 名临床医生完成了调查；其中一小部分（n=13）完成了定性访谈。大多数（86%）报告说在大流行早期减少了宫颈癌筛查，28%的人报告说在调查完成时（2021 年 10 月至 2022 年 7 月）仍在继续减少服务。近一半（45%）的人报告人员短缺影响了他们筛查或跟踪患者的能力。与妇产科医生相比，家庭医生和其他专业的医生更经常报告说与大流行前相比筛查减少。大多数（92%）人认为使用 HPV 自我采样进行筛查将非常或有些有助于解决筛查积压问题。定性访谈强调了人员短缺的影响以及改善的策略。
结论
研究结果表明，在 2021 年末和 2022 年初，许多 FQHC 的临床医生报告说宫颈癌筛查减少，而且与大流行相关的人员短缺影响了筛查和随访。如果不加以解决，未来服务不足人群的筛查减少可能会导致宫颈癌的差异进一步恶化。
资助
这项研究由美国癌症协会资助，该协会在研究的设计、进行或报告中没有任何作用。
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