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对 2020 年 1 月至 12 月期间 COVID-19 对全球乳腺癌筛查参与率和数量的影响进行快速回顾。

A rapid review of COVID-19's global impact on breast cancer screening participation rates and volumes from January to December 2020.

机构信息

Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.

Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom.

出版信息

Elife. 2023 Sep 12;12:e85680. doi: 10.7554/eLife.85680.

Abstract

COVID-19 has strained population breast mammography screening programs that aim to diagnose and treat breast cancers earlier. As the pandemic has affected countries differently, we aimed to quantify changes in breast screening volume and uptake during the first year of COVID-19 . We systematically searched Medline, the World Health Organization (WHO) COVID-19 database, and governmental databases. Studies covering January 2020 to March 2022 were included. We extracted and analyzed data regarding study methodology, screening volume, and uptake. To assess for risk of bias, we used the Joanna Briggs Institute (JBI) Critical Appraisal Tool. Twenty-six cross-sectional descriptive studies (focusing on 13 countries/nations) were included out of 935 independent records. Reductions in screening volume and uptake rates were observed among eight countries. Changes in screening participation volume in five nations with national population-based screening ranged from -13 to -31%. Among two countries with limited population-based programs, the decline ranged from -61 to -41%. Within the USA, population participation volumes varied ranging from +18 to -39%, with suggestion of differences by insurance status (HMO, Medicare, and low-income programs). Almost all studies had high risk of bias due to insufficient statistical analysis and confounding factors. The extent of COVID-19-induced reduction in breast screening participation volume differed by region and data suggested potential differences by healthcare setting (e.g., national health insurance vs. private healthcare). Recovery efforts should monitor access to screening and early diagnosis to determine whether prevention services need strengthening to increase the coverage of disadvantaged groups and reduce disparities.

摘要

COVID-19 对旨在更早诊断和治疗乳腺癌的人群乳腺 X 线筛查计划造成了压力。由于大流行对各国的影响不同,我们旨在量化 COVID-19 第一年期间乳腺筛查数量和参与率的变化。我们系统地检索了 Medline、世界卫生组织(WHO)COVID-19 数据库和政府数据库。纳入了涵盖 2020 年 1 月至 2022 年 3 月的研究。我们提取并分析了有关研究方法、筛查数量和参与率的数据。为了评估偏倚风险,我们使用了 Joanna Briggs 研究所(JBI)的批判性评估工具。在 935 篇独立记录中,有 26 项横断面描述性研究(重点关注 13 个国家/地区)被纳入。有 8 个国家观察到筛查数量和参与率下降。在 5 个有全国人群筛查的国家中,筛查参与量的变化范围为 -13% 至 -31%。在 2 个有限的人群筛查计划的国家中,下降幅度为 -61% 至 -41%。在美国,人群参与量变化范围为 +18% 至 -39%,提示保险状况(HMO、医疗保险和低收入计划)存在差异。由于统计分析和混杂因素不足,几乎所有研究都存在高偏倚风险。COVID-19 导致的乳腺筛查参与量减少的程度因地区而异,数据提示医疗保健环境(例如,国家健康保险与私人医疗保健)可能存在差异。恢复工作应监测筛查和早期诊断的机会,以确定是否需要加强预防服务,以增加弱势群体的覆盖面并减少差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cd2/10569787/707535f885f9/elife-85680-fig1.jpg

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