Paul Albrechtsen Research Institute CancerCare Manitoba, Winnipeg, MB, Canada.
Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241263616. doi: 10.1177/15330338241263616.
Strategies to minimize the impact of the COVID-19 pandemic led to a reduction in diagnostic testing. It is important to assess the magnitude and duration of this impact to plan ongoing care and avoid long-lasting impacts of the pandemic. We examined the association between the COVID-19 pandemic and the rate of diagnostic tests for breast, cervical, and colorectal cancer in Manitoba, Canada. A population-based, cross-sectional study design with an interrupted time series analysis was used that included diagnostic tests from January 1, 2015 until August 31, 2022. Manitoba, Canada. Outcomes included mammogram, breast ultrasound, colposcopy, and colonoscopy rates per 100,000. Cumulative and percent cumulative differences between the fitted and counterfactual number of tests were estimated. Mean, median, and 90th percentile number of days from referral to colonoscopy date by referral type (elective, semiurgent, urgent) were determined. In April 2020, following the declaration of the COVID-19 public health emergency, bilateral mammograms decreased by 77%, unilateral mammograms by 70%, breast ultrasounds by 53%, colposcopies by 63%, and colonoscopies by 75%. In Winnipeg (the largest urban center in the province), elective and semiurgent colonoscopies decreased by 76% and 39%, respectively. There was no decrease in urgent colonoscopies. As of August 2022, there were an estimated 7270 (10.7%) fewer bilateral mammograms, 2722 (14.8%) fewer breast ultrasounds, 836 (3.3%) fewer colposcopies, and 11 600 (13.8%) fewer colonoscopies than expected in the absence of COVID-19. As of December 2022, in Winnipeg, there were an estimated 6030 (23.9%) fewer elective colonoscopies, 313 (2.6%) fewer semiurgent colonoscopies, and 438 (27.3%) more urgent colonoscopies. In Manitoba, the COVID-19 pandemic was associated with sizable decreases in diagnostic tests for breast, colorectal, and cervical cancer. Two and a half years later, there remained large cumulative deficits in bilateral mammograms, breast ultrasounds, and colonoscopies.
为了最小化 COVID-19 大流行的影响，我们减少了诊断检测。评估这种影响的程度和持续时间非常重要，以便规划持续的护理并避免大流行的长期影响。我们研究了 COVID-19 大流行与加拿大马尼托巴省乳腺癌、宫颈癌和结直肠癌诊断检测率之间的关系。采用基于人群的横断面研究设计和中断时间序列分析，包括 2015 年 1 月 1 日至 2022 年 8 月 31 日的诊断检测。加拿大马尼托巴省。结局包括每 10 万人的乳房 X 光检查、乳房超声、阴道镜检查和结肠镜检查率。估计拟合和反事实检测数量的累积和百分比累积差异。根据转诊类型（选择性、半紧急、紧急）确定从转诊到结肠镜检查日期的平均、中位数和第 90 个百分位数的天数。2020 年 4 月，在宣布 COVID-19 公共卫生紧急事件后，双侧乳房 X 光检查减少了 77%，单侧乳房 X 光检查减少了 70%，乳房超声检查减少了 53%，阴道镜检查减少了 63%，结肠镜检查减少了 75%。在该省最大的城市温尼伯，选择性和半紧急结肠镜检查分别减少了 76%和 39%。紧急结肠镜检查没有减少。截至 2022 年 8 月，估计有 7270 例（10.7%）双侧乳房 X 光检查、2722 例（14.8%）乳房超声检查、836 例（3.3%）阴道镜检查和 11600 例（13.8%）结肠镜检查没有发生 COVID-19。截至 2022 年 12 月，在温尼伯，估计有 6030 例（23.9%）选择性结肠镜检查、313 例（2.6%）半紧急结肠镜检查和 438 例（27.3%）紧急结肠镜检查减少。在马尼托巴省，COVID-19 大流行与乳腺癌、结直肠癌和宫颈癌的诊断检测大幅下降有关。两年半后，双侧乳房 X 光检查、乳房超声检查和结肠镜检查仍存在大量累积赤字。
