COVID-19 大流行期间延迟结肠镜筛查对临床结局的影响。
The impact of delayed screening colonoscopies during the COVID-19 pandemic on clinical outcomes.
机构信息
National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland.
National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland; University College Dublin, School of Public Health Physiotherapy and Sports Science, Woodview House, Belfield, Dublin 4, Ireland.
出版信息
Cancer Epidemiol. 2024 Oct;92:102629. doi: 10.1016/j.canep.2024.102629. Epub 2024 Jul 31.
BACKGROUND
Colorectal cancer (CRC) screening services in Ireland were cancelled or postponed for periods during the COVID-19 pandemic. The aim of this study was to assess the impact of screening colonoscopy delays after a positive FIT on clinical and histopathological outcomes due to these restrictions.
METHODS
Participants in the Irish National Bowel Screening Programme with a positive Immunochemical Faecal Test (FIT) during the COVID-19 pandemic (March 2020-December 2021) were included. Patients were categorised into attended for a colonoscopy <3 months and attended for colonoscopy ≥3-17 months post positive FIT. Chi-Square Test of independence was performed using WinPepi.
RESULTS
3227 individuals had a complete index colonoscopy <3 months and 262 attended colonoscopy from ≥3 to 17 months post positive FIT. Of the clients whose colonoscopy was between ≥3-17 months from positive FIT, the median wait time was 3 months. There was no significant difference found between the two groups for CRC (5.8 % vs 5.0 %, p=0.544) or for the proportion of cancer stage I, stage II and unknown (33.7 %, 40.6 %, 25.7 %, p=0.411). There was no difference in the proportions of adenomas (57.8 % vs 58.4 %, p=0.849) and the proportion of advanced adenomas (7.7 % vs 10.7 %, p=0.077) detected between the two groups. A similar proportion of polyps were detected in individuals whose index colonoscopies were postponed <3 months from positive FIT (66.9 % vs 66 %, p=0.786).
CONCLUSION
A median delay of 3 months in screening colonoscopies after a positive FIT does not adversely impact clinical or histopathological outcomes. There was no significant difference in cancer staging, advanced adenomas or polyps detected between those who attended colonoscopies <3 months and ≥3-17 months post positive FIT. COVID-19 related disruptions to the normal functioning of the Irish bowel screening programme did not compromise our key objectives of advanced adenoma and cancer detection.
背景
在 COVID-19 大流行期间，爱尔兰的结直肠癌（CRC）筛查服务被取消或推迟。本研究旨在评估由于这些限制，阳性 FIT 后筛查结肠镜检查延迟对临床和组织病理学结果的影响。
方法
纳入在 COVID-19 大流行期间（2020 年 3 月至 2021 年 12 月）进行爱尔兰国家肠道筛查计划并出现免疫化学粪便测试（FIT）阳性的参与者。将患者分为 FIT 阳性后 3 个月内接受结肠镜检查和 3-17 个月内接受结肠镜检查的两类。使用 WinPepi 进行独立性卡方检验。
结果
3227 名患者进行了 FIT 阳性后 3 个月内的完整结肠镜检查，262 名患者在 FIT 阳性后 3-17 个月内进行了结肠镜检查。在 FIT 阳性后 3-17 个月接受结肠镜检查的患者中，中位等待时间为 3 个月。两组 CRC（5.8%比 5.0%，p=0.544）或癌症 I 期、II 期和未知比例（33.7%比 40.6%比 25.7%，p=0.411）无显著差异。两组的腺瘤比例（57.8%比 58.4%，p=0.849）和高级别腺瘤比例（7.7%比 10.7%，p=0.077）无差异。在 FIT 阳性后 3 个月内推迟进行的结肠镜检查中，检测到的息肉比例相似（66.9%比 66%，p=0.786）。
结论
阳性 FIT 后筛查结肠镜检查的中位延迟 3 个月不会对临床或组织病理学结果产生不利影响。在 FIT 阳性后 3 个月内和 3-17 个月内接受结肠镜检查的患者之间，癌症分期、高级别腺瘤或息肉的检出率无显著差异。与 COVID-19 相关的爱尔兰肠道筛查计划正常功能中断并未影响我们对高级别腺瘤和癌症检出的主要目标。
Zotero 插件