乳腺癌和宫颈癌：新冠疫情前后时期的比较。
Breast cancer and cervical cancer: a comparison of the period before and during the COVID-19 pandemic.
机构信息
Health Sciences Center, State University of Maringá-UEM, Colombo Avenue, 5790, Maringá, Paraná, 87020-900, Brazil.
Secretary Health Curitiba, Curitiba, 80060-240, Brazil.
出版信息
BMC Womens Health. 2024 Sep 3;24(1):485. doi: 10.1186/s12905-024-03325-3.
BACKGROUND
The coronavirus 2019 (COVID-19) pandemic impacted cancer health care in several countries, with delays in the detection and treatment of breast and cervical cancer. The objective of this study is to analyze and compare the screening, diagnosis and treatment of breast and cervical cancer in the pre-COVID period and during the COVID-19 period.
METHODS
Cross-sectional study with secondary data collected from the Mortality Information System (SIM), Hospital Information System (SIH), Ambulatory Information System (SIA) and the Oncology Panel (PO) of breast cancer notifications with ICD C50.0 to C50.9 and cervix ICD C53.0 to C53.9, The analyzed period before the pandemic was from March 1 to October 1, 2019, and during the pandemic from March 1 to October 1, 2020. The period from 2013 to 2022 was also analyzed with the same information, including the number of diagnoses, treatments, and deaths from breast cancer and cervical cancer. The study population consisted of Brazilian women aged 25 to 70 years. In order to compare categorical variables between periods, the Chi-Square or Fisher's Exact tests, and Mann-Whitney U tests were applied, and the Poisson Regression model was applied to model the number of reported cases of COVID-19 and the amount of procedures.
RESULTS
There was a decrease in the number of mammograms and cytopathological exams during COVID-19, as well as a decrease in cases of breast and cervical cancer. The Poisson regression showed that the increase in the number of COVID-19 cases caused a decrease in the number of breast cytopathological examinations, cervical-vaginal cytopathological examinations/microflora and screening, diagnosis, initiation of treatment for breast cancer and deaths from this disease. Meanwhile, in some regions of Brazil, as the number of Covid-19 increased, there was a significantly increase in the number of mammograms performed and cervical cancer diagnoses.
CONCLUSIONS
The COVID-19 period in 2020 significantly impacted screening, diagnosis, treatment for breast and cervical cancer.
背景
2019 年冠状病毒病（COVID-19）大流行对多个国家的癌症医疗保健产生了影响，导致乳腺癌和宫颈癌的检测和治疗出现延误。本研究旨在分析和比较 COVID-19 大流行前和大流行期间乳腺癌和宫颈癌的筛查、诊断和治疗情况。
方法
这是一项使用从死亡信息系统（SIM）、住院信息系统（SIH）、门诊信息系统（SIA）和乳腺癌通知肿瘤学小组（PO）收集的二级数据进行的横断面研究，通知中使用的 ICD 编码为 C50.0 至 C50.9 和 C53.0 至 C53.9 用于宫颈癌。大流行前的分析期为 2019 年 3 月 1 日至 10 月 1 日，大流行期间为 2020 年 3 月 1 日至 10 月 1 日。还分析了 2013 年至 2022 年的相同信息，包括乳腺癌和宫颈癌的诊断数量、治疗数量和死亡人数。研究人群为年龄在 25 至 70 岁之间的巴西女性。为了比较两个时期的分类变量，应用了卡方检验或 Fisher 精确检验和 Mann-Whitney U 检验，以及 Poisson 回归模型来对报告的 COVID-19 病例数和程序数量进行建模。
结果
COVID-19 期间，乳房 X 光检查和细胞病理学检查的数量减少，乳腺癌和宫颈癌的病例也减少。Poisson 回归显示，COVID-19 病例数的增加导致乳腺癌细胞病理学检查、宫颈阴道细胞学检查/微生物群和筛查、诊断、开始治疗以及死于乳腺癌的数量减少。与此同时，在巴西的一些地区，随着 COVID-19 病例数的增加，乳房 X 光检查和宫颈癌诊断的数量显著增加。
结论
2020 年的 COVID-19 时期对乳腺癌和宫颈癌的筛查、诊断和治疗产生了重大影响。
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