Bull Claudia, Spilsbury Katrina, Lawrence David, Saxby Karinna I, Kisely Steve
Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Woolloongabba, QLD, Australia.
Queensland Centre for Mental Health Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia.
Aust N Z J Psychiatry. 2025 Jul;59(7):640-650. doi: 10.1177/00048674251336034. Epub 2025 Apr 28.
OBJECTIVE: The impact of COVID-19 on Australia's National Bowel Cancer Screening Program remains unclear, especially for individuals with severe mental illness. These individuals have historically participated in the National Bowel Cancer Screening Program at significantly lower rates than the general population. This study aimed to understand the impact of COVID-19 on participation in Australia's National Bowel Cancer Screening Program among individuals with severe mental illness. METHODS: Cohort study using deidentified linked health and National Bowel Cancer Screening Program data. We compared participation in the National Bowel Cancer Screening Program between individuals with and without severe mental illness by examining rates of participation (returning an immunochemical faecal occult blood test), returning a valid immunochemical faecal occult blood test, receiving a positive immunochemical faecal occult blood test result and undergoing a follow-up colonoscopy before (25 January 2018-24 January 2020) and during (25 January 2020-31 July 2021) the COVID-19 pandemic. RESULTS: Overall National Bowel Cancer Screening Program participation fell by 10.3% from pre-COVID to during COVID. Less than one-quarter (23.9%) of people with severe mental illness participated in the National Bowel Cancer Screening Program during the COVID-19 pandemic compared to 30.5% before. People with severe mental illness were less likely to return a valid immunochemical faecal occult blood test and more likely to return a positive immunochemical faecal occult blood test result both before and during the pandemic, compared to the general population. They were also significantly less likely to have a colonoscopy following positive immunochemical faecal occult blood test result (pre-COVID adjusted relative risk = 0.97, 95% confidence interval: 0.94-1.01, vs during COVID adjusted relative risk = 0.87, 95% CI: 0.82-0.91). CONCLUSION: The pandemic significantly reduced the rate at which all Australians participated in the National Bowel Cancer Screening Program. Disparities between people with severe mental illness and the general population generally improved with the exception of follow-up colonoscopy after positive immunochemical faecal occult blood test result.
目的：新冠疫情对澳大利亚国家肠癌筛查计划的影响尚不清楚，尤其是对患有严重精神疾病的个体。从历史上看，这些个体参与国家肠癌筛查计划的比例显著低于普通人群。本研究旨在了解新冠疫情对患有严重精神疾病的个体参与澳大利亚国家肠癌筛查计划的影响。 方法：采用去识别化的关联健康数据和国家肠癌筛查计划数据进行队列研究。我们通过检查参与率（返还免疫化学粪便潜血试验）、返还有效的免疫化学粪便潜血试验、获得阳性免疫化学粪便潜血试验结果以及在新冠疫情之前（2018年1月25日至2020年1月24日）和期间（2020年1月25日至2021年7月31日）接受后续结肠镜检查的情况，比较了患有和未患有严重精神疾病的个体参与国家肠癌筛查计划的情况。 结果：从新冠疫情前到疫情期间，国家肠癌筛查计划的总体参与率下降了10.3%。在新冠疫情期间，不到四分之一（23.9%）的严重精神疾病患者参与了国家肠癌筛查计划，而疫情前这一比例为30.5%。与普通人群相比，严重精神疾病患者在疫情之前和期间返还有效免疫化学粪便潜血试验的可能性较小，而返还阳性免疫化学粪便潜血试验结果的可能性较大。在免疫化学粪便潜血试验结果呈阳性后，他们接受结肠镜检查的可能性也显著较低（疫情前调整后的相对风险=0.97，95%置信区间：0.94-1.01，而疫情期间调整后的相对风险=0.87，95%置信区间：0.82-0.91）。 结论：疫情显著降低了所有澳大利亚人参与国家肠癌筛查计划的比例。除了免疫化学粪便潜血试验结果呈阳性后接受后续结肠镜检查外，严重精神疾病患者与普通人群之间的差距总体上有所改善。
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