McLeod Deanna, Martins Ilidio, Tinker Anna V, Selk Amanda, Brezden-Masley Christine, LeVasseur Nathalie, Altman Alon D
Kaleidoscope Strategic Inc., Toronto, ON, Canada.
BC Cancer Agency, BC Cancer-Vancouver Centre, University of British Columbia, 600 West 10th Avenue, 4th Floor, Vancouver, BC V5Z 4E6, Canada.
Ther Adv Med Oncol. 2025 May 26;17:17588359251339919. doi: 10.1177/17588359251339919. eCollection 2025.
The initial response to coronavirus disease 2019 (COVID-19) in Ontario included suspension of cancer screening programs and deferral of diagnostic procedures and many treatments. Although the short-term impact of these measures on female cancers is well documented, few studies have assessed the mid- to long-term impacts.
To compare annual billing prevalence and incidence rates of female cancers during the COVID-19 period (2020-2022) to pre-COVID-19 levels (2015-2019).
Retrospective analysis of aggregated claims data for female cancer diagnostic codes from the Ontario Health Insurance Plan (OHIP).
Linear regression analysis was used to fit pre-COVID-19 (2015-2019) data for each OHIP billing code and extrapolate counterfactual values for the years of 2020-2022. Excess billing rates were calculated as the difference between projected and actual rates for each year.
In 2020, OHIP billing prevalence rates for cervical, breast, uterine, and ovarian cancers decreased relative to projected values for that year by -50.7/100k, -13.9/100k, -3.5/100k, and -3.8/100k, respectively. The reverse was observed in 2021 with rate increases of 47.8/100k, 59.1/100k, 2.5/100k, and 3.7/100k, respectively. In 2022, the excesses were further amplified, especially for cervical and breast cancers (111.2/100k and 78.67/100k, respectively). The net excess patient billing rate for 2020-2022 was largely positive for all female cancer types (108.3/100k, 123.7/100k, 5.2/100k, and 1.8/100k, respectively). Analysis of billing incidence rates showed similar trends.
The expected female cancer billing rate decreases in 2020 were followed by large increases in 2021 and 2022, resulting in a cumulative excess during the COVID-19 period. Further research is required to assess the nature of these changes.
安大略省对2019冠状病毒病（COVID-19）的最初应对措施包括暂停癌症筛查项目、推迟诊断程序和许多治疗。尽管这些措施对女性癌症的短期影响已有充分记录，但很少有研究评估其中长期影响。
比较COVID-19期间（2020 - 2022年）与COVID-19之前（2015 - 2019年）女性癌症的年度计费患病率和发病率。
对安大略省医疗保险计划（OHIP）中女性癌症诊断代码的汇总索赔数据进行回顾性分析。
使用线性回归分析对每个OHIP计费代码的COVID-19之前（2015 - 2019年）数据进行拟合，并推断2020 - 2022年的反事实值。计算每年的超额计费率，即各年预测率与实际率之间的差值。
2020年，宫颈癌、乳腺癌、子宫癌和卵巢癌的OHIP计费患病率相对于当年预测值分别下降了-50.7/10万、-13.9/10万、-3.5/10万和-3.8/10万。2021年情况相反，患病率分别上升了47.8/10万、59.1/10万、2.5/10万和3.7/10万。2022年，超额情况进一步加剧，尤其是宫颈癌和乳腺癌（分别为111.2/10万和78.67/10万）。2020 - 2022年所有女性癌症类型的患者超额计费率净增长在很大程度上为正值（分别为108.3/10万、123.7/10万、5.2/10万和1.8/10万）。计费发病率分析显示了类似趋势。
2020年女性癌症预期计费率下降之后，2021年和2022年大幅上升，导致COVID-19期间出现累计超额。需要进一步研究以评估这些变化的性质。
