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1.
Int J Environ Res Public Health ; 19(10)2022 05 17.
Article in English | MEDLINE | ID: covidwho-1887190

ABSTRACT

Screening mammograms have resulted in a reduction in breast cancer mortality, yet the uptake in Malaysia was low. This study aimed to determine the prevalence and factors associated with screening mammogram uptake among women attending a Malaysian primary care clinic. A cross-sectional study was conducted among 200 women aged 40 to 74 attending the clinic. The data was collected using questionnaires assessing sociodemographic, clinical characteristics, knowledge and health beliefs. Multiple logistic regression was used to identify factors associated with mammogram uptake. The prevalence of screening mammograms was 46.0%. About 45.5% of women with high breast cancer risk had never undergone a mammogram. Older participants, aged 50 to 74 (OR = 2.57, 95% CI: 1.05, 6.29, p-value = 0.039) and those who received a physician's recommendation (OR = 7.61, 95% CI: 3.81, 15.20, p-value < 0.001) were more likely to undergo screening mammography. Significant health beliefs associated with mammogram uptake were perceived barriers (OR = 0.81, 95% CI: 0.67, 0.97, p-value = 0.019) and cues to action (OR = 1.30, 95% CI: 1.06, 1.59, p-value = 0.012). Approximately half of the participants and those in the high-risk group had never undergone a mammogram. Older age, physician recommendation, perceived barriers and cues to action were significantly associated with mammogram uptake. Physicians need to play an active role in promoting breast cancer screening and addressing the barriers.


Subject(s)
Breast Neoplasms , Mammography , Breast Neoplasms/diagnosis , Cross-Sectional Studies , Early Detection of Cancer , Female , Humans , Malaysia/epidemiology , Primary Health Care , Universities
2.
Topics in Antiviral Medicine ; 30(1 SUPPL):219, 2022.
Article in English | EMBASE | ID: covidwho-1880395

ABSTRACT

Background: Cervical cancer disproportionately affects women in resource-limited settings, as access to secondary prevention is currently limited. Women living with HIV (WLHIV) are at increased risk of human papillomavirus (HPV) infection and once infected are at greater risk of progression to cancer;therefore, timely screening and treatment is of utmost concern. The goal of the pilots was to introduce integrated HPV testing using existing NAT platforms in public health HIV programs in sub-Saharan Africa and describe the cascade of care. Methods: Observational, prospective pilot studies were conducted across 32 facilities in Malawi, Nigeria, Uganda, and Zimbabwe between September 2019 and April 2021. All countries except Zimbabwe utilized near-point-of-care (POC) devices for HPV testing. Zimbabwe conducted testing on platforms at a centralized laboratory;Uganda conducted HPV testing on both near-POC and centralized platforms. Self-collected sampling was offered as an alternative to clinician-sampling in Malawi, Nigeria, and Uganda. The target population was WLHIV;age-inclusion criteria followed country guidelines, ranging from 25-49 years. All women identified as HPV-positive were to receive visual inspection with acetic acid (VIA), and if pre-cancerous or cancerous lesions were evident, receive treatment or referral. Results: Across the four countries, 14155 tests were conducted, with 4% of tests invalid and 5% missing results, leaving 12962 valid results (Table). HPV prevalence was 35%. 66% of HPV-positive women received their result (median time to result: 34 days, interquartile range: 7-64). Among women who received VIA, 584 (22%) were VIA-positive and among those 86% received treatment (70% on same-day as VIA). 30 (1%) were suspected of cancer and of those 80% had a documented referral for tertiary care. In Uganda, 53% of HPV-positive women tested at centralized laboratory received VIA versus 73% of women tested on near-POC devices (p=0.07). Conclusion: HPV testing was found to be feasible across the four pilot countries in a public health setting. While many women did not receive their HPV results, these pilots were conducted during COVID-19, where lockdowns and other disruptions to health-seeking behavior were major barriers. Once women did receive VIA, most who required treatment received it, the majority on the same day. With proper systems in place, use of HPV testing for cervical cancer screening program as recommended by WHO is a promising model in low-and middle-income countries.

3.
Deutsches Arzteblatt International ; 118(44):A2054, 2021.
Article in German | EMBASE | ID: covidwho-1880323
4.
Cancer Med ; 2022 Jun 05.
Article in English | MEDLINE | ID: covidwho-1877565

ABSTRACT

BACKGROUND: Colorectal cancer screening (CRCS) needs to be pandemic-resilient to avoid long-lasting shutdowns; however, realistic participation target remains unelucidated. This study aimed to identify the lowest acceptable participation rate in CRCS during a pandemic, focusing on vulnerable older populations who require urgent intervention. METHODS: This nationwide cross-sectional study included 80,946 inpatients aged 70-85 years who were first diagnosed with colorectal cancer (CRC) after 70 years of age, between April 1, 2014 and March 31, 2019, in Japan. To evaluate the association between area-level CRCS participation rate and individual early CRC detection, a multilevel logistic regression model was constructed. The mandatorily implemented screening rates were converted to the total screening rate equivalents (TSREs), which reflect the remaining contributions of voluntarily provided screenings. RESULTS: Early detections during stages 0-I were significantly observed when primary screening rate was ≥38% (TSRE) and combined follow-up rate was ≥85%. For early detection during Tis-T1, primary screening rate ≥ 38% (TSRE) and combined follow-up rate ≥ 90% were necessary. For follow-up rates ≥70% or ≥75%, there were cases where missed detection of Tis-T1 were observed. CONCLUSION: The results indicate that, even during pandemic, CRCS should achieve a primary screening rate of 38% and follow-up rate of 85% for vulnerable older populations. These values, lower than the current desirable rates, suggest the maximum possible compromise in balancing the resources between cancer screening and pandemic measures. Moreover, they also indicate the minimum target for shifting to fecal immunochemical test-focused program. Further explorations with varied CRCS settings are necessary for verification.

5.
Asian Pac J Cancer Prev ; 23(5): 1497-1504, 2022 May 01.
Article in English | MEDLINE | ID: covidwho-1876507

ABSTRACT

OBJECTIVE: A systematic review and meta-analysis were carried out to assess the pooled proportion of women screened for cervical cancer before and during the COVID-19 pandemic. METHODS: After ruling out registered or ongoing systematic reviews in the PROSPERO database regarding the impact of the COVID-19 pandemic in cervical cancer screening, the protocol of our systematic review and meta-analysis was registered in PROSPERO (CRD42021279305). The electronic databases were searched for articles published in English between January 2020 and October 2021and the study was designed based on PRISMA guidelines updated in 2020. Meta-analysis was accomplished in STATA version 13.0 (College Station, Texas 77,845 USA). The pooled proportion of women who had undergone cervical cancer screening was reported with 95% CI. In order to quantify the heterogeneity, Chi2 statistic (Q statistic) and I2 index were used. RESULTS: The meta-analysis included seven studies from Slovenia, Italy, Ontario (Canada), Scotland, Belgium, and the USA, comprising 403,986 women and 199,165 women who were screened for cervical cancer before the COVID-19 pandemic in 2019 and during the pandemic in 2020, respectively. The pooled proportion of women screened for cervical cancer in 2019 was 9.79% (95% CI 6.00%-13.59%, 95% prediction interval 0.42%-23.81%). During the pandemic, the pooled proportion of screened women declined to 4.24% (95% CI 2.77%-5.71%, 95% prediction interval 0.9%-17.49%). CONCLUSION: There was a substantial drop in the cervical cancer screening rate due to lockdowns and travel restrictions to curb the COVID-19 pandemic. Scaling up cervical cancer screening strategies is essential to prevent the long-term impact of cervical cancer burden.


Subject(s)
COVID-19 , Uterine Cervical Neoplasms , COVID-19/diagnosis , COVID-19/epidemiology , Communicable Disease Control , Early Detection of Cancer , Female , Humans , Pandemics/prevention & control , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology
6.
Viruses ; 14(5)2022 04 25.
Article in English | MEDLINE | ID: covidwho-1875797

ABSTRACT

The NeuMoDx HPV assay is a novel fully automated, real-time PCR-based assay for the qualitative detection of high-risk human papillomavirus (HPV) DNA in cervical specimens. The assay specifically identifies HPV16 and HPV18 and concurrently detects 13 other high-risk HPV types at clinically relevant infection levels. Following the international guidelines, the clinical performance of the NeuMoDx HPV assay for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) against the reference standard Hybrid Capture 2, as well as intra- and inter-laboratory reproducibility were assessed on PreservCyt samples. The clinical accuracy of the assay was additionally evaluated against the clinically validated Alinity m HR HPV and COBAS 4800 HPV Test on PreservCyt samples, and against the clinically validated HPV-Risk assay on SurePath samples. The NeuMoDx HPV assay performance for CIN2+ was non-inferior to the reference methods on both sample types (all p < 0.05), and showed excellent intra- and inter-laboratory reproducibility (95.7%; 95% CI: 93.9-97.3; kappa value 0.90 (95% CI: 0.86-0.94); and 94.5%; 95% CI: 92.6-96.2; kappa value 0.87 (95% CI: 0.82-0.92), respectively). In conclusion, the NeuMoDx HPV assay meets international guideline criteria for cross-sectional accuracy and reproducibility, and performs equally well on cervical screening specimens collected in two widely used collection media. The NeuMoDx HPV assay fulfils the requirements to be used for primary cervical screening.


Subject(s)
Papillomavirus Infections , Uterine Cervical Neoplasms , Cross-Sectional Studies , Early Detection of Cancer/methods , Female , Humans , Papillomaviridae/genetics , Papillomavirus Infections/diagnosis , Reproducibility of Results , Sensitivity and Specificity , Uterine Cervical Neoplasms/diagnosis
8.
Health Policy ; 2022 May 25.
Article in English | MEDLINE | ID: covidwho-1867176

ABSTRACT

We examined the effects of the COVID-19 pandemic on the screening, diagnosis and treatment of breast cancer in Hungary based on administrative data until June 2021, covering three pandemic waves. After correcting for trend and seasonality, the number of mammography examinations decreased by 68% in 2020q2, was around its usual level in 2020q3 and was reduced by 20-35% throughout 2020q4-2021q2. The reduction was caused by a combination of supply-side (temporary suspensions of screening) and demand-side (lower screening participation during the pandemic waves) factors. The number of new breast cancer diagnoses and mastectomy surgeries responded with a lag, and were below their usual level by 15-30% in all quarters between 2020q2 and 2021q2, apart from 2020q4, when there was no significant difference. Using a regression discontinuity framework, we found that the partial mastectomy rate (indicative of early diagnosis) dropped more substantially in 2020q2 in the 61-65 years old age group that was just below the age cut-off of organized screening than in the 66-70 years old age group, and this difference was partially offset in 2021q1. We suggest that policymakers need to motivate the target population (by providing both information and incentives) to catch up on missed screenings.

9.
Nowotwory ; 72(3):195-199, 2022.
Article in English | Academic Search Complete | ID: covidwho-1865629

ABSTRACT

Introduction. To investigate the public interest in cancer screening before, during and after one year of the COVID-19 pandemic, in relation to the number of cases and deaths caused by the coronavirus. Material and methods. Google Trends (GT) was used to obtain data on online interest in screening for the most common cancer types during COVID-19 pandemic. Results. It was found that although online interest in screening collapsed during the early stages of the pandemic, it managed to gradually return to its pre-pandemic levels six months later despite a growing number of COVID-19 related deaths. Nevertheless, some data and reports suggest that this unprecedented crisis may result in increased mortality and incidence rates. Conclusions. The study raises the importance of continuous and active actions aimed at raising cancer awareness which appears to be crucially important during a public health crisis such as the COVID-19 pandemic. [ FROM AUTHOR] Copyright of Nowotwory is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

10.
Annals of Oncology ; 33:S184, 2022.
Article in English | EMBASE | ID: covidwho-1850629

ABSTRACT

Background: Risk-stratified BCS, integrating personal, familial variables and a polygenic risk score (PRS) is a promising strategy that may improve current BCS outcomes. Real-time risk assessment and field implementation are some of the main challenges for such an approach. Methods: MyPeBS is an ongoing EU-funded international randomized trial running in 6 countries. Eligible women (wn) aged 40-70 are randomized 1:1 between continuing standard organized BCS as recommended in their participating country/region and switching to risk-stratified BCS, in which BCS schedule and modalities are adapted to the individual predicted 5-year risk of invasive BC (IBC). Primary endpoint is 4-year incidence of stage 2 and higher BC. Secondary endpoints include PROs. 5-year IBC risk is estimated using the Mammorisk® BCSC-derived or the Tyrer Cuzick risk score and the centrally-determined PRS313 obtained from a saliva sample and calibrated for national BC incidence and age. We aim to describe 1) the feasibility of real-time assessment of BC risk and 2) the characteristics and risk profiles of the participants. Results: As of Sept. 7, 2021, 16,550 wn had been randomized. 29% were aged <50 (median age 54 (range 40-70), 13% had a previous benign breast biopsy, 40% a mammographic breast density C or D, 19% a 1st degree family history of breast or ovarian cancer;72% had tertiary education. 36% were estimated at low risk (<1% risk of IBC at 5 years), 29% at average risk, and 35% at high (34%) or very high risk (1%) (>1.67% and >6% risk, respectively). Only 2.5% of DNA extractions were not usable for genotyping, due to DNA concentration or quality;and 98.8% of the eligible DNA samples were successfully genotyped. Median turnover time from saliva sampling to risk result available was 11 weeks despite the COVID pandemic (currently 7 weeks). Conclusions: Real-time BC risk assessment based on a large set of polymorphisms, family, screening and hormonal history, and breast density is feasible within organized screening programmes. Participants are so far representative of different categories with some over-representation of highly educated participants. Clinical trial identification: NCT03672331. Legal entity responsible for the study: Unicancer. Funding: European Commission and French National Cancer Institute. Disclosure: S. Delaloge: Financial Interests, Institutional, Advisory Board: AstraZeneca;Financial Interests, Institutional, Invited Speaker: Exact Sciences;Financial Interests, Institutional, Advisory Board: Novartis;Financial Interests, Institutional, Advisory Board: Pierre fabre;Financial Interests, Institutional, Advisory Board: Orion;Financial Interests, Institutional, Advisory Board: Sanofi;Financial Interests, Institutional, Advisory Board: Rappta;Financial Interests, Institutional, Advisory Board: Cellectis;Financial Interests, Institutional, Advisory Board: Isis/servier;Financial Interests, Institutional, Invited Speaker: Pfizer;Financial Interests, Institutional, Invited Speaker: Seagen;Financial Interests, Institutional, Invited Speaker: Lilly;Financial Interests, Institutional, Invited Speaker: AstraZeneca;Financial Interests, Institutional, Invited Speaker: MSD;Financial Interests, Institutional, Advisory Board, ad board: Besins Healthcare;Financial Interests, Institutional, Invited Speaker: Roche Genentech;Financial Interests, Institutional, Invited Speaker: BMS;Financial Interests, Institutional, Invited Speaker: Puma;Financial Interests, Institutional, Invited Speaker: AstraZeneca;Financial Interests, Institutional, Invited Speaker: Orion;Financial Interests, Institutional, Invited Speaker: Sanofi;Financial Interests, Institutional, Funding: GE;Financial Interests, Institutional, Invited Speaker: Pfizer;Financial Interests, Institutional, Invited Speaker, clinical research funding to my institution: Taiho;Non-Financial Interests, Invited Speaker, Société Française de Sénologie et Pathologie Mammaire: SFSPM. D. Keatley: Financial Interests, Personal, Advisory Board: Public Advisory Board of Heealth Data UK. E. Gauthier: Financial Interests, Personal, Stocks/Shares: Predilife;Financial Interests, Personal, Full or part-time Employment: Predilife. S. Michiels: Financial Interests, Personal, Advisory Role: IDDI;Financial Interests, Personal, Advisory Role: Amaris;Financial Interests, Personal, Advisory Role: Roche;Financial Interests, Personal, Advisory Role: Sensorion;Financial Interests, Personal, Advisory Role: Biophytis;Financial Interests, Personal, Advisory Role: Servier;Financial Interests, Personal, Advisory Role: Yuhan. All other authors have declared no conflicts of interest.

12.
Surg Today ; 2022 Apr 15.
Article in English | MEDLINE | ID: covidwho-1850342

ABSTRACT

PURPOSE: This study aims to clarify the influence of the COVID-19 pandemic on cancer surgery in Gunma Prefecture. METHODS: A total of 9839 cases (1406 gastric cancer, 3569 colorectal cancer, 1614 lung cancer, and 3250 breast cancer) from 17 hospitals in Gunma Prefecture were investigated. We compared the number of surgical cases, proportion of cases found by screening, and cStage at the time of the first visit by month in 2020 and 2021 with those in 2019. RESULTS: The rate of decline in cancer surgery was 8.9% in 2020 compared with 2019 (p = 0.0052). Compared with the same month of 2019, in some months of 2020 and 2021, significant decreases were observed in the number of surgeries for gastric and colorectal cancer, the percentage of surgical cases detected by screening in all four cancers, and the proportion of cancers with a relatively early cStage in gastric and breast cancer. CONCLUSIONS: The number of surgical cases of the four cancer types detected by cancer screening decreased in Gunma Prefecture owing to the influence of the COVID-19 pandemic. Furthermore, for some cancer types, the number of operations performed in patients with early-stage cancer is also decreased.

13.
J Clin Med ; 11(9)2022 Apr 29.
Article in English | MEDLINE | ID: covidwho-1847352

ABSTRACT

(1) Background: Low patient's adherence to conventional cervical cancer screening methods determined the need to take into consideration alternative approaches, and vaginal HPV self-sampling is one of them. We aimed to evaluate, using an online survey, the Romanian women's acceptability of vaginal HPV self-sampling. (2) Methods: A 13-questions online survey was distributed on three Facebook groups, and the results were summarized. (3) Results: Despite of good educational background, 10.8% (n = 60) of the respondents did not know what a Pap smear is, and 33% (n = 183) were not informed about the free national cervical cancer screening program. Multivariate analysis revealed an increased likelihood of vaginal self-sampling acceptance among respondents who did not know about Pap test (OR: 7.80; 95%CI: 1.062-57.431; p = 0.021), national cervical cancer screening program (OR: 1.96; 95%CI: 1.010-3.806; p = 0.02), HPV infection (OR: 7.35; 95%CI: 3.099-17.449; p< 0.001) or HPV test (OR: 1.67; 95%CI: 0.950-2.948; p = 0.03). Moreover, women who did not previously undergo a cervical cancer screening program were more likely to accept the new screening method (OR: 1.62; 95%CI: 0.878-3.015; p = 0.04). (4) Conclusions: Our results showed high acceptability rates of vaginal HPV self-sampling among participants.

14.
Cancer Nursing Practice ; 21(3):5-5, 2022.
Article in English | CINAHL | ID: covidwho-1841676

ABSTRACT

An introduction is presented to a series of articles within the issue focused on the importance of good communication skills and compassion to providing nursing care for cancer patients.

16.
J Am Med Inform Assoc ; 29(5): 779-788, 2022 04 13.
Article in English | MEDLINE | ID: covidwho-1821748

ABSTRACT

OBJECTIVE: The US Preventive Services Task Force (USPSTF) requires the estimation of lifetime pack-years to determine lung cancer screening eligibility. Leading electronic health record (EHR) vendors calculate pack-years using only the most recently recorded smoking data. The objective was to characterize EHR smoking data issues and to propose an approach to addressing these issues using longitudinal smoking data. MATERIALS AND METHODS: In this cross-sectional study, we evaluated 16 874 current or former smokers who met USPSTF age criteria for screening (50-80 years old), had no prior lung cancer diagnosis, and were seen in 2020 at an academic health system using the Epic® EHR. We described and quantified issues in the smoking data. We then estimated how many additional potentially eligible patients could be identified using longitudinal data. The approach was verified through manual review of records from 100 subjects. RESULTS: Over 80% of evaluated records had inaccuracies, including missing packs-per-day or years-smoked (42.7%), outdated data (25.1%), missing years-quit (17.4%), and a recent change in packs-per-day resulting in inaccurate lifetime pack-years estimation (16.9%). Addressing these issues by using longitudinal data enabled the identification of 49.4% more patients potentially eligible for lung cancer screening (P < .001). DISCUSSION: Missing, outdated, and inaccurate smoking data in the EHR are important barriers to effective lung cancer screening. Data collection and analysis strategies that reflect changes in smoking habits over time could improve the identification of patients eligible for screening. CONCLUSION: The use of longitudinal EHR smoking data could improve lung cancer screening.


Subject(s)
Early Detection of Cancer , Lung Neoplasms , Aged , Aged, 80 and over , Cross-Sectional Studies , Early Detection of Cancer/methods , Electronic Health Records , Humans , Lung Neoplasms/diagnosis , Mass Screening/methods , Middle Aged , Smoking
17.
Prev Med ; 160: 107076, 2022 07.
Article in English | MEDLINE | ID: covidwho-1821533

ABSTRACT

The English Bowel Cancer Screening Programme invites people between the ages of 60 and 74 to take a Faecal Immunochemical Test every two years. This programme was interrupted during the coronavirus pandemic. The research aimed: (1) to estimate the impact of colorectal cancer (CRC) Faecal Immunochemical Test screening pauses of different lengths and the actual coronavirus-related screening pause in England, and (2) to analyse the most effective and cost-effective strategies to re-start CRC screening to prepare for future disruptions. The analysis used the validated Microsimulation Model in Cancer of the Bowel built in the R programming language. The model simulated the life course of a representative English screening population from 2019, by age, sex, socio-economic deprivation, and prior screening history. The modelling scenarios were based on assumptions and data from screening centres in England. Pausing bowel screening in England due to coronavirus pandemic is predicted to increase CRC deaths by 0.73% within 10 years and 0.13% over the population's lifetime, with excess deaths due to peak in 2023. More deaths are expected in men and people aged over 70. Pausing screening for longer would result in greater additional CRC cases and deaths. Postponing screening for everyone would be the most cost-effective strategy to minimise the impact of screening disruption without any additional endoscopy capacity. If endoscopy capacity can be increased, temporarily raising the Faecal Immunochemical Test threshold to 190 µg/g may help to minimise CRC deaths, particularly if screening programmes start from age 50 in the future.


Subject(s)
Colorectal Neoplasms , Coronavirus Infections , Coronavirus , Aged , Colonoscopy , Colorectal Neoplasms/prevention & control , Coronavirus Infections/epidemiology , Decision Support Techniques , Early Detection of Cancer , England/epidemiology , Humans , Male , Mass Screening , Middle Aged , Occult Blood , Pandemics
18.
Curr Oncol ; 29(5): 3282-3290, 2022 05 04.
Article in English | MEDLINE | ID: covidwho-1820195

ABSTRACT

BACKGROUND: Public health measures have imposed drastic reductions in cancer screening programs at the beginning of the COVID-19 pandemic, with an unknown impact on the diagnosis and staging of colorectal cancer (CRC). METHODS: Newly diagnosed CRC cases at the Centre Hospitalier de l'Université de Montréal (CHUM) were divided into two groups according to the timeline: pre-pandemic (1 January 2018-12 March 2020), and pandemic (13 March 2020-30 June 2021) periods. Colonoscopy, surgery, and staging at diagnosis during the pandemic period were compared to the pre-pandemic period. RESULTS: 254 CRC diagnoses were made during the pre-pandemic period in comparison to 125 during the pandemic period. Mean diagnosis rates were lower in the pandemic period (7.8 vs. 9.8 diagnoses/month, p = 0.048). Colonoscopy deadlines were less respected in the pandemic period (51.7% vs. 38.3%, p = 0.049). The rate of elective surgery did not differ (2.9 vs. 3.5 surgeries/month, p = 0.39) and mean delays were similar (58.6 vs. 60.4 days, p = 0.77). Stages at diagnosis did not differ (p = 0.17). Most of the delayed colonoscopies led to a stage 0 or I CRC (p = 0.2). CONCLUSION: In our center, the COVID-19 pandemic resulted in a decreased rate of CRC diagnosis and increased endoscopic delays without affecting the rate of advanced stage disease. Delays to surgery were quite similar once the CRC diagnosis was established.


Subject(s)
COVID-19 , Colorectal Neoplasms , COVID-19/epidemiology , Canada , Colonoscopy , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Humans , Pandemics
19.
Scientific Journal of Kurdistan University of Medical Sciences ; 26(5):1-12, 2021.
Article in Persian | EMBASE | ID: covidwho-1819175

ABSTRACT

Background and Aim: This study investigated the results of the non-communicable diseases prevention and control program in Isfahan under the supervision of the Vice Chancellor for Health of the University of Medical Sciences from 2017 to March 2021. Materials and Methods: In this cross-sectional study, the target group was all the population over 30 years in Isfahan province referring to health centers for screening programs for non-communicable diseases and risk factors (cardiovascular and diabetes). Breast cancer screening was performed in women between 30 to 70 years and colorectal cancer screening was performed in men and women between 50 to 70 years. Results: The number of people diagnosed with diabetes at the end of March 2021 was 148,250 and its prevalence was 11.59%. Also, the number of patients with high blood pressure registered in electronic patient record from 2017 to the end of March 2021 was 249294 (prevalence 19.74%). In colorectal cancer screening, 1593 cases of polyps were detected from 5367 colonoscopies during 4 years of the program. Also, by screening 46.9% of the target population, 513 cases of breast cancer were detected. Conclusion: In the evaluation of the process of diagnosis and patient care, an increase was evident during 2017 to 2019, but there was a decrease in the number of risk assessments and patient care in 2020-2021 due to the COVID19 pandemic.

20.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816936

ABSTRACT

The COVID-19 pandemic has interrupted oncology services including screening, diagnosis, and treatment. In this study pathology services were investigated as a proxy for cancer screening, diagnosis, and treatment delays to assess the effect of the pandemic on oncology services. In order to quantify the impact of COVID-19 we reviewed all pathology reports from January 1 through November 30 in 2018, 2019, and 2020 from 5 central registries in the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Using the SEER Data Management System and SAS, pathology reports were counted by cancer site (breast, lung, colorectal, prostate, other), patient age category (<50, 50-64, 65-74, >75 years), bi-weekly collection interval, and registry. Only pathology laboratories with monthly electronic reporting to their central registry throughout the study period were included. The reporting counts from 2020 were compared to those of the prior two years. In comparison to the 2019 baseline volume, March through November 2020 had an 11.2% decrease in pathology volume (48,779 fewer reports) in the 5 central registries. Over 75% of this decrease in volume occurred over a 10-week period, March through May 2020, with 30.2% fewer (37,127 reports) than expected pathology reports during this initial peak of the COVID-19 pandemic. The maximum bi-weekly decrease observed was 41.7% (>10,000 reports) from the 2019 baseline, which occurred in April 2020. During this 10-week period the decrease in volume by age category ranged 29.6-32.2%, cancer site ranged 27.5-39.1% and central registry ranged 26.1-36.8%. Two additional periods of volume decrease also occurred, both of shorter duration and magnitude, mid-July through August and mid-October through mid-November. Since the onset of the pandemic there remains a deficit (>11%) in the expected pathology volume compared to 2019, reflecting the continued impact of COVID-19 across oncology services. The majority of the pathology volume decrease in 2020 occurred during the initial peak of the COVID-19 pandemic. This period of decreased reporting volume along with two smaller decreases align with the 3 peaks of COVID-19 new cases reported by the CDC COVID Data Tracker. Prior to the onset of the pandemic the 2020 volume started at a bi-weekly rate greater than 2019, and the 2019 volume was consistently greater than 2018. Therefore, the 2020 expected values would be greater than those of the 2019 comparison year, i.e., the volume decreases reported would likely represent conservative estimates of the actual volume decrease. Continued longitudinal monitoring and the addition of more registries to this analysis are planned as well as pathology report type categorization (screening, surveillance, or treatment). This study also demonstrates the ability of the NCI SEER program to assist with near real time reporting of cancer data in quantifying the effect on the healthcare system of the COVID-19 pandemic.

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