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Background. During the COVID-19 pandemic, annual adult check-ups have been postponed, resulting in cancer screening disruption. The aim of the study was to evaluate changes in the incidence and stage distribution of malignancies included in the screening program during the COVID-19 pandemic using the Arkhangelsk Regional Cancer Registry (ARRC). Material and Methods. We assessed the changes of the incidence rates and stage distribution for the colon, rectum, lung, breast, cervix, uterine body, ovary, prostate and kidney cancers over the periods 2018–19 and 2020–21. Results. A total of 12354 cases with 9 cancers were selected: 6680 for the period 2018–19 and 5674 (-15.1 %) for the period 2020-21. The most significant decrease in crude and age-standardized incidence rates was registered in patients with lung (-18.0–18.1 %), rectum (-25.1–25.9 %) and cervix (-33.6–36.9 %) cancers, p<0.001. The decrease was not significant in patients with breast, uterine body, and kidney cancers. The proportion of patients with stage I decreased in lung cancer (-20.0 %, from 14.8 % to 11.8 %), rectum (-20.2 %, from 20.9 % to 16.7 %), and uterine cervix (-37.1 %, from 53.2 % to 33.5 %). In prostate and kidney cancers, the proportion of patients with stage I increased by 30 % (from 19.5 % to 25.4 %) and 17.6 % (from 45.9 % to 54.0 %), respectively. A significant reduction in the proportion of early stages during the COVID-19 pandemic was observed in lung and cervical cancer. Conclusion Postponed health checkups due to COVID-19 pandemic disruptions have led to substantial reductions in new cancers being diagnosed, mainly for cervical, lung, colon and rectal cancers. No significant changes were observed for other cancers. Further analysis of mortality and survival of cancer patients is required.
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BACKGROUND: After the confirmation of coronavirus infection in Japan, a behavioral change caused people and physicians to refrain from visiting hospitals or undergoing examinations. This study aimed to assess how the trend of diagnosis in gastric cancers changed, and how it affected the therapeutic strategies and the interval from diagnosis to treatment during the COVID-19 pandemic. METHODS: We use 15 cancer-designated hospitals' registries in Hiroshima, Japan. The target period was March to December 2020, and the same period in 2019 was set as the control period. The monthly mean of diagnoses and the interval from diagnosis to treatment were compared overall and separately by age, treatment procedure, diagnostic process, and clinical stage. RESULT: In 2020, the monthly mean (standard deviation [SD]) of patients was 192.2 (29.9), a significant 20.1% decrease from 240.7 (20.7) in 2019 due to older age and curative treatment groups. By reason for performing endoscopy, the change rate in cancer screening, endoscopic follow-up, and symptomatic status were -27.0%, -18.0%, and -17.3%, respectively. Meanwhile, the interval (days) from diagnosis to treatment (SD) was 37.8 (26.5) in 2020, significantly shorter than 46 (31.5) in 2019. CONCLUSION: From 2019 to 2020, we observed a significant decrease in the diagnosis of curable early-stage gastric cancer and treatments, although the interval from diagnosis to treatment decreased. This study suggests that cancer screening played a significant role in the decline in cancer diagnosis that occurred during the COVID-19 pandemic. Even under COVID-19 pandemic conditions, there should be an awareness of cancer screening and endoscopic follow-up.
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Background: COVID-19 disrupted the healthcare system and services across the cancer continuum. Early on, breast and cervical (B & C) screenings were effectively halted, and many diagnostic and treatment procedures delayed. Emerging evidence suggests that uninsured populations and patients of color were disproportionately affected, but less is known about ruralurban differences. The Illinois Breast and Cervical Cancer Screening Program (IBCCP), administered by agencies across 102 counties, provides screening and diagnostic services for lowincome, uninsured, and underinsured persons. This study assesses the impact of COVID-19 on agencies' administrative functions and clients' ability to receive services, and to examine rural-urban differences. Method(s): IBCCP coordinators were invited to complete an online survey that asked about COVID-19's effect on administrative functions and services at two different time periods, the height of the pandemic and in the past month (11/2021-12/2021). Chi-square and Fisher's exact tests were used to examine differences between rural and urban agencies (classified by using the 2013 NCHS Urban-Rural Classification Scheme). Result(s): In total, 32 agencies (50% urban, 50% rural), responded. Concerning administrative functions, in the past month compared to at the height of the pandemic, fewer agencies overall reported that COVID-19 had a moderate to great impact (compared to occasional or no impact) on staffing (47% vs. 74%) and client enrollment (34% vs. 90%). Although not significant, more rural than urban agencies reported effects on staffing (56% vs. 38%) and enrollment (50% vs. 19%) in the past month. Concerning clients' ability to receive services, in the past month compared to the height of the pandemic, fewer agencies overall reported COVID-19 effects on screening (31% vs. 75%), diagnostic (19% vs. 61%), and treatment (3% vs. 38%) services. Some rural-urban differences were noted;at the height of the pandemic, urban agencies were more likely to report effects on diagnostic (88% vs. 33%, p=.002) and treatment (56% vs. 19%, p=.028) services when compared to rural. Although not significant, in the past month, more urban (vs. rural) agencies reported COVID-19 related effects on screening (44% vs. 19%), diagnostic (31% vs. 6%), and treatment (7% vs. 0%) services. Conclusion(s): Overall, agencies implementing this safety net program are generally rebounding from the pandemic's effect on administrative functions and clients' ability to receive services. However, rural and urban agencies may be differentially affected by the pandemic. For example, in the past month, a greater proportion of rural agencies reported effects on administrative functions Interestingly, more urban agencies reported lingering effects on clients' ability to receive screening and diagnostic services. These trends suggest that rural and urban agencies may be differentially affected by the pandemic and geographically tailored responses may best support recovery.
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Background: The COVID-19 pandemic exacerbated health inequities among systematically marginalized populations. At the onset of the pandemic, routine cancer screenings were effectively halted;from March to May 2021, there was a deficit of 9.3 million screens. Early evidence suggests that non-White patients, compared to White, have experienced even greater declines in breast and cervical cancer screenings. Consequences of missed or late screenings include later stage diagnosis and poor outcomes. Community navigation programs have been used to promote engagement in cancer screenings in under-resourced communities, but these too were interrupted as restrictions were put in place to mitigate the spread of COVID-19. Objective(s): To use a mixed methods approach to describe the challenges, strengths, and lessons learned of implementing a community navigation program for breast and cervical cancer screening during the COVID-19 pandemic. Method(s): In 2019, The University of Illinois Cancer Screening, Access, Awareness, and Navigation (UI CAAN) intervention was established to address breast and cervical cancer disparities on Chicago's West side, an area with large Black and Latinx populations. The intervention included community navigators who worked in partnership with community-based safety net hospitals and organizations. Participants were recruited at community events and through clinical referrals and were eligible if they were overdue for a guideline concordant breast or cervical cancer screening. Quantitative navigation and screening data were collected by the navigators in a REDCap database. Qualitative data, four focus groups with participants and partners, were also collected to broaden our understanding of impact of COVID-19 on the community navigation intervention. For these analyses, we describe participants' navigation and screening outcomes and use content analysis methods for the focus groups. We then triangulate the findings to understand the challenges, strengths, and lessons learned of the UI CAAN. Result(s): From 2019-2022, a total of 366 individuals were navigated for breast and cervical cancer screenings. Of these, 68% (n = 248) received a breast and/or cervical cancer screening. Among those who were screened, 75% were Latinx and 23% were Black, 92% were uninsured, and 86% did not have a primary care provider. Concerning services received, 30% had a mammogram and a pap smear, 37% a pap smear only, and 33% a mammogram only. At the height of the pandemic, navigators coordinated with community and clinical partners to deliver 500 meals, held 9 PPE distribution events, distributed 3000 masks, and conducted 2 webinars about COVID-19. Conclusion(s): Despite the challenges of the COVID-19 pandemic, the UI CAAN community navigation program was able to shift its efforts at the height of the pandemic to assist its community and clinical partners. The continued collaboration allowed for a successful resumption of navigation and screening efforts once healthcare systems were able to re-engage patients in cancer screenings.
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African Americans present earlier in age and have higher incidence and mortality from colorectal cancer (CRC) compared to Whites. Socioeconomic inequality in the US that leads to higher comorbid illness among African Americans is likely a driver. Subsequent biological differences in African Americans include higher risk adenoma precursors that are more often proximally located in the colon, low microstatellite instability prevalence, and deficient immunologic profiles compared to Whites that contribute to cancer progression and outcome. Screening for CRC among African Americans had been recommended by some organizations to commence at age 45 or 40 years due to the observed epidemiology;this was not implemented until the US Preventive Services Task Force recommended CRC screening to commence at age 45 years for all races and ethnicities in 2021.Screening for CRC is one modality of intervention that can eliminate disparities;both colonoscopic and non-invasive screening have been shown to eliminate incidence and mortality differences between African Americans and Whites when using navigation. Recent gains in screening utilization among African Americans compared to Whites might be erased as a result of the COVID-19 pandemic. Navigated non-invasive CRC screening might help the unevenness of preventive services recovery from the pandemic if it can be fully implemented.
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Background: While lung cancer is a leading cause of death in the U.S., annual lung cancer screening (LCS) rates remain low at 12.7%. The WUSTL research group began a community intervention to increase LCS called I-STEP (Increasing Screening Through Engaging Primary Care Providers) to address this quality gap. A customizable Toolkit was administered to a collaborative of six hospital systems in Missouri and Illinois, encompassing LCS eligibility and follow up guidelines, navigating LCS referral, and smoking cessation. The COVID-19 pandemic prompted brief suspension of screening, with lingering effects on LCS delivery and I-STEP implementation. Method(s): This was a step-wedged cluster randomized control trial from January 2019 - March 2021. Six hospital systems sequentially entered a three-month training phase, followed by I-STEP implementation into primary care settings. Primary outcomes were mean number of screenings and mean percent change in LCS from baseline. Data were collated into a dashboard. Analyses compared outcomes within I-STEP sites pre- and post- intervention. To investigate whether I-STEP sites recovered screening numbers during the pandemic, we compared I-STEP sites to six comparator hospitals within the collaborative that did not participate in the intervention. Result(s): Mean LCS increased by 63% amongst I-STEP sites (130.8 to 212). Mean screenings increased significantly from pre- to post-intervention phases within I-STEP sites (p = 0.0272). Across I-STEP sites and comparator hospitals, mean LCS increased significantly following emergence of the pandemic in March 2020 (p = 0.0002, LSM difference -72.0, 95% CI [-100.9, -43]) - data adjusted for the three-month period in which LCS was suspended. Findings were similar for mean percent change in LCS. There was no difference in outcomes between I-STEP and comparator sites. Conclusion(s): I-STEP implementation successfully increased mean LCS from pre-intervention baseline. Findings suggest a possible effect of the I-STEP intervention in promoting increased LCS amidst the pandemic.
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COVID-19 has significantly impacted the world and Nepal is no exception. The pandemic has caused a reduction in health service delivery, especially for women's health conditions, resulting in an increase in challenges for an already vulnerable group. Maternity care, reproductive health services, preventive interventions, nutritional advice and mental health care are not being addressed and with an increase in domestic violence, the health and wellbeing of women in Nepal is precarious and needs to be addressed immediately. Copyright © 2020, Kathmandu University. All rights reserved.
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Background At least 80% of new cervical cancer cases and deaths occur in low- and middleincome countries. Vietnam is a middle-income country where cervical cancer is the second most common and the deadliest gynecologic cancer. Cervical cancer incidence in Southern Vietnam has been shown to be 1.5-4 times higher than that in Northern Vietnam. However, less than 10% of Southern Vietnamese women have received the Human papillomavirus (HPV) vaccine and only 50% have ever been screened for cervical cancer. No study has examined the perceptions toward cervical cancer prevention and screening in Southern Vietnamese women. Hence, this study aimed to explore cervical cancer awareness, barriers to screening, and acceptability of HPV self-sampling for cervical cancer screening among rural and urban women in Southern Vietnam. Methods In October-November 2021, three focus groups were conducted in the rural district of Can Gio (n=21 participants) and three were conducted in the urban District Four (n=23 participants) in Ho Chi Minh City, Southern Vietnam. All participants were cervical cancer-free women aged 30-65 years. Awareness of, attitudes toward, and experience with cervical cancer prevention and screening were explored using audio-recorded, semi-structured discussions in Vietnamese. During the focus groups, participants also watched four short videos with Vietnamese subtitles and voiceover about cervical cancer screening methods and discussed their views on each. The recordings were transcribed, translated into English, and coded and analyzed using Dedoose 9.0.46. Results Four main themes emerged. First, women showed low awareness, but high acceptance of cervical cancer screening and HPV vaccination. Second, screening barriers were related to logistics (e.g., cost, time, travel distance), psychology (e.g., fear of pain, embarrassment, fear of the test revealing they had cancer), and healthcare providers (e.g., doctors' impolite manners, male doctors). Third, women were concerned about self-sampling incorrectly and pain, but believed HPV self-sampling to be a feasible screening tool in some circumstances (e.g., during the COVID-19 pandemic, those living in remote areas). Fourth, women related cervical cancer prevention to COVID-19 prevention;they believed strategies that have been successful for COVID-19 control in Vietnam could be applied to cervical cancer. No differences in themes emerged by rural/urban areas. Conclusions Southern Vietnamese women showed low awareness but high acceptance of cervical cancer screening despite barriers. Strategies for successful COVID-19 control in Vietnam, including campaigns to increase public awareness, advocacy from the government and doctors, and efforts to increase access to screening and vaccination, should be applied to cervical cancer control. Health education programs to address HPV self-sampling concerns and promote it as a cervical cancer screening tool are warranted given its potential to improve screening uptake in this low-resource setting.
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Background: Poor prognosis of lung cancer is linked to its late diagnosis, typically in the advanced stage 4 in 50-70% of incidental cases. Lung Cancer Screening Programs provide low-dose lung CT screening to current and former smokers who are at high risk for developing this disease. Greece is an EU country, returning strong from a long period of economic recession, ranked 2nd place in overall age-standardized tobacco smoking prevalence in the EU. In December 2020, at the Metropolitan Hospital of Athens, we started the 1st Screening Program in the country. We present our initial results and pitfalls met. Method(s): A weekly outpatient clinic offers consultation to possible candidates. LDCT (<=3.0mGy), Siemens VIA, Artificial Intelligence multi-computer-aided diagnosis (multi-CAD) system and LungRADS (v.1.1) are used for the validation of any abnormal findings with semi-auto measurement of volume and volume doubling time. Patients get connected when necessary with the smoking cessation and Pulmonology clinic. USPSTF guidelines are used, (plus updated version). Abnormal CT findings are discussed by an MDT board with radiologists, pulmonologists/interventional pulmonologists, oncologists and thoracic surgeons. A collaboration with Fairlife Lung Cancer Care the first non-profit organization in Greece is done, in order to offer the program to population with low income too. An advertisement campaign was organized to inform family doctors and the people about screening programs, together with an anti-tobacco campaign. Result(s): 106 people were screened, 74 males & 32 females (mean age 62yo), 27/106 had an abnormal finding (25%). 2 were diagnosed with a resectable lung cancer tumor (primary adenocarcinoma) of early-stage (1.8%). 2 with extended SCLC (lung lesion & mediastinal adenopathy). 1 with multiple nodules (pancreatic cancer not known until then). 3 patients with mediastinal and hilar lymphadenopathy (2 diagnosed with lymphoma, 1 with sarcoidosis). 19 patients were diagnosed with pulmonary nodules (RADS 2-3, 17%) - CT follow up algorithm. Conclusion(s): We are presenting our initial results, from the first lung cancer screening program in Greece. Greece represents a country many smokers, who also started smoking at a young age, with a both public and private health sector, returning from a long period of economic recession. COVID-19 pandemia has cause practical difficulties along the way. LDCT with AI software, with an MDT board and availability of modern diagnostic and therapeutic alternatives should be considered as essential. A collaboration spirit with other hospitals around the country is being built, in order to share current experience and expertise. Copyright © 2022
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PURPOSE: Partnering with the largest Federally Qualified Health Center (FQHC) in New Haven, CT, the goal is to implement and test 4 evidence-based interventions (EBI) to increase CRC screening, while evaluating real-world implementation. Here, we report on the six-month (approximate) follow up of a cohort of 3,127 patients overdue for CRC screening who received 1 or more EBIs in October 2021. BACKGROUND: Sociocultural and medical concerns are barriers to colonoscopy uptake contributing to disparities in CRC screening. An additional barrier is system level capacity. COVID-19 associated delays exacerbated the existing backlog of individuals overdue for CRC screening, underscoring the need to expand Fecal Immunochemical Testing (FIT) capacity. This was particularly evident in the safety-net primary care setting that serves lower socio-economic status individuals living in urban New Haven, CT. METHOD(S): We are testing the unique and additive value of multiple evidence-based interventions (EBIs) for increasing CRC screening. The EBIs include the use of medical reminders, addressing the structural barriers (social determinants of health [SDOH]), and providing assistance from community health workers (CHW). We randomized 3,127 patients overdue for CRC screening to one of 4 arms of the study. All individuals received a reminder from their providers that they were due/overdue for CRC screening with instructions to contact the FQHC. Arm 2 also included information on SDOH barriers, Arm 3 included this same information with offer of navigation from CHW/navigator;and Arm 4 included the offer of CHW educational video and support if needed. Six-month (approximate) outcomes include: 1) Engagement with FQHC resulting in ordered test;2) completed test. Results by intervention will be assessed at 12 months. RESULT(S): Of the 3,127 randomized patients, ages 50-75, 77% were Hispanic (33%) or Black (44%). At 6+ months, a preliminary look at EMR data show that a minimum of 1,275 (40.8%) patients "engaged" with providers resulting in an ordered FIT Kit (n= 1174) or COMPLETED screening colonoscopy that was not associated with a positive FIT result (n = 102). 217 (18.5%) individuals completed the FIT testing with 13 requiring confirmatory colonoscopy (31% completed at this time). Thus, a minimum of 319 (10%) of 3,127 individuals in the cohort completed CRC screening at approximately 6 months post intervention. DISCUSSION: Despite investments in community engagement, stakeholder input, and FIT kit capacity building, the pandemic presented unforeseen challenges. Flexibility and steadfast commitment from FQHC providers and staff were critical to successful implementation during multiple waves of COVID-19, resulting in CRC screening ordered for 41% of cohort within 6 months of intervention. SUMMARY: At 6 months follow up of 3,127 individual who were overdue for CRC screening, one or more of 4 EBIs, in addition to system level efforts to address CRC screening, resulted CRC screening tests ordered for 41% of cohort with at least 10% completed screening.
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African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups in the U.S. Factors that may be contributing to these high rates, however, remain poorly understood. Specifically, this study assessed the relationship between dietary habits and colorectal cancer screening behavior and intent among individuals who identify as Black, with their ethnicity as African-American, Caribbean, and African. There are many factors that influence dietary habits, and a salient factor is culture. Many studies have experienced challenges recruiting in communities of color for various reasons. The purpose of this presentation is to describe recruitment methods utilized for this study in the midst of the COVID-19 pandemic, and to discuss challenges, strategies that were implemented and lessons learned that can inform and improve future recruitment efforts. Effective recruitment strategies included partnership, consistent engagement, and meeting people in places where they frequent and felt comfortable. Utilizing faith-based locations, barbershops, hair salons, and pivotal community locations allowed individuals to trust the researchers, and also eliminated the need to retain study subjects over a period of time, due to on-site data collection. Though our findings are limited to Black families in predominantly minority neighborhoods, we have identified Cicely successful strategies for this specific high-risk population and potentially similar others.
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Background: Recommendation by a healthcare provider is essential for women to seek preventative cancer screening. Research has shown patients are receptive to information about cancer screening given by health professionals administering influenza vaccines. Promotion of cancer screening during vaccination may be particularly important in Puerto Rico (PR), which, relative to the continental United States, has low cervical and colorectal cancer screening rates. Objective(s): This study aims to determine if receiving the influenza vaccine in the past year or ever receiving the COVID-19 booster is associated with an increased likelihood of women participating in cervical, breast, and colorectal cancer screening in the past year. Method(s): Women older than 18 are recruited weekly in different ongoing community outreach events throughout Puerto Rico as part of the Puerto Rico Community Engagement Alliance (PR-CEAL) against COVID-19 disparities. The PR-CEAL outreach team completes an online community survey as part of their field activities. Initial data was collected from February 17th 2022 through May 28th 2022, with data collection currently ongoing. Pearson chi2 test or Fisher exact test, as appropriate, was used to quantify the association between participation in cancer screening and vaccination status. Result(s): As of May 31st, 253 women with a median age of 59 had been recruited. Of these, 56.1% had received the influenza vaccine in the past year, and 52.6% had received a COVID-19 booster. Nearly 52% of women with the booster and 65% without the booster received cervical cancer screening (p-value =0.29). Women with the booster and those without the booster (75% each) received breast cancer screening (p-value = 0.99). Only 16.1% of women with the booster and 11.8% without the booster had received colorectal cancer screening (p-value = 0.99). Receipt of cancer screening according to influenza vaccine status was as follows: 59.3% vaccinated and 51.5% unvaccinated received cervical cancer screening (p-value = 0.35);31.4% vaccinated and 41.2% unvaccinated received breast cancer screening (p-value = 0.56);and 13.1% vaccinated and 9.3% unvaccinated received colorectal cancer screening (p-value = 0.46). Conclusion(s): No differences in receipt of cancer screening were found by influenza or COVID-19 booster vaccination status among adult women in Puerto Rico. Routine vaccination appointments may therefore represent a missed opportunity to promote cancer screening.
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Background: In Italy, regions have the mandate to implement population-based screening programs for breast, cervical, and colorectal cancer. From March to May 2020, a severe lockdown was imposed due to the COVID-19 pandemic by the Italian Ministry of Health, with the suspension of screening programs. This paper describes the impact of the pandemic on Italian screening activities and test coverage in 2020 overall and by socioeconomic characteristics. Methods: The regional number of subjects invited and of screening tests performed in 2020 were compared with those in 2019. Invitation and examination coverage were also calculated. PASSI surveillance system, through telephone interviews, collects information about screening test uptake by test provider (public screening and private opportunistic). Test coverage and test uptake in the last year were computed by educational attainment, perceived economic difficulties, and citizenship. Results: A reduction of subjects invited and tests performed, with differences between periods and geographical macro areas, was observed in 2020 vs. 2019. The reduction in examination coverage was larger than that in invitation coverage for all screening programs. From the second half of 2020, the trend for test coverage showed a decrease in all the macro areas for all the screening programs. Compared with the pre-pandemic period, there was a greater difference according to the level of education in the odds of having had a test last year vs. never having been screened or not being up to date with screening tests. Conclusions: The lockdown and the ongoing COVID-19 emergency caused an important delay in screening activities. This increased the preexisting individual and geographical inequalities in access. The opportunistic screening did not mitigate the impact of the pandemic. Funding: This study was partially supported by Italian Ministry of Health - Ricerca Corrente Annual Program 2023 and by the Emilian Region DGR 839/22.
Subject(s)
COVID-19 , Neoplasms , Humans , Pandemics/prevention & control , Early Detection of Cancer , Cross-Sectional Studies , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Italy/epidemiology , Neoplasms/epidemiologyABSTRACT
The scoping review investigated how digital technologies have helped to increase cancer screening uptake in communities including adolescents, adults and elderly people during the COVID-19 outbreak between January 2020 and June 2021. Thirteen studies were identified as being relevant, mostly addressing underserved or minority communities with the purpose to increase screening uptake, delivering health education or investigating social and cultural barriers to cancer screening. The interventions effectively used digital technologies such as mobile apps and messengers mobile apps, messaging and Web platforms. The limitations imposed by COVID-19 on social interaction can be supported with digital solutions to ensure the continuity of cancer screening programs. However, more research is needed to clarify the exact nature of effectiveness, especially in large-scale interventions.
Subject(s)
COVID-19 , Neoplasms , Humans , Aged , Adolescent , COVID-19/prevention & control , Early Detection of Cancer , Digital Technology , Neoplasms/diagnosis , Neoplasms/prevention & control , Health PromotionABSTRACT
Cervical cancer is the fourth most common malignancy in females worldwide, and a leading cause of death in the United Kingdom (UK). The human papillomavirus (HPV) is the strongest risk factor for developing cervical intraepithelial neoplasia and cancer. Across the UK, the national HPV immunisation programme, introduced in 2008, has been successful in protecting against HPV-related infections. Furthermore, the National Health Service (NHS) implemented the cytology-based cervical cancer screening service to all females aged 25 to 64, which has observed a decline in cervical cancer incidence. In the UK, there has been an overall decline in age-appropriate coverage since April 2010. In 2019, the COVID-19 pandemic disrupted NHS cancer screening and immunisation programmes, leading to a 6.8% decreased uptake of cervical cancer screening from the previous year. Engagement with screening has also been associated with social deprivation. In England, incidence rates of cervical cancer were reported to be 65% higher in the most deprived areas compared to the least, with lifestyle factors such as cigarette consumption contributing to 21% of cervical cancer cases. In this article, we provide an update on the epidemiology of cervical cancer, and HPV pathogenesis and transmission, along with the current prevention programmes within the NHS.
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Aim: Early diagnosis is very important in some cancers such as breast, cervical and colorectal. However, the COVID-19 pandemic has severely disrupted cancer screening programmers in many countries. In this study, it is aimed to contribute to the literature on this subject by reviewing the status of local cancer screenings during the pandemic period.Methods:This retrospective study includes the 114.727 people in the risky group for cancer screening determined in Bolu, Turkey as two groups. During 2017-2019 years was determined as pre-pandemic group while the year of 2020 was the pandemic group. Data about patients' results of smear / HPV (Human Papilloma Virus), fecal occult blood test (FOBT) and mammography had analyzed and compared with chi-square test.Results: For all of the screening strategies, smear / HPV, FOBT and mammography, mean of screening cases, positive cases and biopsies had significantly decreased (p<0.05), but there was no statistically difference for mean of definitive diagnoses about all of these cancers even if it has been decreased between two groups.Conclusion: The results of our study show that cancer screening processes are significantly disrupted during the pandemic period. Therefore, it is important to develop new screening strategies for the uninterrupted execution of cancer screening programs, especially during pandemic periods. However, we believe in the necessity of supporting studies with larger patient groups.
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Background: Several studies reported sharp decreases in screening mammography for breast cancer and low-dose computerized tomographic screening for lung cancer in the early months of the COVID-19 pandemic, followed by a return to normal or near-normal levels in the summer of 2020. Objective(s): To determine the observed vs. expected mammography and low dose computed tomography rates from the beginning of the pandemic through April 2022. Method(s): Retrospective cohort study assessing mammography and low dose computed tomography rates from January 2017 through April 2022. Data for January 2016 to February 2020 were used to generate expected rates for the period March 2020 to April 2022. Setting(s): United States Medicare population. Participant(s): A 20% national sample of Medicare fee-for-service enrollees among women aged 50-74 for mammography, and men and women aged 55-79 for low dose computerized tomography. Main outcome: Receipt of screening mammography or low dose computed tomography. Result(s): From January 2017 through February 2020, monthly mammography rates were flat, while there was a monotonic increase in low dose computed tomography rates, from approximately 500 per million per month in early 2017 to 1100 per million per month by January 2020. Over the period from March 2020 to April 2022, there were episodic drops in both mammography and low dose computed tomography rates, coincident with increases in national COVID-19 infection rates. For the periods from March 2020 to February 2020 and March 2021 to February 2022, the observed low dose computed tomography rates were 24% (95% Confidence Interval: 23%, 24%) and 14% (95% Confidence Interval: 13%, 15%) below expected rates, while mammography rates were 17% (95% Confidence Interval: 17%, 18%) and 4% (95% Confidence Interval: 4%, 3%) below expected. Conclusions and Relevance: The negative impact of the COVID-19 pandemic on lung cancer screening and breast cancer screening did not resolve after the initial pandemic surges. Successful interventions to improve screening rates should address pandemic-specific reasons for low screening participation.
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The COVID-19 pandemic posed a setback to health maintenance screenings worldwide. These delays have impacted minorities and those of low socioeconomic status in the same way that disparities in cancer screenings have historically trended. Here, we evaluated the performance of a student-run free clinic in maintaining women up-to-date with cancer screenings before, during, and after the pandemic in relation to national trends. We identified all women eligible for screening mammography and cervical cancer screenings between 2018 and 2022 at the clinic (N = 185). Adequate adherence to screening was defined according to the American Cancer Society (ACS) recommendations for breast mammography, and the United States Preventive Services Task Force (USPSTF) guidelines for cervical cancer screenings. For cervical cancer screening, 166 female patients seen between 2018 and 2022 were eligible, and up-to-date proportions were as follows: 81.3% in 2018; 90.9% in 2019; 83.3% in 2020; 93.3% in 2021; 93.8% in 2022. For breast surveillance, 143 women were eligible for screening mammography, and up-to-date proportions were as follows: 66.7% in 2018; 62.5% in 2019; 91.7% in 2020; 73.1% in 2021; 84.1% in 2022. These proportions were higher than or near national averages.In conclusion, adherence remained steady during the pandemic and was not subject to the declines seen nationally. Our clinic represents an effective model for promoting women's health maintenance and tempering the disparities seen among women of low socioeconomic status.