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2.
Reprod Health ; 18(1): 228, 2021 Nov 13.
Article in English | MEDLINE | ID: covidwho-1515447

ABSTRACT

OBJECTIVE: To assess the effect of a blended educational program to promote performing the PST among Iranian women. DESIGN: In a randomized control trial four main variables; knowledge, attitude, self-efficacy, and practice about PST was evaluated using a man-made questionnaire for PST. SETTING: Women aged 18-49 living in Andimeshk (Khuzestan, Iran), covered by 16 health centers, participated in study from November 2019 till April 2019. METHOD: The educational intervention conducted to increasing women's performing the PST. The experimental group received an intervention, whereas the control group received usual care. Participants were tested at four-time points: pre-test (baseline), post-test 1 (immediately after the program's completion) post-test 2 (4 weeks after the program's completion) and post-test 3 (12 weeks after the program completion). RESULTS: A total of 84 women with average aged 32.27 (42 in the experimental group, 42 in the control group) were recruited from 16 health centers in Andimeshk, southern Iran. Significant group differences were found at different times in knowledge, attitude, self-efficacy, and practice about PST. CONCLUSION: A blended method was effective in sustaining the effects of the educational program in the experimental group. The development of appropriate teaching method on restricted situation such as COVID-19 pandemic to promote participation is suggested.


Subject(s)
COVID-19 , Uterine Cervical Neoplasms , Early Detection of Cancer , Female , Health Knowledge, Attitudes, Practice , Humans , Iran , Pandemics , SARS-CoV-2 , Uterine Cervical Neoplasms/epidemiology
3.
CA Cancer J Clin ; 71(5): 366-368, 2021 09.
Article in English | MEDLINE | ID: covidwho-1512012
4.
BMJ Open Respir Res ; 8(1)2021 11.
Article in English | MEDLINE | ID: covidwho-1505920

ABSTRACT

COVID-19 has had a devastating impact on outcomes in lung cancer leading to later stage presentation, less curative treatment and higher mortality. This has amplified the existing problem of late-stage presentation in lung cancer and is a call to arms for a multifaceted strategy to address this, including public awareness campaigns to promote healthcare review in patients with persistent chest symptoms. We report the learning from patient and public insight work from across the North of England exploring the barriers to seeking healthcare review with persistent chest symptoms. Members of the public described how a lack of importance is placed on the common symptoms of lung cancer and a feeling of being unworthy of review by healthcare professionals. They would feel motivated to seek review by dispelling the nihilism of lung cancer and would be able to take action more easily by removing the logistical hassle in the process. We propose a four-pillar framework (validation-endorsement-motivation-action) for developing the content of any public awareness campaigns promoting early diagnosis of lung cancer based on the findings of this comprehensive insight work. All providers and commissioners must work together to overcome the perceived and real barriers to patients with persistent chest symptoms.


Subject(s)
COVID-19 , Lung Neoplasms , Early Detection of Cancer , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Pandemics , SARS-CoV-2
5.
Clin Gastroenterol Hepatol ; 19(7): 1410-1417.e9, 2021 07.
Article in English | MEDLINE | ID: covidwho-1499706

ABSTRACT

BACKGROUND & AIMS: The SARS-CoV-2 pandemic had a sudden, dramatic impact on healthcare. In Italy, since the beginning of the pandemic, colorectal cancer (CRC) screening programs have been forcefully suspended. We aimed to evaluate whether screening procedure delays can affect the outcomes of CRC screening. METHODS: We built a procedural model considering delays in the time to colonoscopy and estimating the effect on mortality due to up-stage migration of patients. The number of expected CRC cases was computed by using the data of the Italian screened population. Estimates of the effects of delay to colonoscopy on CRC stage, and of stage on mortality were assessed by a meta-analytic approach. RESULTS: With a delay of 0-3 months, 74% of CRC is expected to be stage I-II, while with a delay of 4-6 months there would be a 2%-increase for stage I-II and a concomitant decrease for stage III-IV (P = .068). Compared to baseline (0-3 months), moderate (7-12 months) and long (> 12 months) delays would lead to a significant increase in advanced CRC (from 26% to 29% and 33%, respectively; P = .008 and P < .001, respectively). We estimated a significant increase in the total number of deaths (+12.0%) when moving from a 0-3-months to a >12-month delay (P = .005), and a significant change in mortality distribution by stage when comparing the baseline with the >12-months (P < .001). CONCLUSIONS: Screening delays beyond 4-6 months would significantly increase advanced CRC cases, and also mortality if lasting beyond 12 months. Our data highlight the need to reorganize efforts against high-impact diseases such as CRC, considering possible future waves of SARS-CoV-2 or other pandemics.


Subject(s)
COVID-19 , Colorectal Neoplasms , Delayed Diagnosis , Early Detection of Cancer , Aged , Colonoscopy , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/mortality , Humans , Italy , Mass Screening , Middle Aged , Neoplasm Staging , Pandemics
6.
Lancet Oncol ; 22(11): e474-e487, 2021 11.
Article in English | MEDLINE | ID: covidwho-1488012

ABSTRACT

The increasing burden of cancer represents a substantial problem for Latin America and the Caribbean. Two Lancet Oncology Commissions in 2013 and 2015 highlighted potential interventions that could advance cancer care in the region by overcoming existing challenges. Areas requiring improvement included insufficient investment in cancer control, non-universal health coverage, fragmented health systems, inequitable concentration of cancer services, inadequate registries, delays in diagnosis or treatment initiation, and insufficient palliative services. Progress has been made in key areas but remains uneven across the region. An unforeseen challenge, the COVID-19 pandemic, strained all resources, and its negative effect on cancer control is expected to continue for years. In this Series paper, we summarise progress in several aspects of cancer control since 2015, and identify persistent barriers requiring commitment of additional resources to reduce the cancer burden in Latin America and the Caribbean.


Subject(s)
COVID-19/epidemiology , Neoplasms/prevention & control , SARS-CoV-2 , Caribbean Region/epidemiology , Cost of Illness , Delivery of Health Care/economics , Early Detection of Cancer , Health Services Accessibility , Humans , Latin America/epidemiology , Medical Oncology/education , Neoplasms/epidemiology
7.
Aust J Gen Pract ; 502021 10 25.
Article in English | MEDLINE | ID: covidwho-1485737

ABSTRACT

At-home screening and risk stratification are strategies that can be employed at times of disruption to maintain adequate levels of cancer prevention and early detection.


Subject(s)
COVID-19 , Neoplasms , Australia , Early Detection of Cancer , Humans , Mass Screening , Neoplasms/diagnosis , SARS-CoV-2
8.
Med J Aust ; 215(10): 479-484, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1481136

ABSTRACT

INTRODUCTION: Driven by the need to reduce risk of SARS-CoV-2 infection and optimise use of health system resources, while maximising patient outcomes, the COVID-19 pandemic has prompted unprecedented changes in cancer care. Some new or modified health care practices adopted during the pandemic will be of long term value in improving the quality and resilience of cancer care in Australia and internationally. The Cancer Australia consensus statement is intended to guide and enhance the delivery of cancer care during the pandemic and in a post-pandemic environment. This article summarises the full statement, which is available at https://www.canceraustralia.gov.au/covid-19/covid-19-recovery-implications-cancer-care. MAIN RECOMMENDATIONS: The statement is informed by a desktop literature review and input from cancer experts and consumers at a virtual roundtable, held in July 2020, on key elements of cancer care that changed during the pandemic. It describes targeted strategies (at system, service, practitioner and patient levels) to retain, enhance and embed high value changes in practice. Principal strategies include: implementing innovative models of care that are digitally enabled and underpinned by clear governance, policies and procedures to guide best practice cancer care; enabling health professionals to deliver evidence-based best practice and coordinated, person-centred cancer care; and empowering patients to improve health literacy and enhancing their ability to engage in informed, shared decision making. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT: Widespread adoption of high value health care practices across all levels of the cancer control sector will be of considerable benefit to the delivery of optimal cancer care into the future.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care , Neoplasms/therapy , Pandemics , Australia , Decision Making, Shared , Early Detection of Cancer , Health Literacy , Humans , Neoplasms/diagnosis , Neoplasms/prevention & control , Palliative Care , Patient Care Team , Patient-Centered Care , SARS-CoV-2 , Scholarly Communication , Social Support , Telemedicine
9.
World J Gastroenterol ; 27(38): 6415-6429, 2021 Oct 14.
Article in English | MEDLINE | ID: covidwho-1472443

ABSTRACT

Faecal immunochemical tests (FITs) are the most widely colorectal cancer (CRC) diagnostic biomarker available. Many population screening programmes are based on this biomarker, with the goal of reducing CRC mortality. Moreover, in recent years, a large amount of evidence has been produced on the use of FIT to detect CRC in patients with abdominal symptoms in primary healthcare as well as in surveillance after adenoma resection. The aim of this review is to highlight the available evidence on these two topics. We will summarize the evidence on diagnostic yield in symptomatic patients with CRC and significant colonic lesion and the different options to use this (thresholds, brands, number of determinations, prediction models and combinations). We will include recommendations on FIT strategies in primary healthcare proposed by regulatory bodies and scientific societies and their potential effects on healthcare resources and CRC prognosis. Finally, we will show information regarding FIT-based surveillance as an alternative to endoscopic surveillance after high-risk polyp resection. To conclude, due to the coronavirus disease 2019 pandemic, FIT-based strategies have become extremely relevant since they enable a reduction of colonoscopy demand and access to the healthcare system by selecting individuals with the highest risk of CRC.


Subject(s)
COVID-19 , Colorectal Neoplasms , Colonoscopy , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Early Detection of Cancer , Feces/chemistry , Hemoglobins/analysis , Humans , Mass Screening , Occult Blood , SARS-CoV-2 , Sensitivity and Specificity
11.
JCO Clin Cancer Inform ; 5: 1028-1033, 2021 09.
Article in English | MEDLINE | ID: covidwho-1468135

ABSTRACT

PURPOSE: This study examined changes in prostate disease screening (prostatic-specific antigen [PSA] testing), prostate biopsy testing, and prostate cancer diagnoses during the COVID-19 pandemic through December 2020. MATERIALS AND METHODS: This analysis included test results from men ≥ 40 years, without prior International Classification of Diseases-10 record of prostate cancer since January 2016, who received PSA or prostate biopsy testing at Quest Diagnostics during January 2018-December 2020. Monthly trends were evaluated for three periods: prepandemic (January 2018-February 2020), early-pandemic (March-May 2020), and late-pandemic (June-December 2020). RESULTS: Meeting inclusion criteria were 16,365,833 PSA and 48,819 prostate biopsy results. The average monthly number of PSA tests declined from 465,187 prepandemic to 295,786 early-pandemic (36.4% decrease; P = .01) before rebounding to 483,374 (3.9% increase; P = .23) late-pandemic. The monthly average number of PSA results ≥ 50 ng/mL (23,356; 0.14% of all PSA results) dipped from 659 prepandemic to 506 early-pandemic (23.2% decrease; P = .02) and rebounded to 674 late-pandemic (2.3% increase; P = .65). The average monthly number of prostate biopsy results decreased from 1,453 prepandemic to 903 early-pandemic (37.9% decrease; P = .01) before rebounding to 1,190 late-pandemic (18.1% decrease; P = .01). The average monthly number for Gleason score ≥ 8 (6,241; 12.8% of all prostate biopsies) declined from 182 prepandemic to 130 early-pandemic (28.6% decrease; P = .02) and decreased to 161 late-pandemic (11.5% decrease; P = .02). CONCLUSION: The findings suggest that a substantial number of prostate screening opportunities and cancer diagnoses have been missed. Efforts are needed to bring such patients back for screening and diagnostic testing and to restore appropriate care for non-COVID-19-related medical conditions.


Subject(s)
COVID-19 , Early Detection of Cancer/statistics & numerical data , Prostate-Specific Antigen/analysis , Prostatic Neoplasms , Biopsy , Humans , Male , Pandemics , Prostate , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology
13.
Viruses ; 13(3)2021 03 16.
Article in English | MEDLINE | ID: covidwho-1457709

ABSTRACT

BACKGROUND: Efficacy for cervical cancer prevention of opportunistic HPV vaccination in post-pubertal girls is lower than in 11-year-olds. METHODS: Women born between 1986 and 1992 vaccinated at 15-25 years of age (at least one dose of 4-valent HPV vaccine) and screened at 24-27 years of age were included. Frequency of opportunistic vaccination, overall and by birth cohort, was calculated; screening outcomes were compared between vaccinated and unvaccinated women. RESULTS: Overall, 4718 (4.9%) HPV-vaccinated, and 91,512 unvaccinated, women were studied. The frequency of vaccination increased by birth cohort, ranging between 1.8% and 9.8%; age at vaccination decreased progressively by birth cohort (p < 0.0001). Participation in screening was 60.8% among vaccinated, and 56.6% among unvaccinated, women (p < 0.0001). Detection rates (DR) for high-grade lesions were lower in vaccinated women (2.11‰ vs. 3.85‰ in unvaccinated, for CIN3+, p = 0.24; 0.0‰ vs. 0.22‰ for cancer). The DR of CIN3+ increased with age at vaccination, scoring respectively 0.0‰, 0.83‰, and 4.68‰ for women vaccinated when they were 15-16, 17-20, and 21-25 years old (p = 0.17). CONCLUSIONS: In comparison to unvaccinated women, higher compliance with cervical cancer screening invitation and lower CIN3+ DR among vaccinated women was observed. Age at vaccination was inversely correlated to vaccination efficacy.


Subject(s)
Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/administration & dosage , Uterine Cervical Neoplasms/prevention & control , Adolescent , Adult , Early Detection of Cancer , Female , Humans , Italy/epidemiology , Mass Screening , Retrospective Studies , Young Adult
14.
Cancer Prev Res (Phila) ; 14(10): 919-926, 2021 10.
Article in English | MEDLINE | ID: covidwho-1450634

ABSTRACT

The World Health Organization global call to eliminate cervical cancer encourages countries to consider introducing or improving cervical cancer screening programs. Brazil's Unified Health System (SUS) is among the world's largest public health systems offering free cytology testing, follow-up colposcopy, and treatment. Yet, health care networks across the country have unequal infrastructure, human resources, equipment, and supplies resulting in uneven program performance and large disparities in cervical cancer incidence and mortality. An effective screening program needs multiple strategies feasible for each community's reality, facilitating coverage and follow-up adherence. Prioritizing those at highest risk with tests that better stratify risk will limit inefficiencies, improving program impact across different resource settings. Highly sensitive human papillomavirus (HPV)-DNA testing performs better than cytology and, with self-collection closer to homes and workplaces, improves access, even in remote regions. Molecular triage strategies like HPV genotyping can identify from the same self-collected sample, those at highest risk requiring follow-up. If proven acceptable, affordable, cost-effective, and efficient in the Brazilian context, these strategies would increase coverage while removing the need for speculum exams for routine screening and reducing follow-up visits. SUS could implement a nationwide organized program that accommodates heterogenous settings across Brazil, informing a variety of screening programs worldwide.


Subject(s)
COVID-19/complications , Cytodiagnosis/methods , Early Detection of Cancer/methods , Papillomaviridae/isolation & purification , Papillomavirus Infections/complications , SARS-CoV-2/isolation & purification , Uterine Cervical Neoplasms/diagnosis , Brazil/epidemiology , DNA, Viral/analysis , DNA, Viral/genetics , Female , Humans , Papillomavirus Infections/genetics , Papillomavirus Infections/virology , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/virology
15.
BMJ Open ; 11(9): e048144, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1443592

ABSTRACT

INTRODUCTION: The primary objective of the ReIMAGINE Prostate Cancer Screening Study is to explore the uptake of an invitation to prostate cancer screening using MRI. METHODS AND ANALYSIS: The ReIMAGINE Prostate Cancer Screening Study is a prospective single-centre feasibility study. Eligible men aged 50-75 years with no prior prostate cancer diagnosis or treatment will be identified through general practitioner practices and randomly selected for invitation. Those invited will be offered an MRI scan and a prostate-specific antigen (PSA) blood test. The screening MRI scan consists of T2-weighted, diffusion-weighted and research-specific sequences, without the use of intravenous contrast agents. Men who screen positive on either MRI or PSA density will be recommended to have standard of care (National Health Service) tests for prostate cancer assessment, which includes multiparametric MRI. The study will assess the acceptability of an MRI-based prostate screening assessment and the prevalence of cancer detected in MRI-screened men. Summary statistics will be used to explore baseline characteristics in relation to acceptance rates and prevalence of cancer. ETHICS AND DISSEMINATION: ReIMAGINE Prostate Cancer Screening is a single-site screening study to assess the feasibility of MRI as a screening tool for prostate cancer. Ethical approval was granted by London-Stanmore Research Ethics Committee Heath Research Authority (reference 19/LO/1129). Study results will be published in peer-reviewed journals after completion of data analysis and used to inform the design of a multicentre screening study in the UK. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04063566).


Subject(s)
Prostate-Specific Antigen , Prostatic Neoplasms , Aged , Early Detection of Cancer , Feasibility Studies , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Prospective Studies , Prostatic Neoplasms/diagnostic imaging , State Medicine
16.
Prev Med ; 153: 106826, 2021 12.
Article in English | MEDLINE | ID: covidwho-1440420

ABSTRACT

Worldwide, cancer screening faced significant disruption in 2020 due to the COVID-19 pandemic. If this has led to changes in public attitudes towards screening and reduced intention to participate, there is a risk of long-term adverse impact on cancer outcomes. In this study, we examined previous participation and future intentions to take part in cervical and colorectal cancer (CRC) screening following the first national lockdown in the UK. Overall, 7543 adults were recruited to a cross-sectional online survey in August-September 2020. Logistic regression analyses were used to identify correlates of strong screening intentions among 2319 participants eligible for cervical screening and 2502 eligible for home-based CRC screening. Qualitative interviews were conducted with a sub-sample of 30 participants. Verbatim transcripts were analysed thematically. Of those eligible, 74% of survey participants intended to attend cervical screening and 84% intended to complete home-based CRC screening when next invited. Thirty percent and 19% of the cervical and CRC samples respectively said they were less likely to attend a cancer screening appointment now than before the pandemic. Previous non-participation was the strongest predictor of low intentions for cervical (aOR 26.31, 95% CI: 17.61-39.30) and CRC (aOR 67.68, 95% CI: 33.91-135.06) screening. Interview participants expressed concerns about visiting healthcare settings but were keen to participate when screening programmes resumed. Intentions to participate in future screening were high and strongly associated with previous engagement in both programmes. As screening services recover, it will be important to monitor participation and to ensure people feel safe to attend.


Subject(s)
COVID-19 , Colorectal Neoplasms , Uterine Cervical Neoplasms , Adult , Colorectal Neoplasms/diagnosis , Communicable Disease Control , Cross-Sectional Studies , Early Detection of Cancer , Female , Health Knowledge, Attitudes, Practice , Humans , Intention , Mass Screening , Pandemics , SARS-CoV-2 , Uterine Cervical Neoplasms/diagnosis
17.
Br J Gen Pract ; 71(712): e826-e835, 2021 11.
Article in English | MEDLINE | ID: covidwho-1430995

ABSTRACT

BACKGROUND: There is substantial variation in the use of urgent suspected cancer referral (2-week wait [2WW]) between practices. AIM: To examine the change in use of 2WW referrals in England over 10 years (2009/2010 to 2018/2019) and the practice and population factors associated with cancer detection. DESIGN AND SETTING: Retrospective cross-sectional study of English general practices and their 2WW referral and Cancer Waiting Times database detection data (all cancers other than non-melanoma skin cancers) from 2009/2010 to 2018/2019. METHOD: A retrospective study conducted using descriptive statistics of changes over 10 years in 2WW referral data. Yearly linear regression models were used to determine the association between cancer detection rates and quintiles of practice and population characteristics. Predicted cancer detection rates were calculated, as well as the difference between lowest to highest quintiles. RESULTS: Over the 10 years studied there were 14.89 million 2WW referrals (2.24 million in 2018/2019), and 2.68 million new cancer diagnoses, of which 1.26 million were detected following 2WW. The detection rate increased from 41% to 52% over the time period. In 2018/2019 an additional 66 172 cancers were detected via 2WW compared with 2009/2010. Higher cancer detection via 2WW referrals was associated with larger practices and those with younger GPs. From 2016/2017 onwards more deprived practice populations were associated with decreased cancer detection. CONCLUSION: From 2009/2010 to 2018/2019 2WW referrals increased on average by 10% year on year. The most consistent association with higher cancer detection was found for larger practices and those with younger GPs, though these differences became attenuated over time. The more recent association between increased practice deprivation and lower cancer detection is a cause for concern. The COVID-19 pandemic has led to significant impacts on 2WW referral activity and the impact on patient outcomes will need to be studied.


Subject(s)
COVID-19 , Neoplasms , Cross-Sectional Studies , Early Detection of Cancer , England/epidemiology , Humans , Neoplasms/diagnosis , Neoplasms/epidemiology , Pandemics , Primary Health Care , Referral and Consultation , Retrospective Studies , SARS-CoV-2
18.
CA Cancer J Clin ; 71(6): 466-487, 2021 11.
Article in English | MEDLINE | ID: covidwho-1430676

ABSTRACT

The Hispanic/Latino population is the second largest racial/ethnic group in the continental United States and Hawaii, accounting for 18% (60.6 million) of the total population. An additional 3 million Hispanic Americans live in Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanic individuals in the United States using the most recent population-based data. An estimated 176,600 new cancer cases and 46,500 cancer deaths will occur among Hispanic individuals in the continental United States and Hawaii in 2021. Compared to non-Hispanic Whites (NHWs), Hispanic men and women had 25%-30% lower incidence (2014-2018) and mortality (2015-2019) rates for all cancers combined and lower rates for the most common cancers, although this gap is diminishing. For example, the colorectal cancer (CRC) incidence rate ratio for Hispanic compared with NHW individuals narrowed from 0.75 (95% CI, 0.73-0.78) in 1995 to 0.91 (95% CI, 0.89-0.93) in 2018, reflecting delayed declines in CRC rates among Hispanic individuals in part because of slower uptake of screening. In contrast, Hispanic individuals have higher rates of infection-related cancers, including approximately two-fold higher incidence of liver and stomach cancer. Cervical cancer incidence is 32% higher among Hispanic women in the continental US and Hawaii and 78% higher among women in Puerto Rico compared to NHW women, yet is largely preventable through screening. Less access to care may be similarly reflected in the low prevalence of localized-stage breast cancer among Hispanic women, 59% versus 67% among NHW women. Evidence-based strategies for decreasing the cancer burden among the Hispanic population include the use of culturally appropriate lay health advisors and patient navigators and targeted, community-based intervention programs to facilitate access to screening and promote healthy behaviors. In addition, the impact of the COVID-19 pandemic on cancer trends and disparities in the Hispanic population should be closely monitored.


Subject(s)
Early Detection of Cancer/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Hispanic Americans/statistics & numerical data , Neoplasms/ethnology , Adolescent , Adult , Aged , European Continental Ancestry Group/statistics & numerical data , Female , Humans , Incidence , Male , Middle Aged , Neoplasms/mortality , Neoplasms/prevention & control , Puerto Rico/epidemiology , Risk Factors , Survival Rate , United States/epidemiology , Young Adult
19.
JAMA Netw Open ; 4(9): e2126334, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1427027

ABSTRACT

Importance: The COVID-19 pandemic has delayed medical consultations, possibly leading to the diagnosis of gastrointestinal cancer at advanced stages. Objective: To evaluate stage at diagnosis among patients with gastrointestinal cancer in Japan before and during the COVID-19 pandemic. Design, Setting, and Participants: This retrospective cohort study included patients in a hospital-based cancer registry who were diagnosed with gastrointestinal cancer (ie, esophageal, gastric, colorectal, pancreatic, liver, and biliary tract cancers) between January 2016 and December 2020 at 2 tertiary Japanese hospitals. Exposures: The pre-COVID-19 period was defined as January 2017 to February 2020, and the COVID-19 period was defined as March 2020 to December 2020. Main Outcome and Measure: Monthly numbers of patients with newly diagnosed cancer were aggregated, classified by stage, and compared. Results: The study evaluated 5167 patients, including 4218 patients (2825 [67.0%] men; mean [SD] age, 71.3 [10.9] years) in the pre-COVID-19 period and 949 patients (607 [64.0%] men; mean [SD] age, 71.8 [10.7] years) in the COVID-19 period. Comparing the pre-COVID-19 period with the COVID-19 period, significant decreases were observed in the mean (SD) number of patients with newly diagnosed gastric cancer (30.63 [6.62] patients/month vs 22.40 [5.85] patients/month; -26.87% change; P < .001) and colorectal cancer (41.61 [6.81] patients/month vs 36.00 [6.72] patients/month; -13.47% change; P = .03). Significant decreases were also observed in the mean (SD) number of cases of stage I gastric cancer (21.55 [5.66] cases/month vs 13.90 [5.99] cases/month; -35.51% change; P < .001), stage 0 colorectal cancer (10.58 [3.36] cases/month vs 7.10 [4.10] cases/month; -32.89% change; P = .008), and stage I colorectal cancer (10.16 [3.14] cases/month vs 6.70 [2.91] cases/month; -34.04% change; P = .003). No significant increases were observed for esophageal, gastric, pancreatic, liver, or biliary tract cancers. A significant decrease was observed in the mean (SD) number of cases per month of stage II colorectal cancer (7.42 [3.06] cases/month vs 4.80 [1.75] cases/month; -35.32% change; P = .01); a significant increase was observed for the mean (SD) number of cases per month of stage III colorectal cancer (7.18 [2.85] cases/month vs 12.10 [2.42] cases/month; 68.42% change; P < .001). Conclusions and Relevance: In this cohort study of patients in a hospital-based cancer registry form Japan, significantly fewer patients were diagnosed with stage I gastric and colorectal cancers during the COVID-19 pandemic. Thus, the number of screening-detected cancers might have decreased, and colorectal cancer may have been diagnosed at more advanced stages.


Subject(s)
Biliary Tract Neoplasms/diagnosis , COVID-19 , Early Detection of Cancer , Gastrointestinal Neoplasms/diagnosis , Liver Neoplasms/diagnosis , Pancreatic Neoplasms/diagnosis , Pandemics , Aged , Aged, 80 and over , Delayed Diagnosis/trends , Female , Humans , Japan , Male , Mass Screening , Middle Aged , Neoplasm Staging , Retrospective Studies , SARS-CoV-2
20.
J Natl Cancer Inst ; 113(9): 1161-1167, 2021 09 04.
Article in English | MEDLINE | ID: covidwho-1402395

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic led to a near-total cessation of mammography services in the United States in mid-March 2020. It is unclear if screening and diagnostic mammography volumes have recovered to prepandemic levels and whether use has varied by women's characteristics. METHODS: We collected data on 461 083 screening mammograms and 112 207 diagnostic mammograms conducted during January 2019 through July 2020 at 62 radiology facilities in the Breast Cancer Surveillance Consortium. We compared monthly screening and diagnostic mammography volumes before and during the pandemic stratified by age, race and ethnicity, breast density, and family history of breast cancer. RESULTS: Screening and diagnostic mammography volumes in April 2020 were 1.1% (95% confidence interval [CI] = 0.5% to 2.4%) and 21.4% (95% CI = 18.7% to 24.4%) of the April 2019 prepandemic volumes, respectively, but by July 2020 had rebounded to 89.7% (95% CI = 79.6% to 101.1%) and 101.6% (95% CI = 93.8% to 110.1%) of the July 2019 prepandemic volumes, respectively. The year-to-date cumulative volume of screening and diagnostic mammograms performed through July 2020 was 66.2% (95% CI = 60.3% to 72.6%) and 79.9% (95% CI = 75.4% to 84.6%), respectively, of year-to-date volume through July 2019. Screening mammography rebound was similar across age groups and by family history of breast cancer. Monthly screening mammography volume in July 2020 for Black, White, Hispanic, and Asian women reached 96.7% (95% CI = 88.1% to 106.1%), 92.9% (95% CI = 82.9% to 104.0%), 72.7% (95% CI = 56.5% to 93.6%), and 51.3% (95% CI = 39.7% to 66.2%) of the July 2019 prepandemic volume, respectively. CONCLUSIONS: Despite a strong overall rebound in mammography volume by July 2020, the rebound lagged among Asian and Hispanic women, and a substantial cumulative deficit in missed mammograms accumulated, which may have important health consequences.


Subject(s)
Breast Neoplasms/diagnosis , COVID-19/epidemiology , Early Detection of Cancer/statistics & numerical data , Ethnic Groups/psychology , Mammography/statistics & numerical data , Registries/statistics & numerical data , SARS-CoV-2/isolation & purification , Adult , Aged , Breast Neoplasms/psychology , COVID-19/virology , Female , Humans , Middle Aged , United States/epidemiology
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