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1.
Cancer Prev Res (Phila) ; 15(1): 1-2, 2022 01.
Article in English | MEDLINE | ID: covidwho-1613126

ABSTRACT

The First Lady of the United States, Dr. Jill Biden, visited the Hollings Cancer Center at the Medical University of South Carolina on October 25, 2021. This Commentary remarks on the administration's goal of directing public attention to cancer screening and prevention as part of an overall effort to recover ground lost in the COVID-19 pandemic, particularly in underserved communities.


Subject(s)
COVID-19/complications , Early Detection of Cancer/methods , Early Detection of Cancer/standards , Famous Persons , Neoplasms/diagnosis , SARS-CoV-2/isolation & purification , COVID-19/virology , Humans , Neoplasms/epidemiology , Neoplasms/prevention & control , Neoplasms/virology , United States
2.
CMAJ Open ; 9(4): E1205-E1212, 2021.
Article in English | MEDLINE | ID: covidwho-1592340

ABSTRACT

BACKGROUND: Breast cancer screening in Ontario, Canada, was deferred during the first wave of the COVID-19 pandemic, and a prioritization framework to resume services according to breast cancer risk was developed. The purpose of this study was to assess the impact of the pandemic within the Ontario Breast Screening Program (OBSP) by comparing total volumes of screening mammographic examinations and volumes of screening mammographic examinations with abnormal results before and during the pandemic, and to assess backlogs on the basis of adherence to the prioritization framework. METHODS: A descriptive study was conducted among women aged 50 to 74 years at average risk and women aged 30 to 69 years at high risk, who participated in the OBSP. Percentage change was calculated by comparing observed monthly volumes of mammographic examinations from March 2020 to March 2021 with 2019 volumes and proportions by risk group. We plotted estimates of backlog volumes of mammographic examinations by risk group, comparing pandemic with prepandemic screening practices. Volumes of mammographic examinations with abnormal results were plotted by risk group. RESULTS: Volumes of mammographic examinations in the OBSP showed the largest declines in April and May 2020 (> 99% decrease) and returned to prepandemic levels as of March 2021, with an accumulated backlog of 340 876 examinations. As of March 2021, prioritization had reduced the backlog volumes of screens for participants at high risk for breast cancer by 96.5% (186 v. 5469 expected) and annual rescreens for participants at average risk for breast cancer by 13.5% (62 432 v. 72 202 expected); there was a minimal decline for initial screens. Conversely, the backlog increased by 7.6% for biennial rescreens (221 674 v. 206 079 expected). More than half (59.4%) of mammographic examinations with abnormal results were for participants in the higher risk groups. INTERPRETATION: Prioritizing screening for those at higher risk for breast cancer may increase diagnostic yield and redirect resources to minimize potential long-term harms caused by the pandemic. This further supports the clinical utility of risk-stratified cancer screening.


Subject(s)
Breast Neoplasms/diagnosis , COVID-19/epidemiology , Early Detection of Cancer , Guideline Adherence/statistics & numerical data , Mammography , Aged , Early Detection of Cancer/methods , Early Detection of Cancer/standards , Early Detection of Cancer/statistics & numerical data , Female , Health Priorities/standards , Health Priorities/statistics & numerical data , Humans , Mammography/standards , Mammography/statistics & numerical data , Middle Aged , Ontario/epidemiology , Risk Factors
3.
Breast Cancer ; 28(6): 1340-1345, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1303376

ABSTRACT

BACKGROUND: In response to the Coronavirus-19 (COVID-19) pandemic, the Japanese government declared a state of emergency in Saitama, Chiba, Tokyo, Kanagawa, Osaka, Hyogo and Fukuoka prefectures on April 7, 2020; this was extended to the remaining prefectures on April 16, 2020. The state of emergency was lifted on May 25, 2020. Although it was known that breast cancer screening was postponed or canceled during this period, the actual extent of postponement or cancellation has not been clarified. METHODS: We investigated postponement or cancellation of breast cancer screening between April and May 2020 using a cross-sectional, web-based, self-reported questionnaire survey. In addition, we examined the association between socioeconomic and health-related factors and postponement or cancellation by multivariable log-binominal regression. RESULTS: Among 1874 women aged 30-79 years who had scheduled breast cancer screening during the study period, 493 women (26.3%) postponed or canceled screening. While women aged 30-39 years and 70-79 years postponed or canceled less frequently than women aged 40-49 years (prevalence ratio = 0.62 and 0.56, respectively), there was no significant difference between age groups in the women aged 40-69 years. Postponement or cancellation was more frequent in five prefectures, where the state of emergency was declared early (prevalence ratio = 1.25). Employment status, annual household income, family structure, academic background, smoking status, and fear of COVID-19 were not associated with postponement or cancellation. CONCLUSION: Although care should be taken with the interpretation of these findings due to possible biases, they suggest that the postponement or cancellation of breast cancer screening might be due more to facility suspension than to individual factors. It is necessary to explore the ideal way of encouraging breast cancer screening uptake, in an environment of coexistence with COVID-19.


Subject(s)
Breast Neoplasms/diagnosis , COVID-19/prevention & control , Communicable Disease Control/standards , Early Detection of Cancer/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Adult , Age Factors , Aged , Breast Neoplasms/prevention & control , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Cross-Sectional Studies , Early Detection of Cancer/psychology , Early Detection of Cancer/standards , Fear , Female , Humans , Japan/epidemiology , Middle Aged , Pandemics/prevention & control , Patient Acceptance of Health Care/psychology , SARS-CoV-2/pathogenicity , Self Report/statistics & numerical data
5.
JAMA Netw Open ; 4(4): e216454, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1176229

ABSTRACT

Importance: COVID-19 has decreased colorectal cancer screenings. Objective: To estimate the degree to which expanding fecal immunochemical test-based colorectal cancer screening participation during the COVID-19 pandemic is associated with clinical outcomes. Design, Setting, and Participants: A previously developed simulation model was adopted to estimate how much COVID-19 may have contributed to colorectal cancer outcomes. The model included the US population estimated to have completed colorectal cancer screening pre-COVID-19 according the American Cancer Society. The model was designed to estimate colorectal cancer outcomes between 2020 and 2023. This analysis was completed between July and December 2020. Exposures: Adults screened for colorectal cancer and colorectal cancer cases detected by stage. Main Outcomes and Measures: Estimates of colorectal cancer outcomes across 4 scenarios: (1) 9 months of 50% colorectal cancer screenings followed by 21 months of 75% colorectal cancer screenings; (2) 18 months of 50% screening followed by 12 months of 75% screening; (3) scenario 1 with increased use of fecal immunochemical tests; and (4) scenario 2 with increased use of fecal immunochemical tests. Results: In our simulation model, COVID-19-related reductions in care utilization resulted in an estimated 1 176 942 to 2 014 164 fewer colorectal cancer screenings, 8346 to 12 894 fewer colorectal cancer diagnoses, and 6113 to 9301 fewer early-stage colorectal cancer diagnoses between 2020 and 2023. With an abbreviated period of reduced colorectal cancer screenings, increasing fecal immunochemical test use was associated with an estimated additional 588 844 colorectal cancer screenings and 2836 colorectal cancer diagnoses, of which 1953 (68.9%) were early stage. In the event of a prolonged period of reduced colorectal cancer screenings, increasing fecal immunochemical test use was associated with an estimated additional 655 825 colorectal cancer screenings and 2715 colorectal cancer diagnoses, of which 1944 (71.6%) were early stage. Conclusions and Relevance: These results suggest that the increased use of fecal immunochemical tests during the COVID-19 pandemic was associated with increased colorectal cancer screening participation and more colorectal cancer diagnoses at earlier stages. If our estimates are borne out in real-world clinical practice, increasing fecal immunochemical test-based colorectal cancer screening participation during the COVID-19 pandemic could mitigate the consequences of reduced screening rates during the pandemic for colorectal cancer outcomes.


Subject(s)
COVID-19/complications , Colorectal Neoplasms/diagnosis , Early Detection of Cancer/standards , Outcome Assessment, Health Care/standards , Adult , COVID-19/prevention & control , Early Detection of Cancer/methods , Early Detection of Cancer/statistics & numerical data , Female , Humans , Male , Middle Aged , Outcome Assessment, Health Care/statistics & numerical data , Pandemics/prevention & control , Pandemics/statistics & numerical data , Risk Factors , United States
6.
Br J Biomed Sci ; 78(4): 211-217, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1101764

ABSTRACT

Introduction: We aimed to determine the analytical capabilities of a commonly used faecal immunochemical test (FIT) to detect faecal haemoglobin (Hb) in symptomatic people attending primary care in the context of the English NICE DG30 guidance.Materials and Methods: Data obtained from independent verification studies and clinical testing of the HM-JACKarc FIT method in routine primary care practice were analysed to derive performance characteristics.Results: Detection capabilities for the FIT method were 0.5 µg/g (limit of blank), 1.3 µg/g (limit of detection) and 3.0 µg/g (limit of quantitation). Of 33 non-homogenized specimens, 31 (93.9%) analysed in triplicate were consistently categorized relative to 10 µg/g, compared to all 33 (100%) homogenized specimens. Imprecision was higher (median 27.8%, (range 20.5% to 48.6%)) in non-homogenized specimens than in homogenized specimens (10.2%, (7.0 to 13.5%)). Considerable variation was observed in sequential clinical specimens from individual patients but no positive or negative trend in specimen degradation was observed over time (p = 0.26).Discussion: The FIT immunoassay evaluated is capable of detecting faecal Hb at concentrations well below the DG30 threshold of 10 µg/g and is suitable for application in this context. The greatest practical challenge to FIT performance is reproducible sampling, the pre-analytical step associated with most variability. Further research should focus on reducing sampling variability, particularly as post-COVID-19 guidance recommends greater FIT utilization.


Subject(s)
Colorectal Neoplasms/diagnosis , Early Detection of Cancer/standards , Feces/chemistry , Hemoglobins/analysis , Immunohistochemistry/standards , Occult Blood , Primary Health Care , Biomarkers/analysis , COVID-19 , Colorectal Neoplasms/blood , England , Humans , Limit of Detection , Predictive Value of Tests , Reproducibility of Results
7.
Semin Oncol ; 48(2): 156-159, 2021 04.
Article in English | MEDLINE | ID: covidwho-1012703

ABSTRACT

The comprehensive care and treatment for cancer patients in Brazil, regulated by the National Cancer Prevention and Control Policy, is provided by Brazilian Unified Healthcare System (SUS) in certified health institution. Due the COVID-19 pandemic, several restrictive measures have been implemented by the State federation's governments, and cancer diagnosis reference centers were also impacted by these measures. Thus, this study aimed to compare SUS-oriented cancer diagnosis in Brazil before and during the pandemic so far. The average number of cancer diagnoses has dropped considerably in all Brazilian Regions since the pandemic period started. The number of new cancer cases has plunged in all regions, ranged from -24.3% in the North to -42.7% in Northeast region. The overall Brazilian average deficit reached 35.5%, corresponding to about 15,000 undiagnosed cases of cancer monthly. The pandemic period has dramatically reduced the diagnosis of new cases of cancer in Brazil, since consultations in public health services were compromised by restrictive measures. Therefore, effective measures must be urgently put in action in order to minimize the damage, and consequently, the negative health impacts caused by the COVID-19 pandemic in the care of cancer patients.


Subject(s)
COVID-19/complications , Early Detection of Cancer/standards , Neoplasms/diagnosis , SARS-CoV-2/isolation & purification , Brazil/epidemiology , COVID-19/transmission , COVID-19/virology , Humans , Neoplasms/epidemiology , Neoplasms/virology
11.
J Plast Reconstr Aesthet Surg ; 74(3): 644-710, 2021 03.
Article in English | MEDLINE | ID: covidwho-912071

ABSTRACT

The SARS-CoV-2 cornovirus disease (COVID-19) pandemic has significantly affected referrals of new suspected cancers from primary care to specialist services in the National Health Service (NHS) across the UK.  Amongst the many factors causing delay, such as fear and uncertainty about COVID-19 transmission, reluctance to seek medical attention for cancer sypmtoms and avoiding additional pressure on NHS services, we anticipate a surge in urgent skin cancer referrals to our plastic surgery service as we enter a post-COVID recovery phase.  On the basis of previous referral data and statistical forecasting, we share our predicted numbers against our actual number of urgent skin cancer referrals for the COVID-19 period and, based on this analysis, encourage all cancer services to prepare and allocate resources appropriately for the busy months to follow.


Subject(s)
COVID-19 , Referral and Consultation , Skin Neoplasms , Surgery, Plastic , Time-to-Treatment/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Critical Pathways/trends , Early Detection of Cancer/methods , Early Detection of Cancer/standards , Health Services Misuse/prevention & control , Health Services Misuse/statistics & numerical data , Humans , Infection Control/methods , Infection Control/organization & administration , Needs Assessment , Referral and Consultation/organization & administration , Referral and Consultation/trends , SARS-CoV-2 , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/surgery , Surgery, Plastic/methods , Surgery, Plastic/organization & administration , Surgery, Plastic/trends , United Kingdom/epidemiology
13.
J Med Radiat Sci ; 67(4): 352-355, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-833893

ABSTRACT

The first wave of the COVID-19 pandemic in Australia forced a temporary closure of BreastScreen Australia services. Now reopened, the BreastScreen experience has been redefined for both staff and clients and the journey to the 'new BreastScreen normal' is continually evolving in response to the ongoing threat of COVID-19 and government directives on health policy. Many changes mirror those undertaken in the wider community and emphasise wellness to attend, hygiene and social distancing. Importantly, radiographers have been identified as having a high-risk role and have had to modify positioning techniques and cleaning regimes accordingly. Beyond the pandemic, the 'new normal' needs to be one which enables well women to continue screening with a visible sense of reassurance that all that can be done is being done to ensure the safe and continued early detection of breast cancer.


Subject(s)
Breast Neoplasms/diagnosis , COVID-19/complications , Early Detection of Cancer/standards , Mammography/standards , Practice Guidelines as Topic/standards , SARS-CoV-2/isolation & purification , Australia/epidemiology , Breast Neoplasms/virology , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Female , Humans
14.
Ginekol Pol ; 91(7): 428-431, 2020.
Article in English | MEDLINE | ID: covidwho-719820

ABSTRACT

The Polish Society of Gynecologists and Obstetricians and Polish Society of Colposcopy and Cervical Pathophysiology Interim Guidelines goal at aiding gynecologists in providing a cervical cancer prevention care during the evolving SARS-CoV-2 pan-demic. Presented guidelines were developed on a review of limited data and updated when new relevant publications were revealed. Timing for deferrals of diagnostic-therapeutic procedures were mostly covered in the guidelines. Also, a support for the existing Polish recommendations on abnormal screening results in a subject of minor and major screening abnor-malities terminology were given. The guidelines are obligatory for the specified COVID-19 pandemic period only and they might be changed depending on the new available evidence.


Subject(s)
Cervical Intraepithelial Neoplasia , Cervix Uteri/pathology , Colposcopy , Coronavirus Infections , Early Detection of Cancer , Pandemics , Pneumonia, Viral , Uterine Cervical Neoplasms , Betacoronavirus , COVID-19 , Cervical Intraepithelial Neoplasia/diagnosis , Cervical Intraepithelial Neoplasia/pathology , Colposcopy/methods , Colposcopy/standards , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Diagnosis, Differential , Early Detection of Cancer/standards , Female , Humans , Pandemics/prevention & control , Patient Care Management/methods , Patient Care Management/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Poland/epidemiology , SARS-CoV-2 , Secondary Prevention/methods , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control
15.
Dig Dis Sci ; 66(8): 2578-2584, 2021 08.
Article in English | MEDLINE | ID: covidwho-716328

ABSTRACT

BACKGROUND: COVID-19 has caused a backlog of endoscopic procedures; colonoscopy must now be prioritized to those who would benefit most. We determined the proportion of screening and surveillance colonoscopies appropriate for rescheduling to a future year through strict adoption of US Multi-Society Task Force (USMSTF) guidelines. METHODS: We conducted a single-center observational study of patients scheduled for "open-access colonoscopy"-ordered by a primary care provider without being seen in gastroenterology clinic-over a 6-week period during the COVID-19 pandemic. Each chart was reviewed to appropriately assign a surveillance year per USMSTF guidelines including demographics, colonoscopy history and family history. When guidelines recommended a range of colonoscopy intervals, both a "conservative" and "liberal" guideline adherence were assessed. RESULTS: We delayed 769 "open-access" screening or surveillance colonoscopies due to COVID-19. Between 14.8% (conservative) and 20.7% (liberal), colonoscopies were appropriate for rescheduling to a future year. Conversely, 415 (54.0%) patients were overdue for colonoscopy. Family history of CRC was associated with being scheduled too early for both screening (OR 3.9; CI 1.9-8.2) and surveillance colonoscopy (OR 2.6, CI 1.0-6.5). The most common reasons a colonoscopy was inappropriately scheduled this year were failure to use new surveillance colonoscopy intervals (28.9%), incorrectly applied family history guidelines (27.2%) and recommending early surveillance colonoscopy after recent normal colonoscopy (19.3%). CONCLUSION: Up to one-fifth of patients scheduled for "open-access" colonoscopy can be rescheduled into a future year based on USMSTF guidelines. Rigorously applying guidelines could judiciously allocate colonoscopy resources as we recover from the COVID-19 pandemic.


Subject(s)
Appointments and Schedules , COVID-19/epidemiology , Colonoscopy/standards , Early Detection of Cancer/standards , Population Surveillance , Practice Guidelines as Topic/standards , Adult , Advisory Committees/standards , Aged , COVID-19/prevention & control , Colonic Polyps/diagnosis , Colonic Polyps/surgery , Colonoscopy/methods , Early Detection of Cancer/methods , Female , Humans , Male , Middle Aged , Pandemics , Population Surveillance/methods , United States/epidemiology
16.
Chest ; 158(1): 406-415, 2020 07.
Article in English | MEDLINE | ID: covidwho-700492

ABSTRACT

BACKGROUND: The risks from potential exposure to coronavirus disease 2019 (COVID-19), and resource reallocation that has occurred to combat the pandemic, have altered the balance of benefits and harms that informed current (pre-COVID-19) guideline recommendations for lung cancer screening and lung nodule evaluation. Consensus statements were developed to guide clinicians managing lung cancer screening programs and patients with lung nodules during the COVID-19 pandemic. METHODS: An expert panel of 24 members, including pulmonologists (n = 17), thoracic radiologists (n = 5), and thoracic surgeons (n = 2), was formed. The panel was provided with an overview of current evidence, summarized by recent guidelines related to lung cancer screening and lung nodule evaluation. The panel was convened by video teleconference to discuss and then vote on statements related to 12 common clinical scenarios. A predefined threshold of 70% of panel members voting agree or strongly agree was used to determine if there was a consensus for each statement. Items that may influence decisions were listed as notes to be considered for each scenario. RESULTS: Twelve statements related to baseline and annual lung cancer screening (n = 2), surveillance of a previously detected lung nodule (n = 5), evaluation of intermediate and high-risk lung nodules (n = 4), and management of clinical stage I non-small cell lung cancer (n = 1) were developed and modified. All 12 statements were confirmed as consensus statements according to the voting results. The consensus statements provide guidance about situations in which it was believed to be appropriate to delay screening, defer surveillance imaging of lung nodules, and minimize nonurgent interventions during the evaluation of lung nodules and stage I non-small cell lung cancer. CONCLUSIONS: There was consensus that during the COVID-19 pandemic, it is appropriate to defer enrollment in lung cancer screening and modify the evaluation of lung nodules due to the added risks from potential exposure and the need for resource reallocation. There are multiple local, regional, and patient-related factors that should be considered when applying these statements to individual patient care.


Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnosis , Coronavirus Infections , Lung Neoplasms , Multiple Pulmonary Nodules/diagnosis , Pandemics , Pneumonia, Viral , Radiography, Thoracic/methods , Betacoronavirus/isolation & purification , COVID-19 , Consensus , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Early Detection of Cancer/methods , Early Detection of Cancer/standards , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Neoplasm Staging , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Resource Allocation , Risk Assessment/methods , SARS-CoV-2
18.
Radiol Med ; 125(10): 926-930, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-640752

ABSTRACT

The Italian College of Breast Radiologists by the Italian Society of Medical Radiology (SIRM) provides recommendations for breast care provision and procedural prioritization during COVID-19 pandemic, being aware that medical decisions must be currently taken balancing patient's individual and community safety: (1) patients having a scheduled or to-be-scheduled appointment for in-depth diagnostic breast imaging or needle biopsy should confirm the appointment or obtain a new one; (2) patients who have suspicious symptoms of breast cancer (in particular: new onset palpable nodule; skin or nipple retraction; orange peel skin; unilateral secretion from the nipple) should request non-deferrable tests at radiology services; (3) asymptomatic women performing annual mammographic follow-up after breast cancer treatment should preferably schedule the appointment within 1 year and 3 months from the previous check, compatibly with the local organizational conditions; (4) asymptomatic women who have not responded to the invitation for screening mammography after the onset of the pandemic or have been informed of the suspension of the screening activity should schedule the check preferably within 3 months from the date of the not performed check, compatibly with local organizational conditions. The Italian College of Breast Radiologists by SIRM recommends precautions to protect both patients and healthcare workers (radiologists, radiographers, nurses, and reception staff) from infection or disease spread on the occasion of breast imaging procedures, particularly mammography, breast ultrasound, breast magnetic resonance imaging, and breast intervention procedures.


Subject(s)
Appointments and Schedules , Betacoronavirus , Breast Neoplasms/diagnostic imaging , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Radiology , Societies, Medical , Aftercare/organization & administration , Asymptomatic Diseases , Breast Neoplasms/psychology , Breast Neoplasms/therapy , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Early Detection of Cancer/standards , Female , Humans , Italy , Occupational Diseases/prevention & control , Personal Protective Equipment , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , SARS-CoV-2 , Symptom Assessment/methods , Symptom Assessment/standards
20.
Int J Gynecol Cancer ; 30(8): 1097-1100, 2020 08.
Article in English | MEDLINE | ID: covidwho-505825
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