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Modelling the impacts of COVID-19 pandemic on the quality of population-based colorectal cancer screening.
Jen, Grace Hsiao-Hsuan; Yen, Amy Ming-Fang; Hsu, Chen-Yang; Chiu, Han-Mo; Chen, Sam Li-Sheng; Chen, Tony Hsiu-Hsi.
  • Jen GH; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
  • Yen AM; School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
  • Hsu CY; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Daichung Hospital, Miaoli, Taiwan.
  • Chiu HM; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Chen SL; School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: samchen@tmu.edu.tw.
  • Chen TH; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address: chenlin@ntu.edu.tw.
Prev Med ; 151: 106597, 2021 10.
Article in English | MEDLINE | ID: covidwho-1294326
ABSTRACT
COVID-19 pandemic has severely affected regular public health interventions including population-based cancer screening. Impacts of such screening delays on the changes in structure and screening process and the resultant long-term outcomes are unknown. It is therefore necessary to develop a systematic framework to assess theses impacts related to these components of quality. Using population-based cancer screening with fecal immunochemical test (FIT) as an illustration, the main analysis was to assess how various scenarios of screening delays were associated with the capacity for primary screening and full time equivalent (FTE) for colonoscopy and impact long-term outcomes based on a Markov decision tree model on population level. The second analysis was to quantify how the extent of COVID-19 epidemic measured by social distancing index affected capacity and FTE that were translated to delays with an exponential relationship. COVID-19 epidemic led to 25%, 29%, 34%, and 39% statistically significantly incremental risks of late cancer for the delays of 0.5-year, 1-year,1.5-year, and 2-year, respectively compared with regular biennial FIT screening. The corresponding statistically findings of four delayed schedules for death from colorectal cancer (CRC) were 26%, 28%, 29%, and 30%, respectively. The higher social distancing index led to a lower capacity of uptake screening and a larger reduction of FTE, resulting in longer screening delay and longer waiting time, which further impacted long-term outcomes as above. In summary, a systematic modelling approach was developed for demonstrating the strong impact of screening delays caused by COVID-19 epidemic on long-term outcomes illustrated with a Taiwan population-based FIT screening of CRC.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Country/Region as subject: Asia Language: English Journal: Prev Med Year: 2021 Document Type: Article Affiliation country: J.ypmed.2021.106597

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Country/Region as subject: Asia Language: English Journal: Prev Med Year: 2021 Document Type: Article Affiliation country: J.ypmed.2021.106597