Trends in cancer imaging by indication, care setting, and hospital type during the COVID-19 pandemic and recovery at four hospitals in Massachusetts.
Cancer Med
; 10(18): 6327-6335, 2021 09.
Article
in English
| MEDLINE | ID: covidwho-1344970
ABSTRACT
BACKGROUND:
We aimed to investigate the effects of COVID-19 on computed tomography (CT) imaging of cancer.METHODS:
Cancer-related CTs performed at one academic hospital and three affiliated community hospitals in Massachusetts were retrospectively analyzed. Three periods of 2020 were considered as follows pre-COVID-19 (1/5/20-3/14/20), COVID-19 peak (3/15/20-5/2/20), and post-COVID-19 peak (5/3/20-11/14/20). 15 March 2020 was the day a state of emergency was declared in MA; 3 May 2020 was the day our hospitals resumed to non-urgent imaging. The volumes were assessed by (1) Imaging indication cancer screening, initial workup, active cancer, and surveillance; (2) Caresetting:
outpatient and inpatient, ED; (3) Hospital type quaternary academic center (QAC), university-affiliated community hospital (UACH), and sole community hospitals (SCHs).RESULTS:
During the COVID-19 peak, a significant drop in CT volumes was observed (-42.2%, p < 0.0001), with cancer screening, initial workup, active cancer, and cancer surveillance declining by 81.7%, 54.8%, 30.7%, and 44.7%, respectively (p < 0.0001). In the post-COVID-19 peak period, cancer screening and initial workup CTs did not recover (-11.7%, p = 0.037; -20.0%, p = 0.031), especially in the outpatient setting. CT volumes for active cancer recovered, but inconsistently across hospital types the QAC experienced a 9.4% decline (p = 0.022) and the UACH a 41.5% increase (p < 0.001). Outpatient CTs recovered after the COVID-19 peak, but with a shift in utilization away from the QAC (-8.7%, p = 0.020) toward the UACH (+13.3%, p = 0.013). Inpatient and ED-based oncologic CTs increased post-peak (+20.0%, p = 0.004 and +33.2%, p = 0.009, respectively).CONCLUSIONS:
Cancer imaging was severely impacted during the COVID-19 pandemic. CTs for cancer screening and initial workup did not recover to pre-COVID-19 levels well into 2020, a finding that suggests more patients with advanced cancers may present in the future. A redistribution of imaging utilization away from the QAC and outpatient settings, toward the community hospitals and inpatient setting/ED was observed.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pandemics
/
COVID-19
/
Neoplasms
Type of study:
Diagnostic study
/
Observational study
Topics:
Long Covid
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Cancer Med
Year:
2021
Document Type:
Article
Affiliation country:
Cam4.4183
Similar
MEDLINE
...
LILACS
LIS