PDF(Pubmed)
Abstract：
The Coronavirus Disease of 2019 (COVID-19) pandemic had a profound impact on colorectal cancer (CRC) screening and diagnostic testing. During the initial months of the pandemic, there was a sharp decline in colonoscopies performed as many areas were on lockdown and elective procedures could not be performed. In later months, even when routine procedures started being scheduled again, some patients became fearful of contracting COVID during colonoscopy or lost their health insurance, leading to further delays in CRC diagnosis by colonoscopy. Previous studies have reported the dramatic decrease in colonoscopy rates and CRC detection at various institutions across the country, but no previous study has been performed to determine rates of colorectal screening by colonoscopy in Hawai\'i where the demographics of CRC differ. The team investigated the pandemic\'s impact on colonoscopy services and colorectal neoplasia detection at several large outpatient endoscopy centers in Hawai\'i and also classified new CRC cases by patient demographics of age, sex, and ethnicity. There were fewer colonoscopies performed in these endoscopy centers in 2020 than in 2019 and a disproportionate decrease in CRC cases diagnosed. Elderly males as well as Native Hawaiians/Pacific Islanders were most impacted by this decrease in CRC detection. It is possible there will be an increase in later stage presentation of CRC and eventual CRC related mortality among these patients.
摘要：
2019年冠状病毒病（COVID-19）大流行对结直肠癌（CRC）筛查和诊断测试产生了深远的影响。在大流行的最初几个月，结肠镜检查的数量急剧下降，因为许多地区处于封锁状态，无法进行选择性手术。在后来的几个月里，即使当例行程序再次开始被安排时，一些患者在结肠镜检查期间害怕感染COVID，或者失去了医疗保险，导致结肠镜检查进一步延迟CRC诊断。先前的研究报道了全国各种机构的结肠镜检查率和CRC检测显着下降，但是在CRC的人口统计学特征不同的夏威夷，以前没有进行过研究来确定结肠镜检查的结直肠筛查率。该小组调查了大流行对夏威夷几个大型门诊内窥镜检查中心结肠镜检查服务和结直肠瘤形成检测的影响，并根据患者年龄对新的CRC病例进行了分类。性别,和种族。与2019年相比，2020年这些内窥镜中心进行的结肠镜检查较少，诊断的CRC病例不成比例地减少。老年男性以及夏威夷原住民/太平洋岛民受到CRC检测下降的影响最大。在这些患者中，CRC的后期表现和最终的CRC相关死亡率可能会增加。
