背景:将COVID-19大流行的影响降至最低的策略导致诊断检测的减少。重要的是要评估这种影响的程度和持续时间,以计划持续的护理并避免大流行的长期影响。目的:我们研究了COVID-19大流行与乳腺诊断检查率之间的关系,子宫颈,和马尼托巴省的结肠直肠癌,加拿大。设计和参与者:以人口为基础,我们采用横断面研究设计,采用中断时间序列分析,包括2015年1月1日至2022年8月31日的诊断性试验.设置:曼尼托巴,加拿大。主要结果:结果包括乳房X光检查,乳腺超声,阴道镜检查,和结肠镜检查率每100,000。估计了拟合和反事实测试数量之间的累积和百分比累积差异。意思是,中位数,和按转诊类型划分的从转诊到结肠镜检查日期的第90百分位数(选择性,半紧急,紧急)已确定。结果:2020年4月,在宣布COVID-19突发公共卫生事件后,双侧乳房X线照片减少了77%,单侧乳房X线检查70%,53%的乳房超声检查,阴道镜检查率为63%,结肠镜检查75%。在温尼伯(全省最大的城市中心),选择性和半紧急结肠镜检查减少了76%和39%,分别。紧急结肠镜检查没有减少。截至2022年8月,双侧乳房X光检查估计减少了7270例(10.7%),2722(14.8%)减少乳房超声检查,减少836(3.3%)阴道镜检查,在没有COVID-19的情况下,结肠镜检查比预期少11600(13.8%)。截至2022年12月,在温尼伯,估计有6030(23.9%)的选择性结肠镜检查,减少313(2.6%)半紧急结肠镜检查,和438(27.3%)更紧急结肠镜检查。结论:在曼尼托巴省,COVID-19大流行与乳腺诊断检查的大幅减少有关,结直肠,还有宫颈癌.两年半后,双侧乳房X线照片仍有大量累积缺陷,乳腺超声检查,结肠镜检查。
Background: Strategies to minimize the impact of the COVID-19 pandemic led to a reduction in diagnostic testing. It is important to assess the magnitude and duration of this impact to plan ongoing care and avoid long-lasting impacts of the pandemic. Objective: We examined the association between the COVID-19 pandemic and the rate of diagnostic tests for breast, cervical, and colorectal cancer in Manitoba, Canada. Design and Participants: A population-based, cross-sectional study design with an interrupted time series analysis was used that included diagnostic tests from January 1, 2015 until August 31, 2022. Setting: Manitoba, Canada. Main Outcomes: Outcomes included mammogram, breast ultrasound, colposcopy, and colonoscopy rates per 100,000. Cumulative and percent cumulative differences between the fitted and counterfactual number of tests were estimated. Mean, median, and 90th percentile number of days from referral to colonoscopy date by referral type (elective, semiurgent, urgent) were determined. Results: In April 2020, following the declaration of the COVID-19 public health emergency, bilateral mammograms decreased by 77%, unilateral mammograms by 70%, breast ultrasounds by 53%, colposcopies by 63%, and colonoscopies by 75%. In Winnipeg (the largest urban center in the province), elective and semiurgent colonoscopies decreased by 76% and 39%, respectively. There was no decrease in urgent colonoscopies. As of August 2022, there were an estimated 7270 (10.7%) fewer bilateral mammograms, 2722 (14.8%) fewer breast ultrasounds, 836 (3.3%) fewer colposcopies, and 11 600 (13.8%) fewer colonoscopies than expected in the absence of COVID-19. As of December 2022, in Winnipeg, there were an estimated 6030 (23.9%) fewer elective colonoscopies, 313 (2.6%) fewer semiurgent colonoscopies, and 438 (27.3%) more urgent colonoscopies. Conclusions: In Manitoba, the COVID-19 pandemic was associated with sizable decreases in diagnostic tests for breast, colorectal, and cervical cancer. Two and a half years later, there remained large cumulative deficits in bilateral mammograms, breast ultrasounds, and colonoscopies.