COVID-19 大流行期间延迟结肠镜筛查对临床结果的影响。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2024-07-31 DOI:10.1016/j.canep.2024.102629

Róisín McCarthy , Thérèse Mooney , Patricia Fitzpatrick , Rachel A. Kennedy , Hilary Coffey , Mary Sheedy , Padraic MacMathúna

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引用次数: 0

摘要

背景：在 COVID-19 大流行期间，爱尔兰的结直肠癌 (CRC) 筛查服务被取消或推迟了一段时间。本研究旨在评估因这些限制而导致 FIT 阳性后结肠镜筛查延迟对临床和组织病理学结果的影响：方法：纳入在 COVID-19 大流行期间（2020 年 3 月至 2021 年 12 月）粪便免疫化学检验（FIT）呈阳性的爱尔兰国家肠道筛查计划参与者。结果：3227 人进行了完整的结肠镜检查：3227 人接受了完整的结肠镜检查结论：结肠镜检查的中位延迟时间为 3 个月：FIT 阳性后中位延迟 3 个月进行结肠镜筛查不会对临床或组织病理学结果产生不利影响。接受结肠镜检查的患者在癌症分期、晚期腺瘤或息肉检出率方面没有明显差异

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The impact of delayed screening colonoscopies during the COVID-19 pandemic on clinical outcomes

Background

Colorectal cancer (CRC) screening services in Ireland were cancelled or postponed for periods during the COVID-19 pandemic. The aim of this study was to assess the impact of screening colonoscopy delays after a positive FIT on clinical and histopathological outcomes due to these restrictions.

Methods

Participants in the Irish National Bowel Screening Programme with a positive Immunochemical Faecal Test (FIT) during the COVID-19 pandemic (March 2020-December 2021) were included. Patients were categorised into attended for a colonoscopy <3 months and attended for colonoscopy ≥3–17 months post positive FIT. Chi-Square Test of independence was performed using WinPepi.

Results

3227 individuals had a complete index colonoscopy <3 months and 262 attended colonoscopy from ≥3 to 17 months post positive FIT. Of the clients whose colonoscopy was between ≥3–17 months from positive FIT, the median wait time was 3 months. There was no significant difference found between the two groups for CRC (5.8 % vs 5.0 %, p=0.544) or for the proportion of cancer stage I, stage II and unknown (33.7 %, 40.6 %, 25.7 %, p=0.411). There was no difference in the proportions of adenomas (57.8 % vs 58.4 %, p=0.849) and the proportion of advanced adenomas (7.7 % vs 10.7 %, p=0.077) detected between the two groups. A similar proportion of polyps were detected in individuals whose index colonoscopies were postponed <3 months from positive FIT (66.9 % vs 66 %, p=0.786).

Conclusion

A median delay of 3 months in screening colonoscopies after a positive FIT does not adversely impact clinical or histopathological outcomes. There was no significant difference in cancer staging, advanced adenomas or polyps detected between those who attended colonoscopies <3 months and ≥3–17 months post positive FIT. COVID-19 related disruptions to the normal functioning of the Irish bowel screening programme did not compromise our key objectives of advanced adenoma and cancer detection.

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.