在接受结肠镜检查的人群中,Covid-19 大流行病限制措施对腺瘤性息肉和彩色直肠腺癌诊断的影响。

Q2 Medicine
Arquivos de Gastroenterologia Pub Date : 2024-10-21 eCollection Date: 2024-01-01 DOI:10.1590/S0004-2803.24612024-027
Natália Ribeiro Silvério, Isabela Costa Monteiro, Ana Luiza Naves Prudente, Anna Caroliny Navarro Rosa, Américo de Oliveira Silvério
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引用次数: 0

摘要

背景:COVID-19大流行对腺瘤息肉和结直肠癌诊断的影响-COVID-19大流行对腺瘤性息肉和结直肠癌诊断的影响:-一项横断面研究评估了2019年和2020年3月20日至10月31日期间进行的结肠镜检查,分析了10232例结肠镜检查:-与2019年相比,2020年进行的结肠镜检查数量减少了51.0%。在改变的检查结果中,2019 年有 68.8%诊断出腺瘤息肉,2020 年为 78.3%。2019年诊断出CRC的比例为0.9%,2020年为1.6%:-观察到腺瘤息肉和结直肠癌诊断的增加,但不足以弥补检查次数的减少:大肠癌(CRC)是全球第三大最常见的恶性肿瘤,也是全球癌症相关死亡的第二大原因。COVID-19 大流行导致医疗服务机构暂停常规筛查。与 2019 年相比,预计 2020 年癌症诊断总数将下降 35.5%:评估 COVID-19 大流行对巴西戈亚尼亚一家诊所接受结肠镜检查(COL)人群中腺瘤性息肉(AP)和 CRC 诊断的影响:研究伦理委员会批准了一项横断面研究(CAAE-45631421.0.0000.0037),该研究评估了2019年3月20日至10月31日和2020年10月31日期间进行的结肠镜检查。我们分析了与识别、转诊体检、结肠镜检查和组织病理学结果相关的数据:我们对 10232 例(93.4%)COL 进行了评估,根据执行年份分为两组。2019 年共进行了 6777 例(66.2%)结肠镜检查,2020 年为 3455 例(33.8%),减少了 51.0%。共有 3267 例(31.9%)结肠镜检查发现息肉,其中 72.1%为 AP(2019 年为 68.8%,2020 年为 78.3%,PC 结论:COVID-19 大流行使 2020 年的 COL 显著减少,主要原因是对感染的恐惧和限制。不过,每次手术的癌症和息肉检出率有所上升,表明更多有症状的患者寻求医疗救助。尽管如此,发现的肿瘤和腺瘤的绝对数量却减少了,这可能会造成诊断损失和预防结直肠癌病例的减少。因此,适应性策略对于在类似危机中维持基本医疗服务至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
THE IMPACT OF THE COVID-19 PANDEMIC RESTRICTIVE MEASURES ON THE DIAGNOSIS OF ADENOMATOUS POLYPS AND COLORRECTAL ADENOCARCINOMA IN A POPULATION SUBMITTED TO COLONOSCOPY.

Background: •The impact of the COVID-19 pandemic on the diagnosis of adenomatous polyps and colorectal cancer.

Background: •A cross-sectional study evaluating COL performed during the periods from 20 March to 31 October of 2019 and of 2020, which analyzed 10,232 colonoscopies.

Background: •There was a 51,0% reduction in the number of COL performed in 2020 when compared to 2019. Of the altered exams, adenomatous polyps were diagnosed in 68.8% in 2019 and 78.3% in 2020. CRC was diagnosed in 0.9% in 2019 and 1.6% in 2020.

Background: •The increase in adenomatous polyps and colorectal cancer diagnoses was observed, it was not enough to compensate for the reduction in the number of exams.

Background: Colorectal cancer (CRC) is globally the third most common malignant neoplasm and the second leading cause of cancer-related death worldwide. The COVID-19 pandemic led to the suspension of routine screening tests by health services. A 35.5% drop in total cancer diagnoses in 2020 is estimated when compared to 2019.

Objective: To evaluate the impact of the COVID-19 pandemic on the diagnosis of adenomatous polyps (AP) and CRC in a population undergoing colonoscopy (COL) in a clinic in Goiânia, Brazil.

Methods: A cross-sectional study evaluating COL performed during the periods from 20 March to 31 October of 2019 and of 2020, was approved by the Research Ethics Committee (CAAE-45631421.0.0000.0037). We analyzed data related to identification, referral for medical examination, colonoscopic and histopathological findings.

Results: We evaluated 10,232 (93.4%) COL, divided into two groups according to the year of performance. In 2019, 6,777 (66.2%) COL were performed and in 2020, 3,455 (33.8%), demonstrating a reduction of 51.0%. A total of 3,267 (31.9%) colonoscopies found polyps, 72.1% of which were AP (68.8% in 2019 and 78.3% in 2020, P<0.001). High-grade dysplasia was found in 5.0% of the AP (4.9% in 2019 and 5.8% in 2020, P<0.34). CRC was diagnosed in 121 (1.2%) (0.9% in 2019 and 1.6% in 2020, P<0.001).

Conclusion: The COVID-19 pandemic significantly reduced COL in 2020, mainly due to infection fears and restrictions. However, the detection rate of cancer and polyps per procedure increased, indicating more symptomatic patients sought medical attention. Despite this, the absolute number of tumors and adenomas found decreased, potentially causing diagnostic losses and fewer prevented colorectal cancer cases. Thus, adaptive strategies are vital for maintaining essential healthcare services during similar crises.

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来源期刊
Arquivos de Gastroenterologia
Arquivos de Gastroenterologia Medicine-Gastroenterology
CiteScore
2.00
自引率
0.00%
发文量
109
审稿时长
9 weeks
期刊介绍: The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.
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