在COVID-19大流行之前和之后的癌症查差异
Aisha K Lofters1,2,3,4, Fangyun Wu3, Eliot Frymire5,6
1Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, Ontario, Canada.
JAMA network open
|November 20, 2023
概括
在COVID-19大流行后,癌症查差异在移民和低收入人群中扩大,特别是乳腺癌和结直肠癌. 基于团队的初级保健模型显示,查率的下降较小,这表明了潜在的解决方案.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 乳腺,宫和结直肠癌查的现有差异存在于COVID-19大流行之前.
- 疫情对这些查差异的影响,特别是对于像移民和收入有限的人这样的弱势群体,仍然不清楚.
研究的目的:
- 为了评估从COVID-19大流行之前到之后的癌症查率的变化.
- 确定这些变化是否不成比例地影响了移民和收入有限的个人.
- 评估初级保健模式在缓解查差异方面的作用.
主要方法:
- 基于人口的横截面研究,使用加拿大安大略省2019年3月31日和2022年3月31日的数据.
- 包括有资格接受乳腺,宫和结直肠癌查的成年人.
- 根据社区收入五分位数,移民身份和初级保健模式类型分析了查状态.
主要成果:
- 疫情后,乳腺癌,宫癌和结直肠癌的整体查率下降.
- 基于收入和移民身份的查差异扩大了乳腺癌和结直肠癌.
- 与其他模型相比,以团队为基础的初级保健模型中的患者在查中的减少较小,总体吸收率较高.
结论:
- COVID-19大流行加剧了安大略省移民和低收入人口现有的癌症查差异.
- 基于团队的初级保健模型在维持查率方面表现出弹性,这表明它们在减少差异方面的价值.
- 政策建议包括优先考虑和投资于以团队为基础的初级保健,以改善服务不足的人口的获取.
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