COVID-19 大流行对英国常见实体瘤发病率和短期生存率的影响:队列分析

IF 3.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Clinical Epidemiology Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI:10.2147/CLEP.S463160
Nicola L Barclay, Theresa Burkard, Edward Burn, Antonella Delmestri, Andrea Miquel Dominguez, Asieh Golozar, Carlos Guarner-Argente, Francesc Xavier Avilés-Jurado, Wai Yi Man, Àlvar Roselló Serrano, Andreas Weinberger Rosen, Eng Hooi Tan, Ilona Tietzova, Daniel Prieto Alhambra, Danielle Newby
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引用次数: 0

摘要

目的:COVID-19 大流行对医疗保健系统和患者产生了深远影响。有必要了解大流行对非传染性疾病的附带影响。我们研究了大流行对英国乳腺癌、结直肠癌、头颈癌、肝癌、肺癌、食道癌、胰腺癌、前列腺癌和胃癌等常见实体瘤患者短期生存率的影响:这是一项基于人群的队列研究,研究对象是英国初级保健临床实践研究数据链 GOLD 数据库中的电子健康记录。总共纳入了 12259744 名符合条件的患者,这些患者的年龄≥18 岁,病史≥1 年,时间跨度为 2000 年 1 月至 2022 年 12 月。我们估算了2000年至2019年(按五年分层)几种常见癌症的年龄标准化发病率和短期(一年和两年)生存率,并采用卡普兰-梅耶法将其与2020年至2022年进行了比较:结果:大多数癌症的发病率在 2020 年有所下降,并在 2021-2022 年出现不同程度的恢复。大多数癌症的短期生存率在 2000 年至 2019 年期间有所提高,但在 2020-2022 年期间确诊的癌症患者的短期生存率有所下降,尽管降幅很小。结直肠癌的情况最为明显,一年生存率从2015-2019年的78.8%(95% CI 78%-79.6%)下降到2020-2022年确诊者的77%(95% CI 75.6-78.3%):结直肠癌存活率的下降相当于恢复到 2000 年代前十年的死亡率水平。虽然还需要更长期的存活率数据来全面了解 COVID-19 对癌症治疗的影响,但我们的研究结果表明,英国国民健康服务部门需要做出紧急和实质性的承诺,解决目前癌症筛查和诊断程序积压的问题,以改善癌症治疗和死亡率。
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The Impact of the COVID-19 Pandemic on Incidence and Short-Term Survival for Common Solid Tumours in the United Kingdom: A Cohort Analysis.

Purpose: The COVID-19 pandemic profoundly affected healthcare systems and patients. There is a need to comprehend the collateral effects of the pandemic on non-communicable diseases. We examined the impact of the pandemic on short-term survival for common solid tumours, including breast, colorectal, head and neck, liver, lung, oesophageal, pancreatic, prostate, and stomach cancer in the UK.

Methods: This was a population-based cohort study of electronic health records from the UK primary care Clinical Practice Research Datalink GOLD database. In sum, 12,259,744 eligible patients aged ≥18 years with ≥1 year's history identified from January 2000 to December 2022 were included. We estimated age-standardised incidence and short-term (one- and two-year) survival for several common cancers from 2000 to 2019 (in five-year strata) and compared these to 2020-2022 using the Kaplan-Meier method.

Results: Incidence decreased for most cancers in 2020 and recovered to different extents in 2021-2022. Short-term survival improved for most cancers between 2000 and 2019, but then declined, albeit minimally, for those diagnosed in 2020-2022. This was most pronounced for colorectal cancer, with one-year survival falling from 78.8% (95% CI 78%-79.6%) in 2015-2019 to 77% (95% CI 75.6-78.3%) for those diagnosed in 2020-2022.

Conclusion: Short-term survival for many cancers was impacted, albeit minimally, by the pandemic in the UK, with reductions in survivorship from colorectal cancer equivalent to returning to the mortality seen in the first decade of the 2000s. While data on longer-term survival are needed to fully comprehend the impact of COVID-19 on cancer care, our findings illustrate the need for an urgent and substantial commitment from the UK National Health Service to address the existing backlog in cancer screening and diagnostic procedures to improve cancer care and mortality.

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来源期刊
Clinical Epidemiology
Clinical Epidemiology Medicine-Epidemiology
CiteScore
6.30
自引率
5.10%
发文量
169
审稿时长
16 weeks
期刊介绍: Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.
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