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Robles C, Monfil L, Ibáñez R, Roura E, Font R, Peremiquel-Trillas P, Brotons M, Martínez-Bueno C, de Sanjosé S, Espinàs JA, Bruni L. Impact of the COVID-19 pandemic on cervical cancer screening participation, abnormal cytology prevalence and screening interval in Catalonia. Front Oncol 2024; 14:1338859. [PMID: 38873256 PMCID: PMC11171128 DOI: 10.3389/fonc.2024.1338859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
Background The COVID-19 pandemic led to a national lockdown and the interruption of all cancer preventive services, including cervical cancer screening. We aimed to assess the COVID-19 pandemic impact on opportunistic screening participation, abnormal cytology (ASCUS+) prevalence and screening interval in 2020 and 2021 within the Public Health System of Catalonia, Spain. Methods Individual data on cytology and HPV testing of women aged 25-65 from 2014 to 2021 were retrieved from the Information System for Primary Care Services (SISAP). Time-series regression models were used to estimate expected screening participation and abnormal cytology prevalence in 2020 and 2021. The impact was determined by comparing observed and expected values (ratios). Additionally, changes in screening interval trends between 2014 and 2021 were assessed by fitting a Piecewise linear regression model. Results Cervical cancer screening participation decreased by 38.8% and 2.2% in 2020 and 2021, respectively, with the most significant impact on participation (-96.1%) occurring in April 2020. Among older women, participation was lower, and it took longer to recover. Abnormal cytology prevalence was 1.4 times higher than expected in 2020 and 2021, with variations by age (range=1.1-1.5). From June 2020 onwards, the screening interval trend significantly changed from an increase of 0.59 to 3.57 months per year, resulting in a median time of 48 months by December 2021. Conclusions During the pandemic, fewer women have participated in cervical cancer screening, abnormal cytology prevalence has increased, and the screening interval is more prolonged than before. The potential cervical cancer lifetime risk implications highlight the need for organized HPV-based screening.
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Affiliation(s)
- Claudia Robles
- Unit of Infections and Cancer – Information and Interventions, Cancer Epidemiology Research Programme, Institut Català d’Oncologia (ICO), Infections and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Monfil
- Unit of Infections and Cancer – Information and Interventions, Cancer Epidemiology Research Programme, Institut Català d’Oncologia (ICO), Infections and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Raquel Ibáñez
- Unit of Infections and Cancer – Information and Interventions, Cancer Epidemiology Research Programme, Institut Català d’Oncologia (ICO), Infections and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP - CB06/02/0073), Madrid, Spain
| | - Esther Roura
- Unit of Infections and Cancer – Information and Interventions, Cancer Epidemiology Research Programme, Institut Català d’Oncologia (ICO), Infections and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP - CB06/02/0073), Madrid, Spain
| | - Rebeca Font
- Catalan Cancer Strategy, Department of Health, Catalonia, Spain
| | - Paula Peremiquel-Trillas
- Unit of Infections and Cancer – Information and Interventions, Cancer Epidemiology Research Programme, Institut Català d’Oncologia (ICO), Infections and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP - CB06/02/0073), Madrid, Spain
- University of Barcelona, Barcelona, Spain
| | - Maria Brotons
- Unit of Infections and Cancer – Information and Interventions, Cancer Epidemiology Research Programme, Institut Català d’Oncologia (ICO), Infections and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP - CB06/02/0073), Madrid, Spain
| | - Cristina Martínez-Bueno
- University of Barcelona, Barcelona, Spain
- Atenció a la Salut Sexual i Reproductiva (ASSIR) Catalunya, Institut Català de la Salut, Barcelona, Spain
- Grup de Recerca en Salut Sexual i Reproductiva (GRASSIR), Barcelona, Spain
| | - Silvia de Sanjosé
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
- Institut de Salut Global (ISGlobal), Barcelona, Spain
| | | | - Laia Bruni
- Unit of Infections and Cancer – Information and Interventions, Cancer Epidemiology Research Programme, Institut Català d’Oncologia (ICO), Infections and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP - CB06/02/0073), Madrid, Spain
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Cordato DJ, Fatima Shad K, Soubra W, Beran RG. Health Research and Education during and after the COVID-19 Pandemic: An Australian Clinician and Researcher Perspective. Diagnostics (Basel) 2023; 13:diagnostics13020289. [PMID: 36673098 PMCID: PMC9858508 DOI: 10.3390/diagnostics13020289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/23/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Introduction: The COVID-19 pandemic had an unprecedented global effect on teaching and education. This review discusses research, education and diagnostics from the perspectives of four academic clinicians and researchers across different facilities in Australia. Materials and methods: The study adopted a literature review and an Australian researcher's perspective on the impact of the COVID-19 pandemic on health education, research and diagnostics. Results: At the start of the pandemic, medical facilities had to adhere urgently to major work restrictions, including social distancing, mask-wearing rules and/or the closure of facilities to protect staff, students and patients from the risk of COVID-19 infection. Telemedicine and telehealth services were rapidly implemented and adapted to meet the needs of medical education, the teaching of students, trainee doctors, nursing and allied health staff and became a widely accepted norm. The impact on clinical research and education saw the closure of clinical trials and the implementation of new methods in the conducting of trials, including electronic consents, remote patient assessments and the ability to commence fully virtual clinical trials. Academic teaching adapted augmented reality and competency-based teaching to become important new modes of education delivery. Diagnostic services also required new policies and procedures to ensure the safety of personnel. Conclusions: As a by-product of the COVID-19 pandemic, traditional, face-to-face learning and clinical research were converted into online formats. An hybrid environment of traditional methods and novel technological tools has emerged in readiness for future pandemics that allows for virtual learning with concurrent recognition of the need to provide for interpersonal interactions.
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Affiliation(s)
- Dennis J. Cordato
- Department of Neurophysiology, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW 1871, Australia
- Ingham Institute for Applied Medical Research, Campbell St Liverpool, Sydney, NSW 2170, Australia
- South Western Sydney Clinical School, University of NSW, Liverpool, Sydney, NSW 2170, Australia
| | - Kaneez Fatima Shad
- Ingham Institute for Applied Medical Research, Campbell St Liverpool, Sydney, NSW 2170, Australia
- School of Life Sciences, University of Technology, Ultimo, Sydney, NSW 2007, Australia
- Faculty of Health Sciences, Australian Catholic University, 40 Edward St, Sydney, NSW 2060, Australia
- School of Medical Sciences, ISRA, University of Hyderabad Pakistan, Hyderabad 71000, Pakistan
| | - Wissam Soubra
- Ingham Institute for Applied Medical Research, Campbell St Liverpool, Sydney, NSW 2170, Australia
- School of Life Sciences, University of Technology, Ultimo, Sydney, NSW 2007, Australia
- A Healthy Step Podiatry, Lakemba, Sydney, NSW 2195, Australia
| | - Roy G. Beran
- Department of Neurophysiology, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW 1871, Australia
- Ingham Institute for Applied Medical Research, Campbell St Liverpool, Sydney, NSW 2170, Australia
- South Western Sydney Clinical School, University of NSW, Liverpool, Sydney, NSW 2170, Australia
- School of Medicine, Griffith University, Southport, QLD 4222, Australia
- School of Medicine, Western Sydney University, Sydney, NSW 2170, Australia
- Faculty of Sociology, Sechenov Moscow First State University, Moscow 119991, Russia
- Correspondence: ; Fax: +61-0287383648
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Ozcan Y, Ozlu E, Karagun E, Uyar B, Gamsizkan M. Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: a Single Center Experience of 2184 Cases. Dermatol Pract Concept 2022; 12:e2022186. [PMID: 36534561 PMCID: PMC9682974 DOI: 10.5826/dpc.1204a186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Although a trained eye can easily identify typical skin lesions, histopathological examination and clinicopathological correlation are critical in challenging cases. OBJECTIVES The primary objective is to organize the final diagnoses reached following clinicopathological consensus in clinically challenging cutaneous lesions, identifying the most common diagnostic scenarios encountered by dermatopathologists and discussing their diverse differentials submitted by clinicians. The secondary objective is to investigate how the case profile and clinician decision-making processes evolved during the COVID-19 pandemic. METHODS Skin and mucosa samples collected by the dermatology department between 2016 and 2020 were classified based on pathology reports. For frequent diagnoses, preliminary diagnoses stated by clinicians on pathology requisition forms were reviewed. The years preceding and following the first nationally reported COVID-19 case were compared to investigate the pandemic's impact on the distribution of dermatology and dermatopathology cases. RESULTS One thousand nine hundred and eighty-nine reports were classified into 4 major categories: inflammatory (49.8%), neoplastic (30.1%), other diseases (7.1%), and non-diagnostic (12.8%). We further classified inflammatory diseases based on major tissue reaction patterns and neoplasms based on cell origin. We analyzed the leading diagnoses in each category, discussed their differential diagnoses, and provided clinicians with clues to reduce errors in practice. Following the pandemic, the overall number of pathology reports and patient admissions dropped dramatically, with significant changes in case profiles. CONCLUSIONS We presented and discussed the frequently encountered confounding cases to sketch the diagnostic landscape. In the authors' experience, clinicopathological correlation can increase the rate of reaching the diagnosis by up to 75.3%.
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Affiliation(s)
- Yunus Ozcan
- Department of Dermatology, Duzce Ataturk State Hospital, Duzce, Turkey
| | - Emin Ozlu
- Department of Dermatology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Ebru Karagun
- Department of Dermatology, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Belkiz Uyar
- Department of Dermatology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Mehmet Gamsizkan
- Department of Pathology, Faculty of Medicine, Duzce University, Duzce, Turkey
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Ribes J, Pareja L, Sanz X, Mosteiro S, Escribà JM, Esteban L, Gálvez J, Osca G, Rodenas P, Pérez-Sust P, Borràs JM. Cancer diagnosis in Catalonia (Spain) after two years of COVID-19 pandemic: an incomplete recovery. ESMO Open 2022; 7:100486. [PMID: 35714476 PMCID: PMC9197337 DOI: 10.1016/j.esmoop.2022.100486] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- J Ribes
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain; Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain.
| | - L Pareja
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - X Sanz
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain
| | - S Mosteiro
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - J M Escribà
- Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain; Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - L Esteban
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain
| | - J Gálvez
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - G Osca
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Barcelona, Spain
| | - P Rodenas
- Catalan Electronic Health Record, EHealth Office, Health/Catalan Health Service, Department of Health of Catalonia, Barcelona, Spain
| | - P Pérez-Sust
- CatSalut Information Systems and Health Department ICT Unit, Barcelona, Spain
| | - J M Borràs
- Catalan Pathology Registry, Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona (UB), Barcelona, Spain
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