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Impact of the COVID-19 pandemic on cancer healthcare utilization in southwestern China on March 2021

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机构： [1]Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China [2]Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China [3]The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China [4]Department of Biotherapy and Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China [5]College of Software Engineering, Chengdu University of Information Technology, Chengdu, Sichuan, China [6]Sichuan Key Laboratory of Software Automatic Generation and Intelligent Service, Chengdu, Sichuan, China [7]Department of Health Policy and Management, UCLA Fielding School of Public Health, University of California, Los Angeles, California, USA [8]Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China [9]Institute of Hospital Management, West China Hospital of Sichuan University, Chengdu, China [10]Department of Thoracic Oncology, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China [11]Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA [12]Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA [13]Faculty of Humanities and Social Sciences, School of Economics, University of Nottingham Ningbo China, Ningbo, Zhejiang, China [14]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China [15]Frontiers Science Center for Disease-Related Molecular Network, Institute of Respiratory Health, West China Hospital, Sichuan University, Chengdu, Sichuan, China [16]President's Office, West China Hospital, Sichuan University, Chengdu, Sichuan, China [17]Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia, USA

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Oncological care has been disrupted worldwide during the COVID-19 pandemic. We aimed to quantify the long-term impact of the pandemic on cancer care utilization and to examine how this impact varied by sociodemographic and clinical factors in southwestern China, where the Dynamic Zero-COVID Strategy was implemented. This strategy mainly included lockdowns, stringent testing, and travel restrictions to prevent the spread of COVID-19.We identified 859,497 episodes of the utilization of cancer care from electronic medical records between January 1, 2019, and March 31, 2021, from the cancer center of a tertiary hospital serving an estimated population of 8.4 million in southwestern China. Changes in weekly utilization were evaluated via segmented Poisson regression across service categories, stratified by cancer type and sociodemographic factors.A sharp reduction in utilization of in-person cancer services occurred during the first week of the pandemic outbreak in January 2020, followed by a quick rebound in February 2020. Although there were few COVID-19 cases from March 2020 until this analysis, the recovery of most in-person services was slow and remained incomplete as of March 31, 2021. The exceptions were outpatient radiation and surgery, which increased and exceeded pre-pandemic levels, particularly among lung cancer patients; meanwhile, telemedicine utilization increased substantially after the onset of the pandemic. Care disruptions were most prominent for women, rural residents, uninsured, and breast cancer patients.As of March 2021, despite few COVID-19 cases, the COVID-19 pandemic has had a strong and continuing impact on in-person oncology care utilization in southwestern China under the Dynamic Zero-COVID Strategy. Equitable and timely access to cancer care requires adjustment in strict policies for COVID-19 prevention and control, as well as targeted remedies for the most vulnerable populations during and beyond the pandemic. Future studies should monitor the long-term effects of the COVID-19 pandemic and response strategies on cancer care and outcomes.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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出版当年[2023]版：

大类 | 2 区医学

小类 | 3 区肿瘤学

最新[2023]版：

大类 | 2 区医学

小类 | 3 区肿瘤学

第一作者：

第一作者机构： [1]Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China [2]Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China [3]The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China

通讯作者：

通讯机构： [1]Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China [2]Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China [3]The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China [14]Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China [15]Frontiers Science Center for Disease-Related Molecular Network, Institute of Respiratory Health, West China Hospital, Sichuan University, Chengdu, Sichuan, China [16]President's Office, West China Hospital, Sichuan University, Chengdu, Sichuan, China [*1]West China Hospital, Sichuan University, Guo Xue Xiang 37, Chengdu 610041, Sichuan, People's Republic of China.

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