The objective of this study was to determine the correlation between adherence to cancer screening programs and earlier diagnosis of the 14 most common types of cancers in the adult population, before and during the COVID-19 pandemic. National data concerning number of admissions and operations in Italy for adult patients admitted with oncologic problems during the COVID-19 pandemic (2020 to 2022) and in the pre-pandemic period (2015 to 2019) were analyzed. We selected 14 types of cancer that present the most common indications for surgery in Italy. This study included 1,365,000 adult patients who had surgery for the 14 most common types of cancer in the period 2015–2022, and interviews concerning adherence rates to screening for breast, colorectal, and cervical cancer were conducted for 133,455 individuals. A higher decrease in the number of operations for the 14 types of cancer (−45%) was registered during the first three acute phases of the pandemic, and it was more evident for screenable cancers like breast, colorectal, and cervical cancer (p< 0.001). During the first year of the COVID-19 pandemic, the number of screened individuals for breast, colorectal, and cervical cancer decreased by 33.8% (from 7,507,893 to 4,969,000) and the number of diagnoses and operations for these three types of cancer decreased by 10.5% (from 107,656 to 96,405). The increase and return to normality of the number of screened individuals in the last year of the pandemic (2022) and in the first post-pandemic year (2023) was associated with a return to the pre-pandemic levels of diagnoses and operations. The adherence rates were lower for individuals living in rural areas, with low socio-economic status, and unmarried persons; however, the most statistically significant factor for reduced adherence was a lower level of educational attainment. Free screening through nationally organized programs reduced social disparities. There were no significant differences between the pre-pandemic and pandemic periods for several types of cancers (stomach, esophagus, pancreas, liver) that are diagnosed for the occurrence of symptoms and for which nationally organized programs might increase the possibility of earlier diagnosis and improved clinical outcomes. Education, information, and appropriate expenditure for preventive care have the potential to reduce cancer mortality. Nationally organized screening programs for several types of cancers, which are often detected for the occurrence of symptoms, may increase the possibility of diagnosis at earlier stages.
本研究旨在确定在COVID-19大流行之前及期间，成年人群对癌症筛查项目的依从性与14种最常见癌症早期诊断之间的相关性。研究分析了意大利全国范围内关于COVID-19大流行期间（2020年至2022年）及大流行前时期（2015年至2019年）因肿瘤问题入院的成年患者的入院和手术数量数据。我们选取了意大利最常见手术适应症的14种癌症类型。本研究纳入了2015年至2022年间因14种最常见癌症接受手术的1,365,000名成年患者，并对133,455名个体进行了关于乳腺癌、结直肠癌和宫颈癌筛查依从率的访谈。在大流行的前三个急性阶段，14种癌症的手术数量下降更为显著（-45%），其中乳腺癌、结直肠癌和宫颈癌等可通过筛查发现的癌症下降尤为明显（p<0.001）。在COVID-19大流行的第一年，接受乳腺癌、结直肠癌和宫颈癌筛查的个体数量减少了33.8%（从7,507,893人降至4,969,000人），这三种癌症的诊断和手术数量减少了10.5%（从107,656例降至96,405例）。在大流行最后一年（2022年）及大流行后第一年（2023年），筛查个体数量的增加和恢复正常与诊断和手术数量恢复至大流行前水平相关。居住在农村地区、社会经济地位较低及未婚个体的筛查依从率较低；然而，统计学上最显著的依从性降低因素是教育程度较低。通过国家组织的免费筛查项目减少了社会差异。对于几种因症状出现而诊断的癌症（胃、食管、胰腺、肝脏），大流行前与大流行期间未见显著差异，国家组织的筛查项目可能增加这些癌症早期诊断的可能性并改善临床结局。教育、信息传播及预防性医疗的适当投入具有降低癌症死亡率的潜力。针对通常因症状出现才被发现的多种癌症，国家组织的筛查项目可能增加早期诊断的可能性。
肿瘤(癌症)患者之家