新冠肺炎疫情下癌症早诊早治管理工作探讨

目的 了解新型冠状病毒肺炎疫情对于北京城市癌症早诊早治项目的影响,探索疫情防控常态化下相关工作的管理策略。方法 基于2018—2019年度北京城市癌症早诊早治项目,采用整群抽样方法,在北京市6个城区招募40~74岁北京市户籍居民进行癌症风险评估问卷调查,评估得到的高危人群于定点医院接受相关临床检查。其中,2018年度对应2018年11月23日至2019年11月22日(疫情前),2019年度对应2019年11月23日至2020年12月23日(疫情期间)。采用卡方检验比较疫情前后各区、各癌种间问卷评估、临床检查和结果录入完成情况以及临床检查依从性的差异。结果 2018和2019年度分别有21 026和6 663人纳入研究。与2018年度相比,2019年度问卷评估完成率由100.1%降至60.4%,临床检查完成率由101.4%降至57.5%,结果录入率由99.2%降至88.2%,癌症高危人群临床检查参与率由87.3%降至80.8%,以上差异均具有统计学意义(P＜0.001)。结论 新冠肺炎疫情对北京城市癌症早诊早治项目影响较大。未来应在疫情常态化应对背景下着力改变癌症防治的工作模式,使疫情防控与慢性病管理齐头并进。

Discussion on the management of early diagnosis and treatment for cancer under the coronavirus disease(COVID-19)

Objective The aim of this study was to understand the impact of the coronavirus disease(COVID-19)pandemic on the early diagnosis and treatment project for cancer in Beijing,and to explore management strategies for related work under the new normal of epidemic prevention and control. Methods Based on the 2018-2019 Beijing Urban Cancer Early Diagnosis and Treatment Project,cluster sampling was used to recruit Beijing registered residents aged 40 to 74 years old from 6 urban areas in Beijing to conduct a cancer risk assessment questionnaire survey.Subjects relevant clinical examinations were performed in designated hospitals.Among them,Project Year 2018 corresponded to November 23,2018-November 22,2019(before the pandemic),and Project Year 2019 corresponded to November 23,2019-December 23,2020(during the pandemic).The Chi-square test was used to compare differences in the questionnaires evaluation,clinical examination,result entry,and the compliance with clinical examinations in various districts and cancer species before and during the pandemic. Results Overall,21,026 and 6,663 residents were included in the study in Project Year 2018 and 2019,respectively.Compared with the rates in Project Year 2018,the completion rate of questionnaire evaluation decreased from 100.1% to 60.4%,the completion rate of clinical examination tasks decreased from 101.4% to 57.5%,and the result entry rate decreased from 99.2% to 88.2%,and the participation rate in the examination decreased from 87.3% to 80.8% in project Year 2019.All rates,differences mentioned above were statistically significant differences(P＜0.001). Conclusion The coronavirus disease(COVID-19)pandemic has a greater impact on the Beijing Urban Cancer Early Diagnosis and Treatment Project.In the future,efforts should be made to change the work model of cancer prevention and control in the context of normalized response to the pandemic,so that epidemic prevention and control may go hand in hand with the chronic diseases management.