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Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase
Procedural delays due to the coronavirus disease 2019 (COVID-19) pandemic may exacerbate disparities in colorectal cancer (CRC) preventive care. We aimed to measure racial and socioeconomic disparities in the prioritization of CRC screening or adenoma surveillance during the COVID reopening period....
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams And Wilkins
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9169755/ https://www.ncbi.nlm.nih.gov/pubmed/35102113 http://dx.doi.org/10.1097/MEG.0000000000002350 |
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author | Choy, Alexa M Lebwohl, Benjamin Krigel, Anna |
author_facet | Choy, Alexa M Lebwohl, Benjamin Krigel, Anna |
author_sort | Choy, Alexa M |
collection | PubMed |
description | Procedural delays due to the coronavirus disease 2019 (COVID-19) pandemic may exacerbate disparities in colorectal cancer (CRC) preventive care. We aimed to measure racial and socioeconomic disparities in the prioritization of CRC screening or adenoma surveillance during the COVID reopening period. METHODS: We identified CRC screening or surveillance colonoscopies performed during two time periods: (1) 9 June 2019–30 September 2019 (pre-COVID) and (2) 9 June 2020–30 September 2020 (COVID reopening). We recorded the procedure indication, patient age, sex, race/ethnicity, primary language, insurance status and zip code. Multivariable logistic regression was used to determine factors independently associated with undergoing colonoscopy in the COVID reopening era. RESULTS: We identified 1473 colonoscopies for CRC screening or adenoma surveillance; 890 occurred in the pre-COVID period and 583 occurred in the COVID reopening period. In total 342 (38.4%) pre-COVID patients underwent adenoma surveillance and 548 (61.6%) underwent CRC screening; in the COVID reopening cohort, 257 (44.1%) underwent adenoma surveillance and 326 (55.9%) underwent CRC screening (P = 0.031). This increased proportion of surveillance procedures in the reopening cohort was statistically significant on multivariable analysis [odds ratio (OR), 1.26; 95% confidence interval (CI), 1.001–1.58]. Black patients comprised 17.4% of the pre-COVID cohort, which declined to 15.3% (P = 0.613). There was a trend toward an inverse association between reopening phase colonoscopy and Medicaid insurance compared with commercial insurance (OR, 0.71; 95% CI, 0.49–1.04). No significant associations were found between reopening phase colonoscopy and the remaining variables. CONCLUSIONS: During the COVID reopening period, colonoscopies for CRC fell by over one-third with significantly more surveillance than screening procedures. Nonwhite patients and non-English speakers comprised a shrinking proportion in the COVID reopening period. |
format | Online Article Text |
id | pubmed-9169755 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams And Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-91697552022-06-08 Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase Choy, Alexa M Lebwohl, Benjamin Krigel, Anna Eur J Gastroenterol Hepatol Original Articles: Gastroenterology Procedural delays due to the coronavirus disease 2019 (COVID-19) pandemic may exacerbate disparities in colorectal cancer (CRC) preventive care. We aimed to measure racial and socioeconomic disparities in the prioritization of CRC screening or adenoma surveillance during the COVID reopening period. METHODS: We identified CRC screening or surveillance colonoscopies performed during two time periods: (1) 9 June 2019–30 September 2019 (pre-COVID) and (2) 9 June 2020–30 September 2020 (COVID reopening). We recorded the procedure indication, patient age, sex, race/ethnicity, primary language, insurance status and zip code. Multivariable logistic regression was used to determine factors independently associated with undergoing colonoscopy in the COVID reopening era. RESULTS: We identified 1473 colonoscopies for CRC screening or adenoma surveillance; 890 occurred in the pre-COVID period and 583 occurred in the COVID reopening period. In total 342 (38.4%) pre-COVID patients underwent adenoma surveillance and 548 (61.6%) underwent CRC screening; in the COVID reopening cohort, 257 (44.1%) underwent adenoma surveillance and 326 (55.9%) underwent CRC screening (P = 0.031). This increased proportion of surveillance procedures in the reopening cohort was statistically significant on multivariable analysis [odds ratio (OR), 1.26; 95% confidence interval (CI), 1.001–1.58]. Black patients comprised 17.4% of the pre-COVID cohort, which declined to 15.3% (P = 0.613). There was a trend toward an inverse association between reopening phase colonoscopy and Medicaid insurance compared with commercial insurance (OR, 0.71; 95% CI, 0.49–1.04). No significant associations were found between reopening phase colonoscopy and the remaining variables. CONCLUSIONS: During the COVID reopening period, colonoscopies for CRC fell by over one-third with significantly more surveillance than screening procedures. Nonwhite patients and non-English speakers comprised a shrinking proportion in the COVID reopening period. Lippincott Williams And Wilkins 2022-01-31 2022-07 /pmc/articles/PMC9169755/ /pubmed/35102113 http://dx.doi.org/10.1097/MEG.0000000000002350 Text en Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections. |
spellingShingle | Original Articles: Gastroenterology Choy, Alexa M Lebwohl, Benjamin Krigel, Anna Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase |
title | Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase |
title_full | Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase |
title_fullStr | Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase |
title_full_unstemmed | Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase |
title_short | Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase |
title_sort | impact of social determinants of health on colorectal cancer screening and surveillance in the covid reopening phase |
topic | Original Articles: Gastroenterology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9169755/ https://www.ncbi.nlm.nih.gov/pubmed/35102113 http://dx.doi.org/10.1097/MEG.0000000000002350 |
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