Delayed Diagnosis and Treatment of Cancer Patients During the COVID-19 Pandemic in Henan, China: An Interrupted Time Series Analysis

Frontiers in Public Health

article

Xiance Tang¹  Changpeng Liu¹  Heng Piao¹  Tao Zhang²  Dongjian Yang³  Xiaoyan Li¹ 

[1] Department of Medical Records, Office for DRGs ,(Diagnosis Related Groups), Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University;Department of Epidemiology, School of Public Health, Fudan University;Center for Medical Big Data, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University

关键词: COVID-19;    cancer;    ARIMA;    interrupted time series;    Henan;   

DOI  :  10.3389/fpubh.2022.881718

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective To investigate the possible impact of lockdown policies on the diagnosis and treatment of cancer patients in Henan, China. Design, Setting, and Participants We collected data from the Henan Cancer Hospital, affiliated with Zhengzhou University. The monthly numbers of inpatient admissions from January 2014 to December 2019 were used to forecast the number of inpatient admissions in 2020, which was then compared to the actual number of patients admitted during the pandemic to evaluate how the actual number diverges from this forecast. We conducted an interrupted time series analysis using the autoregressive integrated moving average (ARIMA) model. Main Outcomes and Measures For specific diagnoses, treatment modalities, and age groups, we compared the changes in monthly admissions after the pandemic with the forecasted changes from the model. Results The observed overall monthly number of inpatient admissions decreased by 20.2% [95% confidence interval (CI), 11.7–27.2%], 78.9% (95% CI, 77.3–80.4%), and 40.9% (95% CI, 35.6–45.5%) in January, February, and March 2020, respectively, as compared with those predicted using the ARIMA model. After the lockdown, visits for all treatment modalities decreased sharply. However, apparent compensation and recovery of the backlog appeared in later surgeries. As a result, the number of patients who underwent surgery in 2020 (30,478) was close to the number forecasted by the ARIMA model (30,185). In the same period, patients who received other treatments or underwent examinations were 106,074 and 36,968, respectively; the respective numbers that were forecasted by ARIMA were 127,775 and 60,025, respectively. These findings depict a decrease of 16.9 and 38.4% in patients who received other treatments or underwent examinations only, respectively. Regarding diagnosis, the reported incidence of various cancers decreased dramatically in February, with varying extent and speed of recovery. Conclusion and Relevance The COVID-19 pandemic has significantly delayed the diagnosis and treatment of cancer in Henan, China. Long-term research should be conducted to assess the future effects of lockdown policies.

【 授权许可】

CC BY