iGIE : innovation, investigation and insights · 2023
Impact of the coronavirus disease 2019 pandemic on trends and healthcare disparities in use of screening colonoscopy and adenoma detection rates.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Garg Rajat, Patel Vidhi, McMichael John, Sasankan Priya, Dahiya Dushyant S, Singh Amandeep, Thota Prashanthi N, Sanaka Madhusudhan R
Аннотация
BACKGROUND AND AIMS: At the onset of the coronavirus disease 2019 (COVID-19) pandemic, all elective outpatient procedures were halted by Ohio public health authorities between March 2020 and June 2020, leading to limited screening colonoscopies. In this study, we studied the impact of COVID-19 on trends and disparities on screening colonoscopy use.
METHODS: We identified all patients who underwent colonoscopy at Cleveland Clinic Ohio facilities in 2019, 2020, and 2021 from July 1 to December 31 in each year. We then calculated rates of screening colonoscopy and factors associated with colonoscopy use during the study periods.
RESULTS: Among 68,206 colonoscopies, 23,316 (34.2%) were screening colonoscopies. In whites, the rate of colonoscopy use increased in 2021 (76.9%) over 2019 (46%) levels, whereas use of colonoscopy in African Americans decreased to even less than 2019 rates (16.5%) in 2021 (15.9%) (P < .001). Patients with private insurance and the highest quartiles of median household income and education had increasing rates of colonoscopy (P < .001) in 2020 and 2021. Patients who had ≥2 polyps and adenomas significantly increased from 2019 to 2021 (P < .05 for both). On multivariate analysis, age >65 years, male gender, white race, tobacco use, private insurance, and obesity were positive predictors of adenomas (P < .05 for all).
CONCLUSIONS: The pandemic exacerbated pre-existing healthcare disparities in colonoscopy use, which have continued to persist in 2021. These data will assist current and future efforts to increase uptake of colorectal cancer screening, especially in historically marginalized ethnic and low socioeconomic communities.
METHODS: We identified all patients who underwent colonoscopy at Cleveland Clinic Ohio facilities in 2019, 2020, and 2021 from July 1 to December 31 in each year. We then calculated rates of screening colonoscopy and factors associated with colonoscopy use during the study periods.
RESULTS: Among 68,206 colonoscopies, 23,316 (34.2%) were screening colonoscopies. In whites, the rate of colonoscopy use increased in 2021 (76.9%) over 2019 (46%) levels, whereas use of colonoscopy in African Americans decreased to even less than 2019 rates (16.5%) in 2021 (15.9%) (P < .001). Patients with private insurance and the highest quartiles of median household income and education had increasing rates of colonoscopy (P < .001) in 2020 and 2021. Patients who had ≥2 polyps and adenomas significantly increased from 2019 to 2021 (P < .05 for both). On multivariate analysis, age >65 years, male gender, white race, tobacco use, private insurance, and obesity were positive predictors of adenomas (P < .05 for all).
CONCLUSIONS: The pandemic exacerbated pre-existing healthcare disparities in colonoscopy use, which have continued to persist in 2021. These data will assist current and future efforts to increase uptake of colorectal cancer screening, especially in historically marginalized ethnic and low socioeconomic communities.