Cancer Screening Disparities Before and After the COVID-19 Pandemic
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée à la COVID-19
Résumé en anglais
Importance : Breast, cervical, and colorectal cancer–screening disparities existed prior to the COVID-19 pandemic, and it is unclear whether those have changed since the pandemic.
Objective : To assess whether changes in screening from before the pandemic to after the pandemic varied for immigrants and for people with limited income.
Design, Setting, and Participants : This population-based, cross-sectional study, using data from March 31, 2019, and March 31, 2022, included adults in Ontario, Canada, the country’s most populous province, with more than 14 million people, almost 30% of whom are immigrants. At both dates, the screening-eligible population for each cancer type was assessed.
Exposures : Neighborhood income quintile, immigrant status, and primary care model type.
Main Outcomes and Measures : For each cancer screening type, the main outcome was whether the screening-eligible population was up to date on screening (a binary outcome) on March 31, 2019, and March 31, 2022. Up to date on screening was defined as having had a mammogram in the previous 2 years, a Papanicolaou test in the previous 3 years, and a fecal test in the previous 2 years or a flexible sigmoidoscopy or colonoscopy in the previous 10 years.
Results : The overall cohort on March 31, 2019, included 1 666 943 women (100%) eligible for breast screening (mean [SD] age, 59.9 [5.1] years), 3 918 225 women (100%) eligible for cervical screening (mean [SD] age, 45.5 [13.2] years), and 3 886 345 people eligible for colorectal screening (51.4% female; mean [SD] age, 61.8 [6.4] years). The proportion of people up to date on screening in Ontario decreased for breast, cervical, and colorectal cancers, with the largest decrease for breast screening (from 61.1% before the pandemic to 51.7% [difference, −9.4 percentage points]) and the smallest decrease for colorectal screening (from 65.9% to 62.0% [difference, −3.9 percentage points]). Preexisting disparities in screening for people living in low-income neighborhoods and for immigrants widened for breast screening and colorectal screening. For breast screening, compared with income quintile 5 (highest), the
