학술논문

Imaging and physician visits at cancer diagnosis: COVID ‐19 pandemic impact on cancer care
Document Type
article
Source
Cancer Medicine, Vol 12, Iss 5, Pp 6056-6067 (2023)
Subject
cancer diagnosis
COVID‐19
diagnostic imaging
telemedicine
ultrasound
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Language
English
ISSN
2045-7634
Abstract
Abstract Background Little is known about the COVID‐19 pandemic impact on the provision of diagnostic imaging and physician visits at cancer diagnosis. Methods We used administrative databases from Ontario, Canada, to identify MRI/CT/ultrasound scans and in‐person/virtual physician visits conducted with cancer patients within 91 days around the date of diagnosis in 2016–2020. In separate segmented regression procedures, we assessed the trends in weekly volume of these services per thousand cancer patients in prepandemic (June 26, 2016 to March 14, 2020), the change in mean volume at the start of the pandemic, and the additional change in weekly volume during the pandemic (March 15, 2020, to September 26, 2020). Results Totally, 403,561 cancer patients were included. On March 15, 2020 (COVID‐19 arrived), mean scan volume decreased by 12.3% (95% CI: 6.4%–17.9%) where ultrasound decreased the most by 31.8% (95% CI: 23.9%–37.0%). Afterward, the volume of all scans increased further by 1.6% per week (95% CI: 1.3%–2.0%), where ultrasound increased the fastest by 2.4% (95% CI: 1.8%–2.9%). Mean in‐person visits dropped by 47.4% when COVID‐19 started (95% CI: 41.6%–52.6%) while virtual visits rose by 55.15‐fold (95% CI: 4927%‐6173%). In the pandemic (until September 26, 2020), in‐person visits increased each week by 2.6% (95% CI: 2.0%–3.2%), but no change was observed for virtual visits (p ‐value = 0.10). Conclusions Provision of diagnostic imaging and virtual visits at cancer diagnosis has been increasing since the start of COVID‐19 and has exceeded prepandemic utilization levels. Future work should monitor the impact of these shifts on quality of delivered care.