Population-based Oral Cancer Service Screening Disrupted by COVID-19 Pandemic: Observational and Simulation Study
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Abstract
Background
It is important for understanding the impact of COVID-19 pandemic on the missing opportunity for the early detection of oral cancer. This study aimed to assess the impact of COVID-19 pandemic on the existing population-based oral cancer (OC) service screening program in Taiwan.
Methods
Before and after COVID-19 pandemic design was used to assess the impact of COVID-19 on the reduction of screening rate, referral rate, and the effectiveness of this OC service screening. Data and analysis after pandemic covered non-VOC period in 2020 and VOC period in 2021 compared to the historical control before pandemic in 2019.
Results
The screening rate decreased substantially from 26.6% before COVID-19 in 2019 to 16.7% in 2020 and 15.3% in 2021 after pandemic. The reduction of screening rate varied with months, being the most remarkable decline in March (RR=0.61, 95% CI (0.60-0.62)) and June (RR=0.09, 95% CI (0.09-0.10)) in 2021 compared with January. The referral rate was stable at 81.5% in 2020 but it was reduced to 73.1% in 2021. The reduction of screening and referral rate led to the attenuation of effectiveness of advance cancer and mortality attenuated by 4% and 5%, respectively.
Conclusion
COVID-19 pandemic disrupted the screening and the referral rate and further led to statistically significant reduction in effectiveness for preventing advanced cancer and death. Appropriate prioritized strategies must be adopted to ameliorate malignant transformation and tumor upstaging due to deference from participation in the screening.
Funding
This study was financially supported by Health Promotion Administration of the Ministry of Health and Welfare of Taiwan (A1091116).
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SciScore for 10.1101/2022.05.03.22274618: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study approved by the Research Ethics Committee of National Taiwan University Hospital prior to data collection pursuant to the regulation of the Institutional Review Board (202103098W). Sex as a biological variable After screening, the participants with oral potentially malignant disorders or suspected malignancy were referred to the specialists in the hospitals for confirmatory pathological examination. Randomization As we do not have the control group as seen in population-based randomized controlled trial, it is very difficult to estimate the risks of advanced oral cancer or deaths in the absence of screening. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key …
SciScore for 10.1101/2022.05.03.22274618: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study approved by the Research Ethics Committee of National Taiwan University Hospital prior to data collection pursuant to the regulation of the Institutional Review Board (202103098W). Sex as a biological variable After screening, the participants with oral potentially malignant disorders or suspected malignancy were referred to the specialists in the hospitals for confirmatory pathological examination. Randomization As we do not have the control group as seen in population-based randomized controlled trial, it is very difficult to estimate the risks of advanced oral cancer or deaths in the absence of screening. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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