PO.PS01.02 · 人群科学
自COVID-19大流行开始以来加拿大不列颠哥伦比亚省的口腔癌发病率
Oral cancer incidence in British Columbia, Canada since the start of the COVID-19 pandemic
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
目的:自COVID-19大流行开始以来,全球癌症服务出现了显著中断。由于常规牙科就诊中口腔病变的机会性筛查被中断,预计在大流行初期,包括口腔癌在内的可疑口腔疾病的诊断(进而发病率)会出现初步下降。随后,由于诊断延误的恢复,预计在大流行开始后的最初几年口腔癌的诊断和发病率会上升。然而,发病率所观察到的变化也可能与其他促成因素相关。虽然已有关于COVID-19大流行对头颈癌发病率影响的文献,但极少有研究考虑时间趋势,而若不加以考虑,可能会使结果产生偏倚。目前,尚无在考虑时间趋势的同时研究大流行对2021年之后口腔癌发病率影响的研究。本项目将在考虑趋势的前提下,判定加拿大不列颠哥伦比亚省口腔癌的发病率在COVID-19大流行开始后是否发生了变化。
方法:从BC癌症登记处检索了2010年1月至2022年12月不列颠哥伦比亚省新发口腔癌的诊断数据。纳入唇和口腔的癌症,排除皮肤和骨病变。排除唾液腺和咽部癌症。采用间断时间序列设计,通过将大流行后(2020年及以后)观察到的发病率与预期(反事实)大流行后发病率进行比较,来判定大流行后口腔癌发病率的差异。预期的大流行后发病率基于大流行前趋势(2010年至2019年)。大流行前趋势通过连接点回归计算为年龄标准化发病率的年度百分比变化。使用2020年、2021年和2022年观察到的与反事实的大流行后年龄标准化发病率的比值及95%置信区间来判定大流行前后发病率的差异。
结果:2010年至2022年间,不列颠哥伦比亚省诊断出3039例发生于唇和口腔上皮的新发口腔癌。总体上以及按性别分析,预期与观察到的大流行后口腔癌发病率之间均无显著差异。尽管不显著,但总体及女性中观察到的舌癌病例远少于预期病例。按年龄类别和部位的特异性分析尚待完成。
结论:初步结果提示自COVID-19大流行开始以来口腔癌发病率无差异。应评估2022年以后的数据,以继续判定大流行后口腔癌发病率的差异。
查看英文原文 English abstract
Objectives: Since the beginning of the COVID-19 pandemic, there have been notable disruptions to cancer services worldwide. With interruptions to the opportunistic screening of oral lesions at routine dental visits, an initial decrease in the diagnosis and thus incidence of concerning oral diseases, including oral cancer, is expected at the pandemic's onset. Following this, an increase in the diagnosis and incidence of oral cancer in the early years after the start of the pandemic is anticipated due to the recovery of diagnostic delays. However, it is possible that changes observed in the incidence are also related to contributing factors. While there is literature on the impacts of the COVID-19 pandemic on head and neck cancer incidence, minimal research considers temporal trends, which if not considered, it can bias results. Currently, there is no research on the pandemic's impact on oral cancer incidence beyond 2021, while taking into account temporal trends. This project will determine if the incidence of oral cancer in British Columbia, Canada has changed after the start of the COVID-19 pandemic when considering trends.
Methods: Data on the diagnosis of new oral cancers, from January 2010 to December 2022, in British Columbia, were retrieved from the BC Cancer Registry. Cancers of the lip and oral cavity, excluding skin and bone lesions, were included. Salivary gland and pharyngeal cancers were excluded. An interrupted time series design was used to determine differences in oral cancer incidence post-pandemic (2020 and after) by comparing the post-COVID-19 observed incidence to the expected (counterfactual) post-COVID-19 incidence. The expected post-COVID-19 incidence was based on the pre-COVID-19 trend (2010 to 2019). The pre-COVID-19 trend was calculated as the annual percentage change of age-standardized incidence rates using joinpoint regression. Ratios and 95% confidence intervals of observed versus counterfactual post-pandemic age-standardized incidence rates for 2020, 2021, and 2022 were used to determine differences in pre-and post-pandemic incidence.
Results: From 2010 to 2022, there were 3039 new cases of oral cancers in the oral epithelium of the lip and oral cavity diagnosed in British Columbia. There were no significant differences between the expected and observed post-COVID-19 oral cancer incidence overall and by sex-specific analysis. Although not significant, there were much fewer observed compared to expected cases of tongue cancers overall and for females. Age category- and site-specific analysis is to be completed.
Conclusion: Preliminary results suggest no differences in oral cancer incidence since the onset of the COVID-19 pandemic. Data beyond 2022 should be assessed to continue to determine for differences in oral cancer incidence post-pandemic.
利益披露 Disclosure
I. S. Yim, None..
L. Zhang, None..
R. Murphy, None..
M. P. Rosin, None..
D. M. Laronde, None.