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KMID : 1137020230340010007
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Journal of Gynecologic Oncology
2023 Volume.34 No. 1 p.7 ~ p.7
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Monitoring the activities of Italian colposcopy clinics before and during the COVID-19 pandemic
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Carpini Giovanni Delli
Bogani Giorgio
Giannella Luca
Giuseppe Jacopo Di
Ciavattini Andrea
Clemente Nicolo
Sopracordevole Francesco
Barbero Maggiorino
Vincenzo Rosa De
Origoni Massimo
Cantatore Francesco
Gardella Barbara
Dominoni Mattia
Monti Ermelinda
Liverani Carlo Antonio
Viscardi Anna
Pagan Alessio
Amadori Andrea
Alessi Chiara
Andolfatto Matteo
Cattani Paolo
Pieralli Annalisa
Stevenazzi Guido
Giannella Luca
Giuseppe Jacopo Di
Clemente Nicolo
Sopracordevole Francesco
Barbero Maggiorino
Bogani Giorgio
Vincenzo Rosa De
Origoni Massimo
Cantatore Francesco
Gardella Barbara
Dominoni Mattia
Monti Ermelinda
Liverani Carlo Antonio
Viscardi Anna
Pagan Alessio
Amadori Andrea
Alessi Chiara
Andolfatto Matteo
Cattani Paolo
Pieralli Annalisa
Stevenazzi Guido
Ciavattini Andrea
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Abstract
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Objective : To evaluate the impact of healthcare reorganization during the severe acute respiratory syndrome coronavirus 2 pandemic on Italian colposcopy clinic activities, focusing on cervical excision procedures, follow-ups for conservative management of low-grade lesions, and follow-ups post cervical excision.
Methods : Retrospective study conducted in 14 Italian colposcopy clinics. The number and clinical characteristics of cervical excisions, follow-ups for conservative management of low-grade lesions, and follow-ups after cervical excision were compared between the period March 1, 2019 to February 29, 2020 (pre-pandemic) and March 1, 2020 to February 28, 2021 (pandemic) with a Poisson regression analysis.
Results : In the pandemic period, the number of cervical excisions was reduced by 8.8% (95% confidence interval [CI]=?15.6% to ?2%; p=0.011). Excisions were less frequently performed in the operating room (?35.1%; 95% CI=?47.6% to ?22.6%; p<0.001), the number of patients from spontaneous screening was reduced by ?14.0% (95% CI=?23.4% to ?4.6%; p=0.003), and the CO2-laser technique was used less frequently (?30%; 95% CI=?45.1% to ?15.0%; p<0.001). As compared to the pre-pandemic period, the number of follow-ups for conservative management of low-grade lesions was reduced by ?26.7% (95% CI=?39.0% to ?14.4%; p<0.001), and the follow-up appointments after cervical excision were reduced by ?51.0% (95% CI=?58.1% to ?43.9%; p<0.001).
Conclusion : The most significant impact of the healthcare reorganization during the coronavirus disease 2019 pandemic was on follow-ups after cervical excision. The resumption of disrupted activities should follow a risk-based prioritization, starting from women in follow-up after cervical excision. It is advisable that the trend of performing cervical excision as an outpatient procedure is maintained in the post-pandemic period.
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KEYWORD
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Colposcopy, Cervical Cancer, COVID-19 Pandemic, Conization, Screening
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