1.Monitoring the activities of Italian colposcopy clinics before and during the COVID-19 pandemic
Giovanni Delli CARPINI ; Paolo Giorgi ROSSI ; Luca GIANNELLA ; Jacopo Di GIUSEPPE ; Nicolò CLEMENTE ; Francesco SOPRACORDEVOLE ; Maggiorino BARBERO ; Giorgio BOGANI ; Rosa De VINCENZO ; Massimo ORIGONI ; Francesco CANTATORE ; Barbara GARDELLA ; Mattia DOMINONI ; Ermelinda MONTI ; Carlo Antonio LIVERANI ; Anna VISCARDI ; Alessio PAGAN ; Andrea AMADORI ; Chiara ALESSI ; Matteo ANDOLFATTO ; Paolo CATTANI ; Annalisa PIERALLI ; Guido STEVENAZZI ; Andrea CIAVATTINI
Journal of Gynecologic Oncology 2023;34(1):e7-
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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