{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:42:32Z","timestamp":1781376152951,"version":"3.54.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"7-8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Coronavirus disease 2019 (COVID-19) and the resulting societal reaction presented new challenges to the medical community by limiting patient access to care in 2020 and 2021. The Navy Postgraduate Dental School (NPDS) oral and maxillofacial pathology biopsy service is dependent on in-office physician or dentist appointments and patient biopsies. The purpose of this study was to understand the regulatory and societal impacts of COVID-19 restrictions on biopsy service submissions by assessing NPDS biopsy submission quantities and disease distribution.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>All NPDS oral and maxillofacial pathology biopsy submissions from calendar years 2015 to 2016 and 2019 to 2021 were evaluated, and patient demographics and biopsy diagnoses were recorded in a biopsy registry. Data collected included age, sex, biopsy site, and diagnosis. Data from 2015, 2016, and 2019 were defined as pre-COVID and 2020 and 2021 as COVID. Biopsy reports for each year were organized in quarters. Diagnoses were categorized as malignant, pre-malignant, or benign. Categorical and continuous data were evaluated and presented as counts with percentages and means or medians with standard deviations, respectively. Significant differences in proportions or means were assessed using chi-square analysis or Student t-test, respectively. Cases were aggregated by quarter and year and assessed for temporal trends using linear regression analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study evaluated 9,351 biopsy submission reports. The annual pre-COVID count mean (\u00b1 standard deviation) and yearly counts for 2020 and 2021 were 2,063\u2009\u00b1\u200933.3, 1,421, and 1,742, respectively. The mean (\u00b1 standard deviation) percentage of diagnoses classified as malignant from pre-COVID, 2020, and 2021 were 2.46\u2009\u00b1\u20090.005%, 3.59%, and 3.04%, respectively. Case counts and representation as a percentage of all biopsy diagnoses for Human Papillomavirus (HPV)-associated squamous cell carcinoma increased significantly during COVID compared to pre-COVID years (P\u2009&amp;lt;\u2009.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Overall, preventative COVID-19 health measures and protocols resulted in a reduction in biopsy submission frequency, particularly during the second quarter (April to June) of 2020. However, case counts for malignant biopsies remained consistent between pre-COVID and COVID time intervals, suggesting that the identification and analysis of cases requiring follow-on care were unaffected by COVID-19 protocols.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usae102","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T19:36:57Z","timestamp":1711568217000},"page":"e1797-e1804","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of a Pandemic on a Military Oral and Maxillofacial Pathology Biopsy Service"],"prefix":"10.1093","volume":"189","author":[{"given":"Trevor E","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Oral Pathology, William Beaumont Army Medical Center\u2014Fort Bliss , Fort Bliss, TX 79918, USA"},{"name":"Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command , Bethesda, MD 20889, USA"},{"name":"Postgraduate Dental College, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5896-5305","authenticated-orcid":false,"given":"Noel E","family":"Dickens","sequence":"additional","affiliation":[{"name":"Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command , Bethesda, MD 20889, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R","family":"Rehmel","sequence":"additional","affiliation":[{"name":"Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command , Bethesda, MD 20889, USA"},{"name":"Postgraduate Dental College, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Department of Oral Pathology, Womack Army Medical Center , Fort Liberty, NC 28310, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley E","family":"Jones","sequence":"additional","affiliation":[{"name":"Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command , Bethesda, MD 20889, USA"},{"name":"Postgraduate Dental College, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Department of Pathology, Naval Medical Center San Diego , San Diego, CA 92134, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J","family":"Hamlin","sequence":"additional","affiliation":[{"name":"Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command , Bethesda, MD 20889, USA"},{"name":"Postgraduate Dental College, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3665-2820","authenticated-orcid":false,"given":"Quinn 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