IMPORTANCE Population-level reports of suicide-related emergency department (ED) encounters among youth during the COVID-19 pandemic are lacking, along with youth characteristics and preexisting psychiatric service use. OBJECTIVE To characterize population-level and relative change in suicide-related ED encounters among youth during the COVID-19 pandemic compared with 2019. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study evaluated ED encounters in 2019 and 2020 at Kaiser Permanente Northern California-a large, integrated, community-based health system. Youth aged 5 to 17 years who presented to the ED with suicidal thoughts or behaviors were included. EXPOSURE The COVID-19 pandemic. MAIN OUTCOMES AND MEASURES Population-level incidence rate ratios (IRRs) and percent relative effects for suicide-related ED encounters as defined by the US Centers for Disease Control and Prevention-recommended International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes in 4 periods in 2020 compared with the same periods in 2019.RESULTS There were 2123 youth with suicide-related ED encounters in 2020 compared with 2339 in 2019. In the 2020 group, 1483 individuals (69.9%) were female and 1798 (84.7%) were aged 13 to 17 years. In the 2019 group, 1542 (65.9%) were female, and 1998 (85.4%) were aged 13 to 17 years. Suicide-related ED encounter incidence rates were significantly lower in March through May 2020 compared with this period in 2019 (IRR, 0.57; 95% CI, 0.51-0.63; P < .001), then returned to prepandemic levels. However, suicide-related ED visits among female youth from

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OBJECTIVE: To evaluate the performance of a system that standardizes ovarian cancer risk assessment and reporting on ultrasonography. METHODS: We conducted a prospective community-based cohort study of average-risk women undergoing ultrasonography in 2016 using a reporting system that requires adnexal masses to be categorized as 1, 2, 3, or X based on standardized ultrasound criteria including size, presence of solid components, and vascularity assessed by Doppler. With a median follow-up of 18 months, the risk of ovarian cancer or borderline tumor diagnosis for each category was determined. RESULTS: Among 43,606 women undergoing ultrasonography, 6,838 (16%) had an abnormal adnexal mass reported: 70% were category 1, 21% category 2, 3.7% category 3, and 5.4% category X. Among these women, 89 (1.3%) were subsequently diagnosed with ovarian cancer and 59 (0.9%) with borderline tumors. The risks of ovarian cancer diagnosis associated with masses reported as categories 1, 2, 3, and X were 0.2% (95% CI 0.05–0.3%), 1.3% (95% CI 0.7–1.9%), 6.0% (95% CI 3.0–8.9%), and 13.0% (95% CI 9.5–16.4%), respectively; risks of either ovarian cancer or borderline tumor were 0.4% (95% CI 0.2–0.6%), 2.3% (95% CI 1.6–3.1%), 10.4% (95% CI 6.6–14.1%), and 18.9% (95% CI 14.9–23.0%) respectively. Among 36,768 (84%) women with normal or benign adnexal findings reported, 38 women were diagnosed with ovarian cancer, for a risk of 0.1% (95% CI 0.07–0.14%). CONCLUSION: In a community-based setting with low ovarian cancer prevalence, our standardized reporting system differentiated adnexal masses into four categories with distinct levels of risk with 9–10% of women having higher risk masses and 70% of women having masses associated with a risk of cancer similar to that of normal ultrasound findings. The system supports risk-based management by providing clinicians a more consistent assessment of risk based on ultrasound characteristics.

During the first 12 weeks of the coronavirus disease 2019 (COVID-19) pandemic, endometrial cancer diagnoses declined 35% and patient calls for abnormal bleeding declined 33% compared with 2019 levels.