A delay in the diagnosis of colorectal cancer screened by fecal immunochemical tests during the COVID-19 pandemic: a longitudinal cohort study

Ishibashi, Fumiaki; Shida, Dai; Suzuki, Shinichi; Nagai, Mizuki; Mochida, Kentaro; Morishita, Tetsuo

doi:10.1007/s00384-022-04270-z

Cited by 8 publications

(11 citation statements)

References 11 publications

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“…Thus, as in our study, in the recently published Dutch study, the delays associated with the pandemic have not modified the probability of detection of CRC and, only minimally, the detection of advanced neoplasia in colonoscopy. Our results are comparable to those published by the Dutch group and contradict those of other studies with smaller sample sizes where differences were determined in the participation, adherence to the screening test, and changes in the probability of detecting CRC [12,13].…”

Section: Discussionsupporting

confidence: 78%

Impact of the COVID-19 Pandemic on the Diagnosis of Colorectal Cancer within a Population-Based Organized Screening Program

Cubiella,

Calderón-Cruz,

Almazán

et al. 2023

Cancers

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Background: The interruption of the activity of population-based organized colorectal cancer (CRC) screening programs due to the COVID pandemic may have affected their results in terms of the detection of preneoplastic lesions and CRC. We evaluated the impact of the COVID pandemic on the delays, participation, adherence to colonoscopies, lesions detected, and CRC stage at diagnosis in a CRC screening program. Methods: We analyzed all the invitations between 1 January 2019 and 31 December 2021. We defined the pandemic period as the period after 12 March 2020. We calculated the delay intervals (successive and all rounds), the rates of participation, adherence to colonoscopy after a positive fecal immunochemical test (FIT), and the diagnostic yield of colonoscopy, specifically of CRC and colorectal neoplasia (CRC and/or adenoma), as well as the CRC stage at diagnosis. Results: In the period analyzed, 976,187 invitations were sent (61.0% in the pandemic period), 439,687 FIT were returned (62.4% in the pandemic period) and 23,092 colonoscopies were performed (59.1% in the pandemic period). The colonoscopies were normal in 7378 subjects (32.4%) and CRC was detected in 916 subjects (4.0%). In successive rounds, the delay increased significantly by seven months during the pandemic period (p < 0.001). In all the invitations, the delay from the invitation to the colonoscopy increased significantly by 8 days (p < 0.001). Once adjusted for the confounding variables, the participation in the screening program increased significantly (OR = 1.1; 95% CI = 1.09–1.11), with no changes in the adherence to colonoscopy (OR = 0.9; 95% CI = 0.8–1.0). We found no differences in the diagnostic yield of colonoscopy in terms of CRC (OR = 0.90; 95% CI = 0.78–1.02) or colorectal neoplasia (OR = 0.98; 95% CI = 0.92–1.03) detection. Finally, we found no differences in the CRC stage at diagnosis (p = 0.2). Conclusions: Although the interruption of the CRC screening program due to the COVID pandemic increased the delays, it did not reduce participation, adherence to colonoscopy, or the diagnostic yield of colonoscopy.

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Section: Discussionsupporting

confidence: 78%

Impact of the COVID-19 Pandemic on the Diagnosis of Colorectal Cancer within a Population-Based Organized Screening Program

Cubiella,

Calderón-Cruz,

Almazán

et al. 2023

Cancers

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“…Similar hypotheses have been proposed for breast, skin, colorectal, gastric, and lung cancers. 22 , 23 , 24 , 25 , 26 , 27 , 28 …”

Section: Discussionmentioning

confidence: 99%

Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study

Medas¹,

Dobrinja²,

Al-Suhaimi³

et al. 2023

The Lancet Diabetes & Endocrinology

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“…Changes in cancer screening were used during the COVID-19 pandemic to facilitate distancing from sanitary institutions and to cope with the blockage of the surgical waiting list and outpatient activities needed to confirm a cancer diagnosis. Stool testing was increased to counterbalance the decrease in gastrointestinal endoscopy practice [ 26 , 27 ], but as a screening test, it is only effective when the process is completed with colonoscopy [ 17 ]. Similarly, PSA testing is ineffective without a consequent prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Cancer Diagnosis in Madrid (Spain) Based on the RTMAD Tumor Registry (2019–2021)

Garrido-Cantero

Longo

Hernández-González

et al. 2023

Cancers

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The coronavirus disease 2019 (COVID-19) pandemic has caused a significant disruption to cancer diagnosis, treatment and prevention worldwide that could have serious consequences in the near future. We intend to evaluate the weight of this backlog on a community-wide scale in Madrid during the period 2020–2021, and whether a stage shift towards the advanced stage has occurred. Cancer diagnoses in the Madrid tumor registry (RTMAD) from 2019–2021 were evaluated. Absolute and percentage differences in annual volume and observed-to-expected (O/E) volume ratios were calculated. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated using the O/E ratio. The SIR for 2020–2021 compared to 2019 was 94.5% (95% CI 93.8–95.3), with unequal gender-specific cancer diagnosis recovery (88.5% for males and 102.1% for females). Most cancer types were underdiagnosed in 2020. The tendency worsened in 2021 for colorectal and prostate cancers (87.8%), but lung cancer recovered (102.1%) and breast cancer was over-diagnosed (114.4%) compared with reference pre-COVID-19 data. These changes have modified the ranking of the most frequent malignancies diagnosed in Madrid. Breast cancer has overtaken colorectal and prostate cancers, displaced to second and third position, respectively. Not only was colorectal cancer diagnosis affected more as a consequence of the COVID-19 pandemic but diagnosis of this malignancy at the advance stage also increased by 3.6% in 2020 and 4.2% in 2021 compared to the reference period of 2019. In summary, there is a large volume of undetected cancer in Madrid caused by the reduced access to care secondary to the COVID-19 pandemic, especially regarding colorectal and prostate cancer. Strategies are needed to recover the backlog of diagnoses and effectively treat these cases in the future and solve the negative impact that will be caused by the diagnostic delay. Analyzing the impact of new diagnoses suffered by each different malignancy and their recovery will help to understand how the future allocation of resources should look.

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A delay in the diagnosis of colorectal cancer screened by fecal immunochemical tests during the COVID-19 pandemic: a longitudinal cohort study

Cited by 8 publications

References 11 publications

Impact of the COVID-19 Pandemic on the Diagnosis of Colorectal Cancer within a Population-Based Organized Screening Program

Impact of the COVID-19 Pandemic on the Diagnosis of Colorectal Cancer within a Population-Based Organized Screening Program

Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study

Impact of the COVID-19 Pandemic on Cancer Diagnosis in Madrid (Spain) Based on the RTMAD Tumor Registry (2019–2021)

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