A Review of the Impact of the COVID-19 Pandemic on Colorectal Cancer Screening: Implications and Solutions

Sundaram, Suneha; Olson, Sean; Sharma, Paranjay; Rajendra, Shanmugarajah

doi:10.3390/pathogens10111508

Cited by 12 publications

(11 citation statements)

References 28 publications

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“…Furthermore, we were not able to calculate each institution's total screenings missed in 2020, so efforts to address the screenings missed in 2020 are more aspirational than based on data. However, we know from other population‐based studies and national estimates that there is a deficit in total screenings from 2020 from the disruption of routine screening for at least 6 months in 2020, with projected long‐term consequences without the implementation of “catch‐up” screening interventions 1,28‐30 . Thus, we strongly believe that any efforts to increase screening will help to address the backlog of delayed and missed screenings, and reduce late‐stage cancer diagnoses and preventable deaths.…”

Section: Discussionmentioning

confidence: 99%

A national quality improvement study identifying and addressing cancer screening deficits due to the COVID‐19 pandemic

Joung

Nelson

Mullett

et al. 2022

Cancer

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BACKGROUND: Cancer-related deaths over the next decade are expected to increase due to cancer screening deficits associated with the coronavirus disease 2019 (COVID-19) pandemic. Although national deficits have been quantified, a structured response to identifying and addressing local deficits has not been widely available. The objectives of this report are to share preliminary data on monthly screening deficits in breast, colorectal, lung, and cervical cancers across diverse settings and to provide online materials from a national quality improvement (QI) study to help other institutions to address local screening deficits. METHODS: This prospective, national QI study on Return-to-Screening enrolled 748 accredited cancer programs in the United States from April through June 2021. Local prepandemic and pandemic monthly screening test volumes (MTVs) were used to calculate the relative percent change in MTV to describe the monthly screening gap. RESULTS: The majority of facilities reported monthly screening deficits (colorectal cancer, 80.6% [n = 104/129]; cervical cancer, 69.0% [n = 20/29]; breast cancer, 55.3% [n = 241/436]; lung cancer, 44.6% [n = 98/220]). Overall, the median relative percent change in MTV ranged from -17.7% for colorectal cancer (interquartile range [IQR], -33.6% to -2.8%), -6.8% for cervical cancer (IQR, -29.4% to 1.7%), -1.6% for breast cancer (IQR, -9.6% to 7.0%), and 1.2% for lung cancer (IQR, -16.9% to 19.0%). Geographic differences were not observed. There were statistically significant differences in the percent change in MTV between institution types for colorectal cancer screening (P = .02). CONCLUSION: Cancer screening is still in need of urgent attention, and the screening resources made available online may help facilities to close critical gaps and address screenings missed in 2020.

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Section: Discussionmentioning

confidence: 99%

A national quality improvement study identifying and addressing cancer screening deficits due to the COVID‐19 pandemic

Joung

Nelson

Mullett

et al. 2022

Cancer

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“…Other studies looking at the recovery period demonstrated a similar return to prior screening rates without a catch-up period to close the gap in missed screenings, particularly in colorectal cancer screening [ 8 , 9 , 12 ]. This widely recognized screening gap supports concerns about increased morbidity and mortality related to the delayed diagnosis of these cancers [ 13 ]. Ultimately, these data support enhancing investments in colorectal cancer screening efforts, which may take the form of stimulus funding and/or unifying efforts of various stakeholders such as payers, health systems, community-based organizations, and testing laboratories.…”

Section: Discussionmentioning

confidence: 98%

Impact of the COVID-19 Pandemic on Colorectal and Prostate Cancer Screening in a Large U.S. Health System

et al. 2022

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During the first year of the coronavirus disease 2019 (COVID-19) pandemic, prevention measures included quarantining and facility closures. Because cancer screening is dependent on interventions in facilities, the extent of the COVID-19 impact on screening was questioned. A claims registry from a large health system was queried for colorectal and prostate cancer screening. A screening gap and screening loss ratio were calculated by comparing 2020 screening to historical reference years. All cancer screenings decreased in the first four months of the pandemic. Colorectal cancer screening returned to baseline in the latter six months of 2020. Prostate cancer screening exceeded baseline in the latter six months, but with a lesser gain than previous years. Populations disproportionately affected by decreased cancer screening included men and black people. To catch-up after the initial deficit in screening, it is estimated that the rate of colorectal cancer screening needs to increase by 50%.

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“…The DNA comes from cells in the lining of the colon and rectum that are shed and collect in stool as it passes through the large intestine and rectum. It should be repeated every 3 years[ 6 , 8 , 13 , 15 , 20 , 28 - 30 , 32 , 33 ].…”

Section: Screening and Surveillance For Colorectal Cancermentioning

confidence: 99%

“…The association of COVID-19 infection with elevation resulted in unreliability of the biomarker for surveillance of CRC during the COVID-19 pandemic. Social distancing and lockdown measures made access to colonoscopy difficult during the pandemic, and the use of open access colonoscopy and capsule colonoscopy in surveillance of CRC was encouraged[ 25 , 27 , 33 , 50 , 55 ].…”

Section: Screening and Surveillance For Colorectal Cancermentioning

confidence: 99%

Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic

Akbulut¹,

Hargura²,

Garzali³

et al. 2022

WJCC

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Management of colorectal cancer (CRC) was severely affected by the changes implemented during the pandemic, and this resulted in delayed elective presentation, increased emergency presentation, reduced screening and delayed definitive therapy. This review was conducted to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on management of CRC and to identify the changes made in order to adapt to the pandemic. We performed a literature search in PubMed, Medline, Index Medicus, EMBASE, SCOPUS, Reference Citation Analysis ( ) and Google Scholar using the following keywords in various combinations: Colorectal cancer, elective surgery, emergency surgery, stage upgrading, screening, surveillance and the COVID-19 pandemic. Only studies published in English were included. To curtail the spread of COVID-19 infection, there were modifications made in the management of CRC. Screening was limited to high risk individuals, and the screening tests of choice during the pandemic were fecal occult blood test, fecal immunochemical test and stool DNA testing. The use of capsule colonoscopy and open access colonoscopy was also encouraged. Blood-based tests like serum methylated septin 9 were also encouraged for screening of CRC during the pandemic. The presentation of CRC was also affected by the pandemic with more patients presenting with emergencies like obstruction and perforation. Stage migration was also observed during the pandemic with more patients presenting with more advanced tumors. The operative therapy of CRC was altered by the pandemic as more emergencies surgeries were done, which may require exteriorization by stoma. This was to reduce the morbidity associated with anastomosis and encourage early discharge from the hospital. There was also an initial reduction in laparoscopic surgical procedures due to the fear of aerosols and COVID-19 infection. As we gradually come out of the pandemic, we should remember the lessons learned and continue to apply them even after the pandemic passes.

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A Review of the Impact of the COVID-19 Pandemic on Colorectal Cancer Screening: Implications and Solutions

Cited by 12 publications

References 28 publications

A national quality improvement study identifying and addressing cancer screening deficits due to the COVID‐19 pandemic

A national quality improvement study identifying and addressing cancer screening deficits due to the COVID‐19 pandemic

Impact of the COVID-19 Pandemic on Colorectal and Prostate Cancer Screening in a Large U.S. Health System

Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic

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