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

Kelkar, Amar H.; Zhao, Jing; Wang, Shu; Cogle, Christopher R.

doi:10.3390/healthcare10020264

Cited by 16 publications

(17 citation statements)

References 13 publications

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“…43 In the United States, men and black people were disproportionately affected by decreased colorectal cancer screening, and to redress this deficit, it is estimated that rates of colorectal cancer screening need to increase by 50%. 42 Although many screening programs have resumed, the long-term impact of the pandemic on cancer screening and the prevalence of cancer as a result is not yet known. 41 A systematic review of the impact of the pandemic on colorectal cancer diagnosis and treatment, found a reduction in diagnosis and treatment, and that redressing the deficit requires strong and effective action to prevent negative consequences such as the number of people with advanced stages of cancer, potential increased treatment costs, quality of life and survival rates.…”

Section: Discussionmentioning

confidence: 99%

“…The pandemic negatively disrupted routine clinical care, with cancer programs such as screening no exception. Many programs were canceled or postponed, especially in 2020, a period of isolation measures such as lockdowns put in place to contain the spread of the virus 42 . These measures left people without access to recommended routine screening interventions, which were suggested to impact patients, healthcare professionals, and healthcare systems 43 .…”

Section: Discussionmentioning

confidence: 99%

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A systematic review of obesity as a barrier to accessing cancer screening services

Graham

Hayes²,

Cox

et al. 2022

Obesity Science & Practice

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Introduction:Obesity is a known risk factor for the development of cancers, and a significant proportion of the population may be at risk of developing cancer owing to their weight status. There is acknowledged societal stigma towards people living with obesity, which can influence health behaviors and deter help seeking, such as cancer screening. Healthcare professionals' attitudes and views toward people living with obesity may adversely affect the patient-professional interface and treatment.Methods: A systematic review was carried out which aimed to explore the impact of living with obesity on the uptake of three main cancer-screening services: breast, cervical, and colorectal.Results: Ten studies were included in the review. Three main areas were identified from both a patient and healthcare professional perspective: barriers and challenges to screening, gender issues, and disparities in the population living with obesity. Conclusion:Further research is needed to improve uptake of cancer screening services, and for education on weight bias, which is often unconscious, to be considered for healthcare professionals working in cancer screening services. This may help to increase the incidence of early differential diagnosis of potential cancers and improve health outcomes for people living with obesity. K E Y W O R D Sbarriers, cancer screening, obesity | INTRODUCTIONObesity (BMI kg/m 2 ) is a known risk factor for the development of cancers 1,2 with evidence suggesting an increase in cancers such as breast in postmenopausal women, colorectal (higher risk in males), endometrial, esophageal adenocarcinoma, gall bladder, and renal. 1,3 Gender differences in cancer risk among people living with obesity, including the incidence of esophageal, liver, and colorectal cancer, due in part to disparities in body fat distribution between men and women, 4 The rates of obesity have tripled globally since 1975, and as of 2016, the World Health Organization estimated there were 650 million people living with obesity. 5 By 2030, the rates are predicted to increase to one in five women and one in seven men, meaning over 1 billion people across the globe will be living with obesity. 6 Notably,This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A systematic review of obesity as a barrier to accessing cancer screening services

Graham

Hayes²,

Cox

et al. 2022

Obesity Science & Practice

View full text Add to dashboard Cite

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“… 29 To catch-up to this backlog of screening colonoscopies, it has been estimated that the colonoscopy capacity should be expanded up to 150%. 30 Indeed, in the Netherlands, after the CRC screening halt, colonoscopy availability was expanded up to 120%, achieving a catch-up effect in the second part of 2020. 31 However, increasing the colonoscopy capacity is not possible for every health system, so it has been suggested that increasing FIT cutoff or using specific risk factors (male sex and advanced age) could be an effective strategy to prioritize access to colonoscopies and reduced the number of CRC or advanced adenomas underdiagnosed in a CRC screening program, compared with randomly reducing the number of population screened.…”

Section: Impact Of Covid-19 Pandemic In Crc Screeningmentioning

confidence: 99%

The impact of COVID-19 pandemic in the diagnosis and management of colorectal cancer patients

Domper-Arnal

Mallada

Lanas

2022

Therap Adv Gastroenterol

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The novel coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to healthcare systems worldwide, causing downscaling of almost all other activities, especially in its early stages. Currently, the availability of vaccines along with the spread of new viral variants has modified the epidemiology of the disease, and the previous activity is being gradually resumed in most healthcare facilities. In this review, we have summarized the influence of the COVID-19 pandemic in the diagnosis and management of colorectal cancer (CRC) patients. Population-based screening with either colonoscopy or fecal occult blood tests has proven to reduce CRC incidence and mortality, so screening programs have been implemented in most western countries. However, during the first COVID-19 wave, most of these programs had to be disrupted temporarily. In this review, we have thoroughly analyzed the consequences of these disruptions of screening programs as well as of the forced delays in diagnostic and therapeutic services on CRC prognosis, although its exact impact cannot be exactly measured yet. In any way, strategies to minimize its effect, such as catch-up strategies expanding the colonoscopy capacity or using fecal occult blood concentration and other risk factors to prioritize patients, are urgently needed. The COVID-19 pandemic has also led to a change in CRC patient presentation, with an overall temporary decreased incidence due to postponed diagnoses, but with more patients presenting in need of an emergency admission or with symptoms. Finally, changes in treatment approaches in CRC patients have been reported during the pandemic, namely a drop in the proportion of laparoscopic surgeries or a rise in short-term radiotherapy courses. We have therefore aimed to summarize the available evidence to guide the healthcare professionals treating CRC patients to choose the best treatment options in the current pandemic situation.

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“…Evidence from hospital records or insurance claims have suggested that, compared to pre-pandemic levels, mammograms, pap smears and colonoscopies declined 60% to 90% in March/April 2020 (Duszak et al 2020;Bakouny et al 2021;Staib, Catlett, and DaCosta Byfield 2021. However, subsequent research has found that in the later months of 2020, claims and records of cancer screenings returned to pre-pandemic levels (Chen et al 2021); DeGroff et al 2021;Labaki et al 2021;McBain et al 2021;Bello, Chang, and Massarweh 2022;Drescher et al 2022). Still, the pandemic created a major cancer screening deficit which may be difficult to address despite recent investment in "return to screening" initiatives (Chen et al 2021;Hanna et al 2022;Kelkar et al 2022). Even as America returns to screening, some are being left behind (Mafi et al 2022.…”

Section: Introductionmentioning

confidence: 99%

“…However, subsequent research has found that in the later months of 2020, claims and records of cancer screenings returned to pre-pandemic levels (Chen et al 2021); DeGroff et al 2021; Labaki et al 2021; McBain et al 2021; Bello, Chang, and Massarweh 2022; Drescher et al 2022). Still, the pandemic created a major cancer screening deficit which may be difficult to address despite recent investment in “return to screening” initiatives (Chen et al 2021; Hanna et al 2022; Kelkar et al 2022). Even as America returns to screening, some are being left behind (Mafi et al 2022.…”

Section: Introductionmentioning

confidence: 99%

The 2020 U.S. cancer screening deficit and the timing of adults' most recent screen: A population-based quasi-experiment

Semprini

Ranganathan

2022

Preprint

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In 2020, cancer screenings declined, then rebounded, resulting in a cancer screening deficit. The significance of this deficit, however, has yet to be quantified from a population health perspective. Our study addresses this evidence gap by examining how the pandemic changed the timing of American adults' most recent cancer screen. We obtained population-based, cancer screening data from the Behavioral Risk Factor Surveillance System. Mammograms, pap smears, and colonoscopies were each specified as a variable of mutually exclusive categories to indicate the timing since the most recent screening (never, 0-1 years, 1-2 years, 3+ years). Our quasi-experimental design restricts the sample to adults surveyed in January, February, or March. We then leverage a quirk in the BRFSS implementation and consider adults surveyed in the second year of each survey wave as the quasi-treatment cohort. Next, we constructed Linear and Logistic regression models which control for exogenous sociodemographic characteristics, state fixed effects, and temporal trends. Our results suggest that the deficit in 2020 was largely due to a one year delay among adults who receive annual screening, as the proportion of adults reporting a cancer screen in the past year declined by a nearly identical proportion of adults reporting their most recent cancer screen 1-2 years ago (3\% to 4\% points). However, the relative change was higher for mammograms and pap smears (17\%) than colonoscopies (4\%). We also found some evidence that the proportion of women reporting never having completed a mammogram declined in 2020, but the mechanisms for this finding should be further explored with the release of future data. Our estimates for the pandemic's effect on cancer screening rates are smaller than prior studies, but because we account for temporal trends we believe prior studies overestimated the effect of the pandemic and underestimated the overall downward trend in cancer screenings across the country leading up to 2020.

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

Cited by 16 publications

References 13 publications

A systematic review of obesity as a barrier to accessing cancer screening services

A systematic review of obesity as a barrier to accessing cancer screening services

The impact of COVID-19 pandemic in the diagnosis and management of colorectal cancer patients

The 2020 U.S. cancer screening deficit and the timing of adults' most recent screen: A population-based quasi-experiment

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