Impact of the COVID-19 pandemic on colorectal cancer screening in New York City

Abstract

Background The COVID-19 pandemic significantly impacted the delivery of cancer screening. The resulting decrease in outpatient visits and cancellations of non-urgent procedures have negatively affected colorectal cancer (CRC) screening. We aimed to determine the effect of the pandemic on CRC screening at a safety-net hospital and a private health system based in New York City. Methods We identified individuals eligible for CRC screening aged 50 to 75 years presenting for outpatient care at a safety-net public hospital and private health system in April through September of 2019 and 2020. The primary outcome was the proportion of screening-eligible patients seen in primary care who underwent CRC screening. Results The safety-net hospital had 516 (6.1% of screening-eligible individuals) and 269 (4.3%) screening tests completed in 2019 and 2020, respectively (p < 0.01). Fecal immunochemical tests (FIT) accounted for 69.6% of screening in 2019 and 88.1% in 2020. Colonoscopy accounted for 20.3% of screening in 2019 and 11.9% in 2020. The private health system had 39 (0.7%) and 21 (0.6%) screening tests completed in 2019 and 2020, respectively (p = 0.48). FIT accounted for 61.9% of screening in 2019 and 57.1% in 2020. Colonoscopy accounted for 38.1% of screening in 2019 and 42.9% in 2020. Conclusion Absolute numbers of screening tests decreased for both institutions during the COVID-19 pandemic. We observed a decrease in screening uptake and increase in proportional FIT use in the safety-net hospital but no change in the private health system.

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

“…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].…”

Head and Neck Cancer Patient Population, Management, and Oncologic Outcomes from the COVID-19 Pandemic

“…Consistent with previously-reported disparities evident during the COVID-19 pandemic [28][29][30][31][32][33][34], the gender of the head and neck population significantly differed between cohorts with females comprising 42% of the population in 2019 and only 24% in 2020 (p = 0.036). This disparity is evident in other databases that demonstrate a decrease in the proportion of female patients presenting to medical centers during the pandemic vs. pre-pandemic [35][36][37]. It is possible the gender disparity demonstrated in this study is a downstream effect of the disproportionate burden placed on women during the pandemic including existing gender inequalities in the workforce, labor market segregation, and childcare responsibilities [32][33][34][38][39][40][41].…”

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

“…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 participation, adherence to the screening test, and changes in the probability of detecting CRC. [12,13] We have detected a result that deserves a comment. Long delays between the positive FIT and colonoscopy were significantly associated with a reduced risk of CRC detection.…”