Non-compliance with colonoscopy after a positive faecal immunochemical test doubles the risk of dying from colorectal cancer

Zorzi, Manuel; Battagello, Jessica; Selby, Kevin; Capodaglio, Giulia; Baracco, Susanna; Rizzato, Silvia; Chinellato, Enrico

doi:10.1136/gutjnl-2020-322192

Cited by 43 publications

(43 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study shows how essential is achieving a high participation rate in the screening programme. Moreover, it is very important to ensure that people complete the screening process (having a conclusive FOBT result and completing colonoscopy after a positive FOBT) [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

et al. 2021

View full text Add to dashboard Cite

Introduction The effectiveness of colorectal cancer (CRC) screening programs is directly related to participation and the number of interval CRCs. The objective was to analyse specific-mortality in a cohort of individuals invited to a CRC screening program according to type of CRC diagnosis (screen-detected cancers, interval cancers, and cancers among the non-uptake group). Material and methods Retrospective cohort that included invitees aged 50–69 years of a CRC screening program (target population of 85,000 people) in Catalonia (Spain) from 2000–2015 with mortality follow-up until 2020. A screen-detected CRC was a cancer diagnosed after a positive faecal occult blood test (guaiac or immunochemical); an interval cancer was a cancer diagnosed after a negative test result and before the next invitation to the program (≤24 months); a non-uptake cancer was a cancer in subjects who declined screening. Results A total of 624 people were diagnosed with CRC (n = 265 screen-detected, n = 103 interval cancers, n = 256 non-uptake). In the multivariate analysis, we observed a 74% increase in mortality rate in the group with interval CRC compared to screen-detected CRC adjusted for age, sex, location and stage (HR: 1.74%, 95% CI:1.08–2.82, P = 0.02). These differences were found even when we restricted for advanced-cancers participants. In the stratified analysis for type of faecal occult blood test, a lower mortality rate was only observed among FIT screen-detected CRCs. Conclusion CRC screening with the FIT was associated with a significant reduction in CRC mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 32 Other screening methods may be conducted through telehealth visits, such as non-invasive fecal immunochemical test (n-FIT), but positive results still require prompt diagnostic follow-up, requiring in-person visits. 33 …”

Section: Discussionmentioning

confidence: 99%

Trends of Cancer Screenings, Diagnoses, and Mortalities During the COVID-19 Pandemic: Implications and Future Recommendations

Concepcion

Yeager

Alfaro

et al. 2022

The American Surgeon™

View full text Add to dashboard Cite

Introduction The impact of the COVID-19 pandemic on cancer screenings and care has yet to be determined. This study aims to investigate the screening, diagnosis, and mortality rates of the top five leading causes of cancer mortality in the United States from 2019 to 2021 to determine the potential impact of the COVID-19 pandemic on cancer care. Methods A retrospective cohort study investigating the impact of the COVID-19 pandemic on screening, diagnoses, and mortality rates of the top five leading causes of cancer death (lung/bronchus, colon/rectum, pancreas, breast, and prostate), as determined by the National Institute of Health (NIH) utilizing The United States Healthcare Cost Institute and American Cancer Society databases from 2019 to 2021. Results Screenings decreased by 24.98% for colorectal cancer and 16.01% for breast cancer from 2019 to 2020. Compared to 2019, there was a .29% increase in lung/bronchus, 19.72% increase in colorectal, 1.46% increase in pancreatic, 2.89% increase in breast, and 144.50% increase in prostate cancer diagnoses in 2020 (all P < .01). There was an increase in the total number of deaths from colorectal, pancreatic, breast, and prostate cancers from 2019 to 2021. Conclusion There was a decrease in the screening rates for breast and colorectal cancer, along with an increase in the estimated incidence and mortality rate among the five leading causes of cancer deaths from 2019 to 2021. The findings suggest that the COVID-19 pandemic is associated with impaired cancer screening, diagnosis, and care, and further emphasizes the need for proactive screening and follow-up to prevent subsequent cancer morbidity and mortality.

show abstract

“…A timely DC after a positive FIT is a critical step in the CRC screening continuum [4][5][6][7]15]. Flemish data previously supported the importance of a timely DC after a positive FIT [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…Although the screening interval and uptake rate seem to be minimally affected in Flanders, the willingness of a participant with a positive FIT to undergo a DC might be influenced, and the time interval between a positive FIT and DC might have increased due to the COVID-19 pandemic. A delayed DC after a positive FIT may lead to more advanced-stage CRC at the time of diagnosis and increases CRC mortality [4,5]. Flemish data (2013-2017) also indicate that CRCs detected in FIT-positive patients without a DC within 12 months are significantly more frequently diagnosed in stage III (19.7%) and stage IV (12.2%) compared to CRCs detected in FIT-positive patients with a DC within 12 months (9.4% and 2.0%, respectively) [6].…”

Section: Introductionmentioning

confidence: 99%

Self-Reported and Objective Impact of the COVID-19 Pandemic on Planning, Compliance and Timeliness of a Diagnostic Colonoscopy after a Positive FIT Screening Result in the Flemish Colorectal Cancer Screening Program

Hoeck

Janssens²,

Hal

et al. 2022

Gastrointestinal Disorders

View full text Add to dashboard Cite

Background: During the COVID-19 pandemic, the Flemish colorectal cancer (CRC) screening program (by fecal immunochemical test, FIT) was suspended and non-urgent medical procedures were discommended. This study estimates how this impacted diagnostic colonoscopy (DC) scheduling after a positive FIT and the interval between both in 2020. Methods: An online survey was sent to participants in the Flemish CRC screening program with a positive FIT but without a DC to explore the possible impact of COVID-19 on the scheduling of a DC. Self-reported survey results were complemented with objective data on DC compliance and the interval between FIT and DC. Results: In 2020, DC compliance was 4–5% lower than expected (for 3780 positive FITs no DC was performed). In February–March 2020, the median time between a positive FIT and DC significantly increased. Survey participants reported fear of COVID-19 contamination, perception to create hospital overload, delay in non-urgent medical procedures (on government advice) and not being sure a DC could be performed as contributing reasons. Conclusions: On top of a 3% lower participation, the COVID-19 pandemic further increased existing DC non-compliance and the positive FIT–DC interval. The survey confirmed the crucial role of COVID-19 in the decision not to plan a DC.

show abstract

Non-compliance with colonoscopy after a positive faecal immunochemical test doubles the risk of dying from colorectal cancer

Cited by 43 publications

References 28 publications

Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

Trends of Cancer Screenings, Diagnoses, and Mortalities During the COVID-19 Pandemic: Implications and Future Recommendations

Self-Reported and Objective Impact of the COVID-19 Pandemic on Planning, Compliance and Timeliness of a Diagnostic Colonoscopy after a Positive FIT Screening Result in the Flemish Colorectal Cancer Screening Program

Contact Info

Product

Resources

About