Model-Based Estimation of Colorectal Cancer Screening and Outcomes During the COVID-19 Pandemic.
JAMA Netw Open
; 4(4): e216454, 2021 04 01.
Article
in English
| MEDLINE | ID: covidwho-1176229
ABSTRACT
Importance COVID-19 has decreased colorectal cancer screenings. Objective:
To estimate the degree to which expanding fecal immunochemical test-based colorectal cancer screening participation during the COVID-19 pandemic is associated with clinical outcomes. Design, Setting, andParticipants:
A previously developed simulation model was adopted to estimate how much COVID-19 may have contributed to colorectal cancer outcomes. The model included the US population estimated to have completed colorectal cancer screening pre-COVID-19 according the American Cancer Society. The model was designed to estimate colorectal cancer outcomes between 2020 and 2023. This analysis was completed between July and December 2020. Exposures Adults screened for colorectal cancer and colorectal cancer cases detected by stage. Main Outcomes andMeasures:
Estimates of colorectal cancer outcomes across 4 scenarios (1) 9 months of 50% colorectal cancer screenings followed by 21 months of 75% colorectal cancer screenings; (2) 18 months of 50% screening followed by 12 months of 75% screening; (3) scenario 1 with increased use of fecal immunochemical tests; and (4) scenario 2 with increased use of fecal immunochemical tests.Results:
In our simulation model, COVID-19-related reductions in care utilization resulted in an estimated 1â¯176â¯942 to 2â¯014â¯164 fewer colorectal cancer screenings, 8346 to 12â¯894 fewer colorectal cancer diagnoses, and 6113 to 9301 fewer early-stage colorectal cancer diagnoses between 2020 and 2023. With an abbreviated period of reduced colorectal cancer screenings, increasing fecal immunochemical test use was associated with an estimated additional 588â¯844 colorectal cancer screenings and 2836 colorectal cancer diagnoses, of which 1953 (68.9%) were early stage. In the event of a prolonged period of reduced colorectal cancer screenings, increasing fecal immunochemical test use was associated with an estimated additional 655â¯825 colorectal cancer screenings and 2715 colorectal cancer diagnoses, of which 1944 (71.6%) were early stage. Conclusions and Relevance These results suggest that the increased use of fecal immunochemical tests during the COVID-19 pandemic was associated with increased colorectal cancer screening participation and more colorectal cancer diagnoses at earlier stages. If our estimates are borne out in real-world clinical practice, increasing fecal immunochemical test-based colorectal cancer screening participation during the COVID-19 pandemic could mitigate the consequences of reduced screening rates during the pandemic for colorectal cancer outcomes.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
/
Outcome Assessment, Health Care
/
Early Detection of Cancer
/
COVID-19
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
JAMA Netw Open
Year:
2021
Document Type:
Article
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