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Impact of SARS-CoV-2 Pandemic on Colorectal Cancer Screening Delay: Effect on Stage Shift and Increased Mortality.
Ricciardiello, Luigi; Ferrari, Clarissa; Cameletti, Michela; Gaianill, Federica; Buttitta, Francesco; Bazzoli, Franco; Luigi de'Angelis, Gian; Malesci, Alberto; Laghi, Luigi.
  • Ricciardiello L; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy. Electronic address: luigi.ricciardiello@unibo.it.
  • Ferrari C; Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy.
  • Cameletti M; Department of Management, Economics and Quantitative Methods, University of Bergamo, Bergamo, Italy.
  • Gaianill F; Gastroenterology and Endoscopy Unit, University Hospital of Parma, Parma, Italy.
  • Buttitta F; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
  • Bazzoli F; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
  • Luigi de'Angelis G; Department of Medicine and Surgery, University of Parma, Parma, Italy; Gastroenterology and Endoscopy Unit, University Hospital of Parma, Parma, Italy.
  • Malesci A; Department of Gastroenterology, Humanitas Research Institute and Humanitas University, Rozzano, Italy.
  • Laghi L; Department of Medicine and Surgery, University of Parma, Parma, Italy; Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Centre, Rozzano, Italy. Electronic address: luigiandreagiuseppe.laghi@unipr.it.
Clin Gastroenterol Hepatol ; 19(7): 1410-1417.e9, 2021 07.
Article in English | MEDLINE | ID: covidwho-1499706
Semantic information from SemMedBD (by NLM)
1. IMPACT gene PART_OF 2019 novel coronavirus
Subject
IMPACT gene
Predicate
PART_OF
Object
2019 novel coronavirus
2. IMPACT gene PART_OF 2019 novel coronavirus
Subject
IMPACT gene
Predicate
PART_OF
Object
2019 novel coronavirus
ABSTRACT
BACKGROUND &

AIMS:

The SARS-CoV-2 pandemic had a sudden, dramatic impact on healthcare. In Italy, since the beginning of the pandemic, colorectal cancer (CRC) screening programs have been forcefully suspended. We aimed to evaluate whether screening procedure delays can affect the outcomes of CRC screening.

METHODS:

We built a procedural model considering delays in the time to colonoscopy and estimating the effect on mortality due to up-stage migration of patients. The number of expected CRC cases was computed by using the data of the Italian screened population. Estimates of the effects of delay to colonoscopy on CRC stage, and of stage on mortality were assessed by a meta-analytic approach.

RESULTS:

With a delay of 0-3 months, 74% of CRC is expected to be stage I-II, while with a delay of 4-6 months there would be a 2%-increase for stage I-II and a concomitant decrease for stage III-IV (P = .068). Compared to baseline (0-3 months), moderate (7-12 months) and long (> 12 months) delays would lead to a significant increase in advanced CRC (from 26% to 29% and 33%, respectively; P = .008 and P < .001, respectively). We estimated a significant increase in the total number of deaths (+12.0%) when moving from a 0-3-months to a >12-month delay (P = .005), and a significant change in mortality distribution by stage when comparing the baseline with the >12-months (P < .001).

CONCLUSIONS:

Screening delays beyond 4-6 months would significantly increase advanced CRC cases, and also mortality if lasting beyond 12 months. Our data highlight the need to reorganize efforts against high-impact diseases such as CRC, considering possible future waves of SARS-CoV-2 or other pandemics.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Colorectal Neoplasms / Early Detection of Cancer / Delayed Diagnosis / COVID-19 Subject: Colorectal Neoplasms / Early Detection of Cancer / Delayed Diagnosis / COVID-19 Type of study: Diagnostic study / Screening study Language: English Journal: Clin Gastroenterol Hepatol Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Colorectal Neoplasms / Early Detection of Cancer / Delayed Diagnosis / COVID-19 Subject: Colorectal Neoplasms / Early Detection of Cancer / Delayed Diagnosis / COVID-19 Type of study: Diagnostic study / Screening study Language: English Journal: Clin Gastroenterol Hepatol Year: 2021
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