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The impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention.
Holland, Jessica; Cwintal, Michelle; Rigas, Georgia; Pang, Allison J; Vasilevsky, Carol-Ann; Morin, Nancy; Ghitulescu, Gabriela; Faria, Julio; Boutros, Marylise.
  • Holland J; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada.
  • Cwintal M; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada.
  • Rigas G; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada.
  • Pang AJ; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada.
  • Vasilevsky CA; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada.
  • Morin N; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada.
  • Ghitulescu G; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada.
  • Faria J; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada.
  • Boutros M; Division of Colon and Rectal Surgery, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Room G-308, Montreal, QC, H3T 1E2, Canada. marylise.boutros@mcgill.ca.
Surg Endosc ; 36(12): 9364-9373, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1802727
ABSTRACT

PURPOSE:

The COVID-19 pandemic resulted in a partial to total shutdown of endoscopy in many healthcare centers. This study aims to quantify the impact of the reduction in colonoscopies on colorectal cancer (CRC) detection and screening.

METHODS:

After institutional ethics board approval, the endoscopy database at an academic tertiary-care center in Montreal, Canada, was searched for all colonoscopies performed from during the first wave locally (March-June 2020), and during the ramp up period where endoscopy service resumed (July to August 2020). We compared these periods to the same periods in 2019, the pre-pandemic periods. The indications, CRC and adenoma detection rates, as well as the prioritization of urgent procedures were compared.

RESULTS:

In the first wave, only 462 colonoscopies were performed, compared to 2515 in the same period in 2019, an 82% reduction. The ramp up period saw 843 colonoscopies performed compared to 1328 in 2019, a 35% reduction. Urgent and inpatient colonoscopies numbers increased (324 (24.8%) vs. 220 (5.7%)) while surveillance and high-risk screening colonoscopies fell (376 (28.8%) vs 1869 (48.6%)). Emergency access to colonoscopy was preserved with a median time to endoscopy of < 1 day (IQR 0,1) in both pandemic periods. During the pandemic periods, there was an absolute reduction in CRC diagnosis of 28, despite the CRC detection per colonoscopy rate increasing slightly in the first wave from 1.7% (44) to 3.9% (18), and in the ramp up period from 2.5% (33) to 3.6% (31). The rate of adenoma detection per colonoscopy did not increase significantly between the pre- and pandemic periods, resulting in reduction in adenoma removal in 723 patients.

DISCUSSION:

The restriction of access to colonoscopy resulted in a significant reduction in screening and surveillance of high-risk patients, adenomas removed, and CRCs diagnosed. Clinicians and patients will face the oncologic ramifications this the coming years.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Adenoma / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Surg Endosc Journal subject: Diagnostic Imaging / Gastroenterology Year: 2022 Document Type: Article Affiliation country: S00464-022-09211-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Adenoma / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Surg Endosc Journal subject: Diagnostic Imaging / Gastroenterology Year: 2022 Document Type: Article Affiliation country: S00464-022-09211-z