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Modelling the impact of the coronavirus pandemic on bowel cancer screening outcomes in England: A decision analysis to prepare for future screening disruption.
Mandrik, Olena; Chilcott, James; Thomas, Chloe.
  • Mandrik O; School of Health and Related Research, Health Economics and Decision Science, University of Sheffield, Regent Court, Sheffield S1 4DA, UK. Electronic address: o.mandrik@sheffield.ac.uk.
  • Chilcott J; School of Health and Related Research, Health Economics and Decision Science, University of Sheffield, Regent Court, Sheffield S1 4DA, UK.
  • Thomas C; School of Health and Related Research, Health Economics and Decision Science, University of Sheffield, Regent Court, Sheffield S1 4DA, UK.
Prev Med ; 160: 107076, 2022 07.
Article in English | MEDLINE | ID: covidwho-1821533
ABSTRACT
The English Bowel Cancer Screening Programme invites people between the ages of 60 and 74 to take a Faecal Immunochemical Test every two years. This programme was interrupted during the coronavirus pandemic. The research aimed (1) to estimate the impact of colorectal cancer (CRC) Faecal Immunochemical Test screening pauses of different lengths and the actual coronavirus-related screening pause in England, and (2) to analyse the most effective and cost-effective strategies to re-start CRC screening to prepare for future disruptions. The analysis used the validated Microsimulation Model in Cancer of the Bowel built in the R programming language. The model simulated the life course of a representative English screening population from 2019, by age, sex, socio-economic deprivation, and prior screening history. The modelling scenarios were based on assumptions and data from screening centres in England. Pausing bowel screening in England due to coronavirus pandemic is predicted to increase CRC deaths by 0.73% within 10 years and 0.13% over the population's lifetime, with excess deaths due to peak in 2023. More deaths are expected in men and people aged over 70. Pausing screening for longer would result in greater additional CRC cases and deaths. Postponing screening for everyone would be the most cost-effective strategy to minimise the impact of screening disruption without any additional endoscopy capacity. If endoscopy capacity can be increased, temporarily raising the Faecal Immunochemical Test threshold to 190 µg/g may help to minimise CRC deaths, particularly if screening programmes start from age 50 in the future.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Coronavirus Infections / Coronavirus Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Prev Med Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Coronavirus Infections / Coronavirus Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Prev Med Year: 2022 Document Type: Article