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COLONOSCOPY FOLLOWING COVID-19 DELAYS IN PROCEDURES: A SURGE IN NEW COLON CANCER DIAGNOSES
Gastroenterology ; 162(7):S-495, 2022.
Article in English | EMBASE | ID: covidwho-1967328
ABSTRACT

Background:

Colorectal cancer (CRC) screening volume declined by as much as 90% during the coronavirus 2019 (COVID-19) pandemic. The incidence of new patient encounters for CRC also dropped during 2020. CRC screening delays due to COVID-19 have raised concerns about CRC disease upstaging through 2030. In addition to expanding fecal immunochemical testing (FIT) programs, efforts to systematically schedule patients at higher risk for CRC should be an essential mitigation strategy after COVID-19 delays. The effect of COVID-19 delays on CRC incidence remains unknown.

Methods:

We conducted a single-center, retrospective cohort study assessing incident CRC following COVID-related delays in colonoscopic procedures. COVID-19 pandemic was used as an independent exposure event, defined as “pre-COVID” (June 1, 2019 to August 31, 2019) and “COVID-delayed” (June 1, 2020 to August 31, 2020). The odds of a pathology-confirmed CRC diagnosis with staging were assessed. ANOVA, Chi-square test, and Fisher Exact Test, where necessary, were used to determine the unadjusted odds ratio (OR) with a 95% confidence interval (CI).

Results:

A total of 852 pre-COVID patients and 245 patients following COVID-scheduling delays underwent colonoscopy. The average age between cohorts was similar (pre-COVID 63.2+/- 10.5 vs. COVID-delayed 62.2 +/-12.6). About 90% of the patients were male, with about 63% self-identifying as White in both cohorts. An increased odds of CRC was detected in the COVID-delay period (9/245 CRC cases;3.7%), compared with the pre-COVID period (8/852 cases;0.9%;OR = 4.02;95% CI 1.54-10.54). There was also a trend toward upstaging of disease with 55.5% of CRC diagnosed patients having Stage III/IV in the COVID-delayed period compared to only 25% having Stage III/IV disease in the pre-COVID period (p= 0.34).

Conclusion:

Colonoscopy delays imposed during the COVID-19 pandemic were associated with the postponement of critical CRC diagnoses. Increased use of FIT testing, along with ongoing optimization of colonoscopy triage strategies, are necessary to mitigate the effects of ongoing COVID pandemic-related CRC screening/surveillance scheduling delays
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Gastroenterology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Gastroenterology Year: 2022 Document Type: Article