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
adult; analysis of variance; cancer diagnosis; cancer incidence; cancer patient; cancer screening; cancer staging; cohort analysis; colon cancer; colonoscopy; colorectal cancer; conference abstract; controlled study; coronavirus disease 2019; feces; Fisher exact test; human; major clinical study; male; middle aged; pandemic; patient triage; retrospective study
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Gastroenterology
Year:
2022
Document Type:
Article
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