INTERVAL CANCERS IN PATIENTS WITH HEREDITARY GASTROINTESTINAL SYNDROMES AFTER ONE YEAR OF THE SARS-COV-2 PANDEMIC

ABSTRACT

Background: Hereditary colorectal cancer syndromes require timely endoscopic surveillance. Aims: This study evaluated the approach of Italian gastroenterologists to the management of such patients. It then assessed the impact of SARS-CoV-2 on clinical outcomes, including interval cancers (cancers diagnosed during the time between two screening exams). Materials and methods: All members affiliated with the leading gastroenterology Italian societies (AIGO, SIED, and SIGE) received an online questionnaire. Data collection occurred between March 8, 2021, and May 3, 2021. Results: One hundred and twenty-one clinicians from 96 Italian hospitals answered, not necessarily experts in the field (males 73, 60.3%;average clinical experience 20.13±11.69 years). Many collected family history for genetic risk assessment (74.4%), but only 14.0% used online predictive software. 65.6% discussed cases in multidisciplinary units. Genetic analysis was available to most centers, but only a few hospitals offered dedicated endoscopy (19.0%), outpatient clinics (33.9%), or surgeries (23.1%). Since the start of the SARS-CoV-2 pandemic, clinicians noticed a reduction in the number of patients with hereditary colorectal cancer seen at follow-up. The number of clinicians with a high volume of patients decreased (from 38.8% to 28.1%). Almost half of the clinicians (45.5%) reported a delay in the surveillance (median 4-12 months). Ultimately, 30.6% detected one interval colorectal cancer or more in at least one of their patients. 8.1% reported up to five interval cancers. Conclusion: The SARS-CoV-2 pandemic directly affected the surveillance of hereditary colorectal cancer syndromes in Italy. The worst repercussion was the reported increase in interval cancers during the pandemic. This result was likely due to delays in their endoscopy surveillance. Surveillance should resume, to avoid the possible long-term consequences of its interruption, especially for hereditary colorectal cancer syndromes.(Figure Presented)(Figure Presented)