The impact of the COVID-19 pandemic on colorectal cancer services in England

ABSTRACT

Purpose: To assess the impact of the COVID-19 pandemic in England on diagnoses and treatments for colorectal cancer (CRC), and evaluate the variation in deficit of diagnoses and major resections by age and deprivation Methods: Rapid Cancer Registrations Data were used, linked to Hospital Episode Statistics, the Systemic Anti-Cancer Therapy Dataset and the National Radiotherapy Dataset. 33,814 patients newly diagnosed with CRC 1 January 2019 to 31 March 2021 were included Results: There was a large deficit in new CRC diagnoses and treatments early in the pandemic. There was still an 8.6% deficit in new CRC diagnoses by March 2021, a 17.6% deficit in major resections by end 2020, a 21.9% deficit in adjuvant chemotherapy by February 2021, but little deficit in curative radiotherapy for rectal cancer by March 2021. By March 2021 those just below and just above screening age had the largest deficits of new diagnoses. The most deprived patients had the largest deficit of diagnoses and major resections (20 to 21% deficit in major resections in the two most deprived quintiles compared to 16 to 17% in the other quintiles) Conclusion(s) Ongoing efforts to promote and raise awareness of bowel cancer signs and symptoms should continue to try to mitigate the delays in bowel cancer diagnoses during the pandemic, with particular focus on the most deprived and on those just below and just above screening age. Further work is needed to understand the reasons for the association between socioeconomic deprivation and deficit in diagnoses and major resections.