Colorectal cancer (CRC) accounts for many deaths due to malignancy. Screening is known to enable early detection and the removal of precancerous lesions, reducing the cancer burden.
The effect of the coronavirus disease 2019 (COVID-19) pandemic on such programs is explored in a recent paper published as part of the Discovery Series.
Study
In countries with participation data for 2020, the model results showed reduced CRC screening. The reduction ranged from just above 1% to 40%.
There were over seven million fewer fecal screening tests for CRC globally in 2020 globally. About 40% of the deficit occurred in countries with organized screening vs. the rest in countries where screening data was unavailable.
The decreased participation in screening would result in over 10,500 CRC diagnoses in 2020. These would be caught possibly in more advanced stages of the disease or during later screening rounds.
If catch-up screening were not carried out in 2021, this would mean 13,000 more cases of CRC and almost 8,000 more deaths than expected between 2020 and 2050. On the other hand, these figures would be lowered by nearly 80% and 85%, respectively, by such compensatory screening programs.
Any decrease in CRC screening would cause a higher cancer burden over 2020-2050. For instance, opportunistic screening was missed in almost four million individuals in the USA from March to May 2020. This could result in nearly 41,000 cases of CRC, with 17,000 deaths, by 2050.
Conversely, the scientists found that catch-up screening would reduce cases and mortality by 73–88% and 81–94%, respectively.
Conclusion
The interruption of routine medical care, such as CRC screening, because of the pandemic is likely to cause an increase in CRC cases and mortality. However, properly conducted catch-up screening could capture most excess cases and prevent most excess deaths.
The current study modeled various scenarios to cover a range of possibilities, making it likely that the observed disruption and the impact for any given country would lie within this range. Similar is the case for catch-up screening, where the rate will be somewhere between ‘no catch-up’ and ‘full catch-up.’
Despite the administrative difficulties of catch-up screening, it is important to prioritize it in view of the loss of human health and lives.
For instance, the scientists found that mass media campaigns could be expensive and cost-effective in bringing more people into the screening net, thus avoiding unnecessary deaths from CRC.
Other measures include managing the capture rate from catch-up screening. For instance, healthcare systems could consider adjusting screening thresholds or having a longer interval for catch-up screening, thus helping those at higher risk to get the earliest care.
Despite the limitations in data availability, such modeling studies could help improve policies to reduce the impact of large-scale disruptions such as those caused by the COVID-19 pandemic.
Source:
https://www.news-medical.net/news/20230724/Modeling-the-impact-of-COVID-19-on-colorectal-cancer-screening-and-outcomes.aspx