The burden of COVID-19 pandemic extended to patients seeking colorectal (CRC) screening as the disparity gap resulting from socioeconomic and race or ethnicity widened, Saeed Soleymanjahi, MD, said during an abstract presentation at the Digestive Disease Week (DDW) 2023 in Chicago.

Dr Soleymanjahi is a resident in internal medicine at the Yale New Haven Hospital in New Haven, Connecticut.

This topic of how racial and socioeconomic disparities in times of COVID-19 have affected patients in receiving colorectal cancer screening recommendations in the United States was covered in a session on health care disparities and colon cancer screening at DDW .

Dr Soleymanjahi said that even though CRC screening has been recommended to patients for years, one-third of the American population is not up-to-date with the guidelines. The COVID-19 pandemic worsened the numbers even more according to a study that Dr Soleymanjahi undertook with his colleagues analyzing the 2019 and 2021 database from the National Health Interview Survey in a retrospective cross-sectional study.

They included 4270 patients from 2019 and 3634 patients from 2020 who had no prior CRC and were not up-to-date with CRC screening. “In addition to analysis of the pooled dataset, we conducted separate analyses for 2019 and 2021 to determine if the COVID pandemic disproportionally impacted screening recommendations for specific populations,” he said.

In 2019, only 1015 (22.22%) eligible adults received recommendations for CRC screening. In 2021, only 660 (17.9%) of the eligible adults received the guideline-based screening. Dr Soleymanjahi said the factors that most likely affected the low screening numbers included low income, lack of insurance, racial and ethnic minorities, and no access to a usual care facility.

In 2021, disparities related to race and insurance coverage became more pronounced. “Also, the higher likelihood of referral in patients with higher education in 2019 was not seen in 2021,” he noted.

The pandemic worsened the screening numbers for patients with CRC either due to financial constraints or minority bias. The gap widened further among ethnic minorities and the uninsured during the COVID-19 pandemic. “Targeted efforts are even more needed as a result of the pandemic in order to decrease the disparities gap in CRC screening,” Dr Soleymanjahi suggested.

Reference:
Soleymanjahi S. Abstract presentation #30: Impact of the COVID-19 pandemic on racial and socio-economic disparities on receiving colorectal cancer screening recommendations in the United States. Digestive Disease Week 2023. Chicago, Illinois.