Pandemic-Related Delays in CRC Screening Can Affect Outcomes

Pandemic lockdowns that delay colorectal cancer screening more than 6 months would increase the number of advanced cases detected at screening, estimates suggest, while delays longer than 12 months would increase mortality rates. Researchers from Italy published their findings in Clinical Gastroenterology and Hepatology.

“The SARS-CoV-2 pandemic had a sudden, dramatic impact on health care. In Italy, since the beginning of the pandemic, colorectal cancer screening programs have been forcefully suspended,” the authors wrote. “We aimed to evaluate whether screening procedure delays can affect the outcomes of colorectal cancer screening.”

The study used a rigorous, meta-analytical model to estimate the effects of pandemic lockdown colorectal cancer screening delays on the Italian population.

Compared with a 26% advanced colorectal cancer rate at baseline, moderate delays between 7 and 12 months in colorectal cancer screening increased the advanced colorectal cancer rate to 29%, according to the study. Long delays beyond 12 months resulted in a 33% rate of advanced colorectal cancer.

Deaths increased 12% with screening delays beyond 12 months. The study also identified a significant change in mortality distribution by stage with long screening delays.

“Our data highlight the need to avoid breaking the workflow of colorectal cancer screening beyond 12 months in the light of possible future waves of SARS-CoV-2 or other pandemics,” researchers advised.

—Jolynn Tumolo

Reference

Ricciardiello L, Ferrari C, Cameletti M, et al. Impact of SARS-CoV-2 pandemic on colorectal cancer screening delay: effect on stage shift and increased mortality. Clin Gastroenterol Hepatol. 2021;19(7):1410-1417.e9.