COVID-19 Delays Colorectal Cancer Screening Interventions

Fall in the diagnosed number of cases diagnosed for colorectal cancer by 40% is because of the drop in screening and early diagnoses of the disease, possibly hindered by COVID-19 pandemic, reports new research presented today at UEG Week Virtual 2021. After comparing the data collected from multiple healthcare facilities in Spain for 2019, (beginning of COVID) and 2018, the numbers indicated a 27% drop in screening and colonoscopy. Nearly two-thirds of the 1,385 cases of CRC diagnosed over the two years (868 cases, or 62.70 percent) were discovered during the pre-pandemic year from 24,860 colonoscopies. During the pandemic, only 517 cases (37.3 percent) were diagnosed, and the number of colonoscopies performed rose to 17,337.

Colorectal cancer patients diagnosed between 2021 and 2020 were also older than those diagnosed before the pandemic, had more symptoms, more complications, and presented at a later stage of the disease than those diagnosed before the pandemic.

The drop, according to experts, is due to the pandemic's suspension of screening programs and postponement of non-urgent colonoscopy investigations. Less number of cancers were diagnosed for colorectal cancer (CRC) by screening, during the pandemic, compared to the previous year. Almost 81.2 percentages of the patients were diagnosed through symptoms, compared to 69% diagnoses made through diagnoses for the previous year before the pandemic.

Dr. Maria José Domper Arnal, from the Service of Digestive Diseases, University Clinic Hospital and the Aragón Health Research Institute (IIS Aragón) in Zaragoza, Spain, and lead author of the study, commented “These are very worrying findings indeed – cases of colorectal cancer undoubtedly went undiagnosed during the pandemic. Not only were there fewer diagnoses, but those diagnosed tended to be at a later stage and suffering from more serious symptoms.”

This significant increase in the number of colorectal cancer (CRC) patients diagnosed with more frequent symptoms show that they are identified only in the late stage of the ailment. These symptoms severely cause distress to the affected colorectal cancer (CRC) patients, which include perforation in the bowel, painful pus collections, obstruction in the bowel, and bleeding that required hospitalization.

These cases accounted for 10.60 percent of pre-pandemic cases and 14.70 percent of pandemic cases. During the pandemic year, the number of stage IV cancers diagnosed increased, with stage IV cases accounting for 19.90% of all cases, up from 15.90% the previous year.

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“Although these figures are across a population of 1.3 million in Spain, the same drop in diagnoses would likely have happened elsewhere across the globe where screening was stopped and surgeries postponed, especially in countries that were heavily impacted by COVID-19”, explained Dr. Maria José Domper Arnal.

“Colorectal cancer is often curable if it’s caught at an early stage. Our concern is that we’re losing the opportunity to diagnose patients at this early stage, and this will have a knock-on effect on patient outcomes and survival. We are likely to see this fall out for years to come.”

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Bowel cancer, also known as CRC, is recognized as Europe's second prevalent cancer killer. Every year about four hundred thousand new cases are being diagnosed in this part of the world alone, claiming the lives of over 170,000 people.

The CRC mortality rates in Europe decline since the implementation of screening programs, which now cover over 110 million EU citizens. A recent global study published in The Lancet Gastroenterology and Hematology found a link between the implementation of screening campaigns and lower rates of CRC mortality, demonstrating the value of effective screening interventions.

Source-Medindia