Screening delays due to COVID-19 predicted to increase CRC mortality by 12%
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Screen delays due to SARS-C0V-2 would significantly increase advanced colorectal cancer cases and mortality if lasting beyond 12 months, according to results presented at UEG Week Virtual Press Briefing.
“In the light of possible future waves of SARS-CoV-2 or other pandemics, our findings warn against screening delays above 12 months to restrain the negative impact on disease mortality,” Luigi Ricciardiello, MD, from the department of medical and surgical sciences at the University of Bologna, Italy, said during his presentation.
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Ricciardiello and colleagues created a two-step procedural model that considered the delays in time to coloscopy and estimated the impact of on mortality because of up-stage migration of patients. Data form the Italian screened population was used to compute the number of expected CRC cases. A meta-analytic approach was used to assess the estimates of the effects of delays to colonoscopy on CRC stage and of stage on mortality.
“If we have delays that are up to 6 months, we don’t see many differences but if we move from 6 months or beyond we see an up-stage migration of the patients; meaning we see more stage 3 or stage 4, which becomes more dramatic when we move above 12 months threshold,” he said. “You can see that it has a huge impact when moving patients to chemotherapy or end-stage disease.”
When looking at CRC stages 3 and 4, Ricciardiello said there is a 12% increase in mortality at 5 years.
Results predicted a screening delay between 7 to 12 months would cause a 3% increase in advanced stage CRC and a 7% increase with a screening delay over 12 months.
“We are moving back to an era of prescreening and this is something, in my opinion, we cannot afford,” he said.
“We have to have the health care systems find ways of not breaking the chains of high-impact disease such as CRC,” Ricciardiello added. “Have a professional pathway to keep screenings alive. The focus is on SARS-COV-2 and there’s a problem in focusing on other high-impact diseases.”
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Ricciardiello L. Estimated effects of screening delays due to SARS-CoV-2 pandemic on colorectal cancer mortality. Presented at: UEG Week Virtual Press Briefing; Oct. 9, 2020.
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