Pandemic Tied to Drop in Colorectal Cancer Diagnoses

By Megan Brooks

October 05, 2021

NEW YORK (Reuters Health) - A study from Spain shows that the COVID-10 pandemic was associated with a 40% decline in the number of colorectal-cancers diagnosed.

The pandemic has caused a "deep impact" on healthcare systems, Dr. Maria Jose Domper Arnal of University Clinic Hospital and the Aragon Health Research Institute in Zaragoza said in reporting her research at UEG Week Virtual 2021.

On March 14, 2020, three days after the WHO declared the pandemic, the Spanish government declared a lockdown, which led to a "radical change in daily hospital activities," she said.

Gastrointestinal services, especially endoscopy units, had to adjust to this "dramatic and unknown situation." Nonurgent endoscopies were suspended or delayed. Some of the programs offered by health systems that had a greater decrease in activity were those related to preventive health activities such as CRC screening, Dr. Arnal added.

The researchers determined the impact of the pandemic on CRC diagnosis, clinical characteristics, staging and management, across multiple hospitals in Spain. They analyzed data from the pre-pandemic period of March 1, 2019, to March 14, 2020, and the pandemic period of March 15, 2020, to February 28 of this year.

Of 1,385 cases of CRC diagnosed over the two-year period, nearly two-thirds (868 cases, 63%) were diagnosed in the pre-pandemic year from 24,860 colonoscopies. By contrast, in the pandemic year, only 517 cases (37%) were diagnosed from 17,337 colonoscopies, representing a decline of 27% in the number of colonoscopies.

There was a 40.4% decrease in the number of CRC cases diagnosed in the pandemic period, Dr. Arnal said.

She noted that patients diagnosed with CRC during the pandemic period were older, had more frequent symptoms, a greater number of complications and a trend to present with more advanced disease stage.

Of note, there was a "clear trend" towards more stage-IV tumors in the pandemic period versus the pre-pandemic period (19.9% vs. 15.9%), she reported.

"This study reflects, at least in part, the shot-term consequences of the suspension of CRC screening in Spain," Dr. Arnal told the conference.

"Although these figures are across a population of 1.3 million in Spain, it's highly likely that the same drop in diagnoses would have happened elsewhere across the globe where screening was stopped and surgeries postponed, especially in countries that were heavily impacted by COVID-19," she added in a news release.

SOURE: UEG Week Virtual 2021, presented October 3, 2021.