Actual Impact of COVID-19 on CRC (8.7% Reduction) and Advanced Adenoma (26.9% Reduction) Diagnoses in a U.S. Health Care System
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Actual Impact of COVID-19 on CRC (8.7% Reduction) and Advanced Adenoma (26.9% Reduction) Diagnoses in a U.S. Health Care System

Douglas K. Rex, MD, MASGE, reviewing Lee JK, et al. Gastroenterology 2022 May 14.

This study utilized the Kaiser Permanente Northern California (KPNC) health care system to evaluate the actual impact of the COVID-19 pandemic on colorectal cancer (CRC). This health care system, which primarily uses mailed fecal immunochemical test (FIT) kits for CRC screening, halted mailings of FIT kits in March and April 2020. KPNC also paused most elective colonoscopies in those months, but it had ramped back up to full performance by September 2020.

In total, in 2020 compared with 2019, there was an eventual 8.7% increase in mailed FIT kits (in response to decreased availability of elective colonoscopy services) but 9% fewer FITs completed and 10.1% fewer positive tests. Total colonoscopies were down 26.9% in 2020, and there was an 8.7% reduction in CRC cases diagnosed and a 26.9% reduction in diagnoses of advanced adenoma.

Douglas K. Rex, MD, FASGE

COMMENT

There was a lot of modeling of the expected impact of reduced CRC screening during the pandemic; however, this study gives actual observed numbers of reduced diagnoses of CRC and advanced adenoma. These data suggest that the impact of COVID-19 on delayed CRC diagnosis and prevention was significant. Further, this health care system likely ramped up FIT mailings and colonoscopy services faster than many programs, so these reductions in diagnoses may be a best-case scenario. These results may inform policies and procedures in any future pandemics.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Lee JK, Lam AY, Jensen CD, et al. Impact of the COVID-19 pandemic on fecal immunochemical testing, colonoscopy services, and colorectal neoplasia detection in a large United States community-based population. Gastroenterology 2022 May 14. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2022.05.014)

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