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. 2021 Mar;20(1):e5-e11.
doi: 10.1016/j.clcc.2020.07.006. Epub 2020 Jul 30.

Impact of COVID-19 Pandemic on Colorectal Cancer Screening Program

Valeria D'Ovidio  1 , Cristina Lucidi  2 , Giovanni Bruno  2 , Daniele Lisi  2 , Lucia Miglioresi  2 , Marco Emilio Bazuro  2
Affiliations

Impact of COVID-19 Pandemic on Colorectal Cancer Screening Program

Valeria D'Ovidio et al. Clin Colorectal Cancer. 2021 Mar.

Abstract

Introduction: One of the main clusters of coronavirus disease-2019 (COVID-19) has been identified in Italy. Following European and local guidelines, Italian endoscopy units modulated their activity. We aimed at analyzing the need and safety to continue selective colorectal cancer screening (CRCS) colonoscopies during the COVID-19 pandemic.

Patients and methods: We carried out a retrospective controlled cohort study in our "COVID-free" hospital to compare data of the CRCS colonoscopies of the lockdown period (March 9 to May 4, 2020) with those of the same period of 2019 (control group). A pre/post endoscopic sanitary surveillance for COVID-19 infection was organized for patients and sanitary staff.

Results: In the lockdown group, 60 of 137 invited patients underwent endoscopy, whereas in the control group, 238 CRCS colonoscopies (3.9-fold) were performed. In the lower number of examinations during the lockdown, we found more colorectal cancers (5 cases; 8% vs. 3 cases; 1%; P = .002). The "high-risk" adenomas detection rate was also significantly higher in the "lockdown group" than in controls (47% vs. 25%; P = .001). A multiple regression analysis selected relevant symptoms (hazard ratio [HR], 3.1), familiarity (HR, 1.99), and lockdown period (HR, 2.2) as independent predictors of high-risk lesions (high-risk adenomas and colorectal cancer). No COVID-19 infections were reported among staff and patients.

Conclusions: The overall adherence to CRCS decreased during the pandemic, but the continuation of CRCS colonoscopies was efficacious and safe.

Keywords: Adenoma; Colonoscopy; Endoscopy; Lockdown; Neoplastic; SARS-CoV-2.

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Figures

Figure 1
Figure 1
Total Cases of COVID-19 Infections Registered in Italy on March 9, 2020
Figure 2
Figure 2
Comparison of Detected Lesions in Lockdown Group (March 9 to May 4, 2020, COVID-19 Period) (A) and Control Group (Same Period 2019) (B). Total CRCS Colonoscopies in Lockdown Group Versus Control Group (n = 60 vs. n = 238). High-Risk and Low-Risk Superficial Neoplastic Lesions Were Classified according to European Society of Gastrointestinal Endoscopy Guidelines Abbreviation: CRCS = colorectal cancer screening.
See this image and copyright information in PMC

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