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. 2021 Oct:151:106643.
doi: 10.1016/j.ypmed.2021.106643. Epub 2021 Jun 30.

The national FIT-based colorectal cancer screening program in the Netherlands during the COVID-19 pandemic

Tim L Kortlever  1 , Lucie de Jonge  2 , Pieter H A Wisse  3 , Iris Seriese  4 , Patricia Otto-Terlouw  5 , Monique E van Leerdam  6 , Manon C W Spaander  3 , Evelien Dekker  7 , Iris Lansdorp-Vogelaar  2
Affiliations

The national FIT-based colorectal cancer screening program in the Netherlands during the COVID-19 pandemic

Tim L Kortlever et al. Prev Med. 2021 Oct.

Abstract

The COVID-19 pandemic has affected many healthcare services worldwide. Like many other nations, the Netherlands experienced large numbers of individuals affected by COVID-19 in 2020, leading to increased demands on hospitals and intensive care units. The Dutch Ministry of Health decided to suspend the Dutch biennial fecal immunochemical test (FIT) based colorectal cancer (CRC) screening program from March 16, 2020. FIT invitations were resumed on June 3. In this study, we describe the short-term effects of this suspension on a myriad of relevant screening outcomes. As a result of the suspension, a quarter of the individuals due for screening between March and November 2020 had not received their invitation for FIT screening by November 30, 2020. Furthermore, 57.8% of those who received a consecutive FIT between the restart and November 30, 2020, received it outside the upper limit of the standard screening interval (26 months). Median time between positive FIT and colonoscopy did not change as a result of the pandemic. Participation rates of FIT screening and follow-up colonoscopy in the months just before and during the suspension were significantly lower than expected, but returned to normal levels after the suspension. Based on the anticipated 2020 cohort size, we estimate that the number of individuals with advanced neoplasia currently detected up until November 2020 was 31.2% lower compared to what would have been expected without a pandemic. Future studies should monitor the impact on long-term screening outcomes as a result of the pandemic.

Keywords: COVID-19; Colorectal Cancer; Screening.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
5-day rolling averages of daily new hospitalizations and deaths per 100,000 residents in de Netherlands due to COVID-19 in 2020. The grey area highlights the period in which the Dutch CRC screening program suspended the dispatch of FIT invitations.
Fig. 2
Fig. 2
Monthly number of intake slots for follow-up colonoscopy offered by the endoscopy centers in the Dutch CRC screening program in 2018, 2019 and 2020.
Fig. 3
Fig. 3
Monthly number of invitations for FIT screening sent in the Dutch CRC screening program in 2018, 2019, and 2020.
Fig. 4
Fig. 4
Monthly participation to FIT (A) and diagnostic follow-up (B) screening in the Dutch CRC screening program in 2018, 2019 and 2020.
See this image and copyright information in PMC

References

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