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. 2024 Jul 30;8(3):188-194.
doi: 10.23922/jarc.2023-034. eCollection 2024.

Decreased Positive Fecal Occult Blood Tests and Delayed Medical Presentation for Colorectal Cancer during the Initial COVID-19 Pandemic Period: A Single-center Experience

Tadataka Takagi  1 , Fumikazu Koyama  1   2 , Hiroyuki Kuge  1 , Yosuke Iwasa  1 , Takeshi Takei  1 , Tomomi Sadamitsu  1 , Kosuke Fujimoto  1 , Suzuka Harada  1 , Takashi Tamura  1 , Goki Ejiri  1 , Chihiro Yoshikawa  1 , Masayuki Sho  1
Affiliations

Decreased Positive Fecal Occult Blood Tests and Delayed Medical Presentation for Colorectal Cancer during the Initial COVID-19 Pandemic Period: A Single-center Experience

Tadataka Takagi et al. J Anus Rectum Colon. .

Abstract

Objectives: This study aimed to investigate the impact of the COVID-19 pandemic on the examination and treatment of colorectal cancer (CRC) and on the behaviors of patients and practitioners.

Methods: This is a retrospective analysis of the CRC patients who presented to our department between April 2019 and March 2021 and underwent surgery. Clinical presentation of CRC and time from symptom onset to medical presentation were compared between the control (April 2019 to March 2020, n=124) and COVID-19 pandemic periods (April 2020 to March 2021, n=111).

Results: Two hundred and thirty-five patients were reviewed. The rate of positive fecal occult blood tests was significantly lower during the COVID-19 pandemic period (13.5 vs. 25.0%, P = 0.027). Among the symptomatic patients who had melena and abdominal symptoms, the time from symptom onset to medical presentation was significantly longer during the COVID-19 period (115 vs. 31 days, P < 0.001). In addition, the interval between presenting to a practitioner and being referred to our department was similar between the two periods (19 vs. 13 days, P = 0.092). There were no significant differences in the stage of cancer between the two periods. The rate of preoperative sub-obstruction was significantly higher during the COVID-19 period (41.4 vs 23.4%, P = 0.003). There was no significant difference in overall survival and recurrence-free survival between two periods.

Conclusions: Hesitation to seek examination and treatment for CRC was observed in patients but not in practitioners during the COVID-19 pandemic period. The prognosis did not change.

Keywords: COVID-19; colorectal cancer; delayed presentation; fecal occult blood test.

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Conflict of interest statement

Conflicts of Interest There are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Time to seek medical attention in a) patients with melena, b) patients with abdominal symptoms, and c) patients who had colonic preoperative sub-obstruction.
Figure 2.
Figure 2.
Overall survival (a, P = 0.865) and recurrence-free survival (b, P = 0.434) during the control period and the COVID-19 pandemic period.
See this image and copyright information in PMC

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