Impact of COVID 19 Pandemic on Colorectal Cancer Screening Program
Abstract Introduction One of the main cluster 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 need and safety to continue selective CRCS colonoscopies during COVID 19 pandemic. Patients and methods We carried out a retrospective controlled cohort study in our "COVID free" hospital to compare data of CRCS colonoscopies of the lockdown period (9th March 4th May 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 out 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 (5cases, 8% vs 3cases,1% p=0.002) The "high risk" adenomas detection rate was also significantly higher in the "lockdown group" than in controls (47%vs25%,p=0.001) A multiple regression analysis selected relevant symptoms (HR3.1) familiarity (HR1.99) and lockdown period (HR2.2) as independent predictors of high risk lesions (high risk adenomas and CRC) 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 anyway efficacious and safe.
Clinical Colorectal Cancer