Background: The interruption of the activity of population-based organized colorectal cancer (CRC) screening programs due to the COVID pandemic may have affected their results in terms of the detection of preneoplastic lesions and CRC. We evaluated the impact of the COVID pandemic on the delays, participation, adherence to colonoscopies, lesions detected, and CRC stage at diagnosis in a CRC screening program. Methods: We analyzed all the invitations between 1 January 2019 and 31 December 2021. We defined the pandemic period as the period after 12 March 2020. We calculated the delay intervals (successive and all rounds), the rates of participation, adherence to colonoscopy after a positive fecal immunochemical test (FIT), and the diagnostic yield of colonoscopy, specifically of CRC and colorectal neoplasia (CRC and/or adenoma), as well as the CRC stage at diagnosis. Results: In the period analyzed, 976,187 invitations were sent (61.0% in the pandemic period), 439,687 FIT were returned (62.4% in the pandemic period) and 23,092 colonoscopies were performed (59.1% in the pandemic period). The colonoscopies were normal in 7378 subjects (32.4%) and CRC was detected in 916 subjects (4.0%). In successive rounds, the delay increased significantly by seven months during the pandemic period (p< 0.001). In all the invitations, the delay from the invitation to the colonoscopy increased significantly by 8 days (p< 0.001). Once adjusted for the confounding variables, the participation in the screening program increased significantly (OR = 1.1; 95% CI = 1.09–1.11), with no changes in the adherence to colonoscopy (OR = 0.9; 95% CI = 0.8–1.0). We found no differences in the diagnostic yield of colonoscopy in terms of CRC (OR = 0.90; 95% CI = 0.78–1.02) or colorectal neoplasia (OR = 0.98; 95% CI = 0.92–1.03) detection. Finally, we found no differences in the CRC stage at diagnosis (p= 0.2). Conclusions: Although the interruption of the CRC screening program due to the COVID pandemic increased the delays, it did not reduce participation, adherence to colonoscopy, or the diagnostic yield of colonoscopy.
背景：新冠疫情导致基于人群的结直肠癌（CRC）筛查项目活动暂停，这可能对癌前病变和CRC的检出结果产生影响。本研究评估了新冠疫情对CRC筛查项目中各项指标的影响，包括筛查延迟、参与率、结肠镜检查依从性、病变检出率以及诊断时的CRC分期。 方法：我们分析了2019年1月1日至2021年12月31日期间发出的所有筛查邀请。将2020年3月12日之后定义为疫情期。计算了延迟间隔（连续轮次和全部轮次）、参与率、粪便免疫化学检测（FIT）阳性后的结肠镜检查依从率、结肠镜检查的诊断效能（特别是CRC和结直肠肿瘤（CRC和/或腺瘤）的检出率），以及诊断时的CRC分期。 结果：在分析期间，共发出976,187份邀请（疫情期占61.0%），回收439,687份FIT检测（疫情期占62.4%），完成23,092例结肠镜检查（疫情期占59.1%）。其中，7,378例（32.4%）结肠镜检查结果正常，916例（4.0%）检出CRC。在连续轮次筛查中，疫情期的延迟时间显著增加了7个月（p<0.001）。在所有邀请中，从邀请到完成结肠镜检查的延迟时间显著增加了8天（p<0.001）。调整混杂变量后，筛查项目的参与率显著提高（OR=1.1；95% CI=1.09–1.11），而结肠镜检查依从性无显著变化（OR=0.9；95% CI=0.8–1.0）。结肠镜检查在CRC检出（OR=0.90；95% CI=0.78–1.02）或结直肠肿瘤检出（OR=0.98；95% CI=0.92–1.03）方面的诊断效能均无显著差异。最后，诊断时的CRC分期也无显著差异（p=0.2）。 结论：尽管新冠疫情导致的CRC筛查项目中断增加了筛查延迟，但并未降低参与率、结肠镜检查依从性或结肠镜检查的诊断效能。
肿瘤(癌症)患者之家