Impact and recovery from COVID-19-related disruptions in colorectal cancer screening and care in the US: A scenario analysis
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
Résumé en anglais
Background: Many colorectal cancer (CRC)-related procedures were suspended during the COVID-19 pandemic. In this study, we predict the impact of resulting delays in screening (colonoscopy, FIT, sigmoidoscopy) and diagnosis on CRC outcomes, and compare different recovery scenarios.
Methods: Using the MISCAN-Colon model, we simulated the US population and evaluated different impact and recovery scenarios. Scenarios were defined by the duration and severity of the disruption (% of eligible adults affected), the length of delays, and the duration of the recovery. During recovery (6, 12 or 24 months), capacity was increased to catch up missed procedures. Primary outcomes were excess CRC cases and deaths, and additional colonoscopies required during recovery.
Results: With a 24-month recovery, the model predicted that the US population would develop 7,210 (0.18%) excess CRC cases during 2020-2040, and 6,950 (0.65%) excess CRC deaths, and require 108,500 (8.6%) additional colonoscopies per recovery month, compared to a no-disruption scenario. Shorter recovery periods of 6 and 12 months, respectively, decreased excess CRC deaths to 4,190 (0.39%) and 4,580 (0.43%), at the expense of 260,200-590,100 (20.7-47.0%) additional colonoscopies per month. Conclusions: The COVID-19 pandemic will likely cause more than 4,000 excess CRC deaths in the US, which could increase to more than 7,000 if recovery periods are longer.
Impact: Our results highlight that catching-up CRC services within 12 months provides a good balance between required resources and mitigation of the impact of the disruption on CRC deaths.
