The impact of delayed screening colonoscopies during the COVID-19 pandemic on clinical outcomes.

Autor: McCarthy R; National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland., Mooney T; National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland., Fitzpatrick P; National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland; University College Dublin, School of Public Health Physiotherapy and Sports Science, Woodview House, Belfield, Dublin 4, Ireland. Electronic address: patricia.fitzpatrick@ucd.ie., Kennedy RA; National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland., Coffey H; National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland., Sheedy M; National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland., MacMathúna P; National Screening Service, King's Inns House, 200 Parnell Street, Dublin 1 D01 A3Y8, Ireland.
Jazyk: angličtina
Zdroj: Cancer epidemiology [Cancer Epidemiol] 2024 Oct; Vol. 92, pp. 102629. Date of Electronic Publication: 2024 Jul 31.
DOI: 10.1016/j.canep.2024.102629
Abstrakt: Background: Colorectal cancer (CRC) screening services in Ireland were cancelled or postponed for periods during the COVID-19 pandemic. The aim of this study was to assess the impact of screening colonoscopy delays after a positive FIT on clinical and histopathological outcomes due to these restrictions.
Methods: Participants in the Irish National Bowel Screening Programme with a positive Immunochemical Faecal Test (FIT) during the COVID-19 pandemic (March 2020-December 2021) were included. Patients were categorised into attended for a colonoscopy <3 months and attended for colonoscopy ≥3-17 months post positive FIT. Chi-Square Test of independence was performed using WinPepi.
Results: 3227 individuals had a complete index colonoscopy <3 months and 262 attended colonoscopy from ≥3 to 17 months post positive FIT. Of the clients whose colonoscopy was between ≥3-17 months from positive FIT, the median wait time was 3 months. There was no significant difference found between the two groups for CRC (5.8 % vs 5.0 %, p=0.544) or for the proportion of cancer stage I, stage II and unknown (33.7 %, 40.6 %, 25.7 %, p=0.411). There was no difference in the proportions of adenomas (57.8 % vs 58.4 %, p=0.849) and the proportion of advanced adenomas (7.7 % vs 10.7 %, p=0.077) detected between the two groups. A similar proportion of polyps were detected in individuals whose index colonoscopies were postponed <3 months from positive FIT (66.9 % vs 66 %, p=0.786).
Conclusion: A median delay of 3 months in screening colonoscopies after a positive FIT does not adversely impact clinical or histopathological outcomes. There was no significant difference in cancer staging, advanced adenomas or polyps detected between those who attended colonoscopies <3 months and ≥3-17 months post positive FIT. COVID-19 related disruptions to the normal functioning of the Irish bowel screening programme did not compromise our key objectives of advanced adenoma and cancer detection.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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