Effect of the SARS‐CoV‐2 pandemic on colorectal cancer diagnosis and prognosis

Abstract

Background and Study AimsOur aim was to determine the impact of the SARS‐CoV‐2 pandemic on the diagnosis and prognosis of colorectal cancer (CRC).Patients and MethodsThis prospective cohort study included individuals diagnosed with CRC between March 13, 2019 and June 20, 2021 across 21 Spanish hospitals. Two time periods were compared: prepandemic (from March 13, 2019 to March 13, 2020) and pandemic (from March 14, 2020 to June 20, 2021, lockdown period and 1 year after lockdown).ResultsWe observed a 46.9% decrease in the number of CRC diagnoses (95% confidence interval (CI): 45.1%–48.7%) during the lockdown and 29.7% decrease (95% CI: 28.1%–31.4%) in the year after the lockdown. The proportion of patients diagnosed at stage I significantly decreased during the pandemic (21.7% vs. 19.0%; p = 0.025). Centers that applied universal preprocedure SARS‐CoV‐2 PCR testing experienced a higher reduction in the number of colonoscopies performed during the pandemic post‐lockdown (34.0% reduction; 95% CI: 33.6%–34.4% vs. 13.7; 95% CI: 13.4%–13.9%) and in the number of CRCs diagnosed (34.1% reduction; 95% CI: 31.4%–36.8% vs. 26.7%; 95% CI: 24.6%–28.8%). Curative treatment was received by 87.5% of patients diagnosed with rectal cancer prepandemic and 80.7% of patients during the pandemic post‐lockdown period (p = 0.002).ConclusionsThe COVID‐19 pandemic has led to a decrease in the number of diagnosed CRC cases and in the proportion of stage I CRC. The reduction in the number of colonoscopies and CRC diagnoses was higher in centers that applied universal SARS‐CoV‐2 PCR screening before colonoscopy. In addition, the COVID‐19 pandemic has affected curative treatment of rectal cancers.

Influence of the COVID-19 Pandemic on Patients with Rectal Cancer

“…A closer analysis of our patients with regard to restrictions during the lockdowns showed more initially advanced tumor stages during lockdowns (T4b: 27.3% vs. 6.2%), with a consecutive trend towards a higher proportion of neoadjuvant-treated patients compared to the control group ( Table 6 ). This is consistent with the observations of a Spanish group that found higher rates of stage IV colorectal cancer during the lockdown [ 39 ]. Other studies showed similar results at the beginning of the pandemic, comparable to our lockdown periods, with a trend towards higher tumor stages [ 40 , 41 , 42 ] and fewer early-stage cancers [ 10 ] during the COVID-19 pandemic.…”