The elderly population are more vulnerable for the management of colorectal cancer during the COVID-19 pandemic: a nationwide, population-based study

Abstract

Background/Aims: The impact of coronavirus disease 2019 (COVID-19) on the management of colorectal cancer (CRC) may worse in elderly population, as almost all COVID-19 deaths occurred in the elderly patients. This study aimed to evaluate the impact of COVID-19 on CRC management in the elderly population.Methods: The numbers of patients who underwent colonoscopy, who visited hospitals or operated for CRC in 2020 and 2021 (COVID-19 era) were compared with those in 2019, according to 3 age groups (≥70 years, 50–69 years, and ≤49 years), based on the nationwide, population-based database (2019–2021) in South Korea.Results: The annual volumes of colonoscopy and hospital visits for CRC in 2020 were more significantly declined in the old age group than in the young age group (both P<0.001). In addition, the annual volume of patients operated for CRC numerically more declined in old age group than in young age group. During the first surge of COVID-19 (March and April 2020), old age patients showed statistically significant declines for the monthly number of colonoscopies (–46.5% vs. –39.3%, P<0.001), hospital visits (–15.4% vs. –7.9%, <i>P</i><0.001), CRC operations (–33.8% vs. –0.7%, <i>P</i><0.05), and colonoscopic polypectomies (–41.8% vs. –38.0%, <i>P</i><0.001) than young age patients, compared with those of same months in 2019.Conclusions: Elderly population are more vulnerable for the management of CRC during the COVID-19 pandemic. Therefore, the elderly population are more carefully cared for in the management of CRC during the next pandemic.

To overcome medical gap in screening and surveillance of colorectal cancer during the COVID-19 pandemic

“…Several studies have investigated the implementation of CRC screening and management during the COVID-19 pandemic. In the current issue of Intestinal Research , Kang et al [ 4 ] have reported on the management of CRC during the COVID-19 pandemic in Korea. Considering significant regional differences in medical utilization patterns even within the United States [ 5 ], these data examining colonoscopy, colonoscopic polypectomy, hospital visits, and surgical management for CRC in Korea are of great significance.…”