Covid-related delays In colorectal cancer screening jeopardizes preventive care, early treatment

Covid-related delays In colorectal cancer screening jeopardizes preventive care, early treatment

Press releases may be edited for formatting or style | June 19, 2020 Endoscopy
CHICAGO, June 18, 2020 /PRNewswire/ -- With the COVID-19 pandemic interrupting non-urgent medical care, physicians are concerned that important gains in preventing colorectal cancer could be lost and their patients could miss out on life-saving preventive care or treatment.

Colorectal cancer is the second-leading cause of cancer death, yet it is highly preventable and treatable with screening and early diagnosis, said Laura J. Zimmermann, MD, MS, medical director of Rush's Prevention Center and assistant professor of Preventive Medicine and Internal Medicine at Rush Medical College.

"If it's caught early, it has a really high cure rate, but if by delaying we find something later, it may be harder to treat," she said.

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Colonoscopies to screen for colorectal cancer came to a stand-still for more than two months when most states halted elective surgical and endoscopic procedures to help hospitals address the surge in COVID-19 cases. In Illinois, the stoppage lasted from mid-March through mid-May. Before the pandemic, Rush was performing about 800 colonoscopies a month on average.

While Rush is starting to perform screening colonoscopies again, colorectal surgeon Dana Hayden, MD, MPH, associate professor and chief of the Division of Colon and Rectal Surgery at Rush Medical College, worries that the delay in care will linger and patients who had taken the important step of scheduling a colonoscopy may put off rescheduling and others who are due to be screened won't.

"We really don't know how long the delay could last," Hayden said. "Patients may be focused on more urgent matters than preventative care and may also be nervous about coming to the hospital while the pandemic continues."

That would reverse a positive, lifesaving trend:

The rate of people over age 50 who are up to date on colorectal cancer screening has improved greatly in the past several years, from 38% in 2000 to 66% in 2018, according to the American Cancer Society.

"As the rate of screening has increased in these age groups (over 55 years old), the incidence of colorectal cancer has decreased," Hayden said. And the mortality rate has declined as well.

Delayed screening means people will miss the opportunity to prevent or treat the disease early. That leads to a greater incidence of cancer, which is diagnosed at later stages with more severe symptoms and higher mortality, she said.

While it is impossible to know how much screening will be missed because of the pandemic, a look at the number of new colorectal cancer cases projected for 2020 in the U.S., two months with little or no screening theoretically could postpone diagnosis of cancer in 24,650 patients, among those some 9,860 cancers that may be at an advanced stage already.

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