Extending periods might help accommodate COVID-19-related colonoscopy decreases

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March 29, 2021 2 minutes

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Source: de Jonge L, et al. Abstract OP86. Provided at: ESGE Days (virtual). March 25-27, 2021.

Disclosures: De Jonge reports no pertinent monetary disclosures.

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In the wake of a COVID-19 wave, extending screening periods might be the best way to accommodate the decrease in available colonoscopy capacity with the smallest influence on the occurrence of colorectal cancer, according to study results.

In her discussion at the European Society of Gastrointestinal Endoscopy (ESGE) Days 2021, Lucie de Jonge, from Erasmus MC University Medical Center in The Netherlands, stated that the Dutch nationwide CRC screening program was interfered with during the very first wave of COVID-19 in between March and Might of 2020.

“At the reboot of the program, there was 35% of regular colonoscopy capability available, and by September, we were almost back at 100%,” she said. “However, a second wave and more interruptions are expected. For that reason, the objective of this study was to discover the best strategy to momentarily decrease colonoscopy demand based on long-lasting effect.”

Researchers utilized the MISCAN-Colon model to replicate the Dutch national CRC screening program, which typically offers biennial fecal immunochemical screening to people aged 55 to 75 years with a cut-off of 47 µg HB/g. They estimated the reduction in colonoscopy demand in the 2nd half of 2020 and 2021, long-term CRC occurrence, death and influence on life years lost in 3 different situations; increase the fecal immunochemical test (FIT) cut-off value to 60 µg HB/g, skipping people aged 63 or 65 years and extending the screening period to 28 to 36 months. They compared these results with a referral circumstance without any colonoscopy constraints.

Investigators figured out that the needed capacity for 2020 and 2021 with no restrictions was 100,300 colonoscopies.

Increasing the FIT cut-off led to a reduction of in between 11,600 and 27,000 colonoscopies, Nevertheless, it likewise led to in 400 to 900 excess CRC cases and 200 to 500 excess CRC-related deaths from 2020 to 2050.

Leaving out age led to 10,800 to 17,500 less colonoscopies, however 200 to 600 excess CRC cases and 200 to 500 excess CRC-related deaths.

Extending periods led to 16,100 to 49,500 less colonoscopies. Particularly, extending the screening interval as much as 34 months prevented 200 to 300 more CRC cases and 200 to 600 CRC-related deaths. Although every method resulted in more life years lost, a 34-month period had the smallest impact, and scientists did not see a drastic increase in life years lost until the period was increased to 36 months.

“Briefly increasing the screening period had the smallest effect on the long term,” de Jonge said. “If extra reduction is required, increasing the cut-off worth might be thought about.”

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