Impact of COVID-19 pandemic on Colorectal Cancer Screening program

D'Ovidio, Valeria; Lucidi, Cristina; Bruno, Giovanni; Lisi, Daniele; Miglioresi, Lucia; Bazuro, Marco Emilio

INTRODUCTION: One of the main cluster of coronavirus-disease-2019 (COVID-19) has been identified in Italy. Following European and local guidelines, Italian Endoscopy Units modulated their activity. We aimed at analyzing need and safety to continue selective CRCS colonoscopies during COVID-19 pandemic. PATIENTS AND METHODS: We carried out a retrospective controlled cohort study in our “COVID-free” hospital to compare data of CRCS colonoscopies of the lockdown period (9(th) March-4(th) May 2020) with those of the same period of 2019 (control group). A pre/post endoscopic sanitary surveillance for COVID-19 infection was organized for patients and sanitary staff. RESULTS: In the lockdown group, 60 out of 137 invited patients underwent endoscopy, whereas in the control group 238 CRCS colonoscopies (3.9-fold) were performed. In the lower number of examinations during the lockdown we found more colorectal cancers (5cases, 8%, vs 3cases,1%, p=0.002). The “high-risk” adenomas detection rate was also significantly higher in the “lockdown group” than in controls (47%vs25%,p=0.001). A multiple regression analysis selected relevant symptoms (HR3.1), familiarity (HR1.99) and lockdown-period (HR2.2) as independent predictors of high-risk lesions (high-risk adenomas and CRC). No COVID-19 infections were reported among staff and patients. CONCLUSIONS: The overall adherence to CRCS decreased during the pandemic, but the continuation of CRCS colonoscopies was anyway efficacious and safe.