Impact and Recovery from COVID-19-Related Disruptions in Colorectal Cancer Screening and Care in the US: A Scenario Analysis

Rosita van den Puttelaar*, Iris Lansdorp-Vogelaar, Anne I. Hahn, Carolyn M. Rutter, Theodore R. Levin, Ann G. Zauber, Reinier G.S. Meester*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
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Abstract

BACKGROUND: Many colorectal cancer-related procedures were suspended during the COVID-19 pandemic. In this study, we predict the impact of resulting delays in screening (colonoscopy, FIT, and sigmoidoscopy) and diagnosis on colorectal cancer-related outcomes, and compare different recovery scenarios. METHODS: Using the MISCAN-Colon model, we simulated the US population and evaluated different impact and recovery scenarios. Scenarios were defined by the duration and severity of the disruption (percentage of eligible adults affected), the length of delays, and the duration of the recovery. During recovery (6, 12 or 24 months), capacity was increased to catch up missed procedures. Primary outcomes were excess colorectal cancer cases and -related deaths, and additional colonoscopies required during recovery. RESULTS: With a 24-month recovery, the model predicted that the US population would develop 7,210 (0.18%) excess colorectal cancer cases during 2020-2040, and 6,950 (0.65%) excess colorectal cancer-related deaths, and require 108,500 (8.6%) additional colonoscopies per recovery month, compared with a no-disruption scenario. Shorter recovery periods of 6 and 12 months, respectively, decreased excess colorectal cancer-related deaths to 4,190 (0.39%) and 4,580 (0.43%), at the expense of 260,200-590,100 (20.7%-47.0%) additional colonoscopies per month. CONCLUSIONS: The COVID-19 pandemic will likely cause more than 4,000 excess colorectal cancer-related deaths in the US, which could increase to more than 7,000 if recovery periods are longer. IMPACT: Our results highlight that catching-up colorectal cancer-related services within 12 months provides a good balance between required resources and mitigation of the impact of the disruption on colorectal cancer-related deaths.

Bibliographical note

Funding Information:
I. Lansdorp-Vogelaar reports grants from National Cancer Institute during the conduct of the study; and grants from National Cancer Institute, Dutch Institute of Public Health, European Commission, and Dutch Association for Gastrointestinal Diseases outside the submitted work. A.I. Hahn reports grants from National Cancer Institute during the conduct of the study. C.M. Rutter reports grants from the National Cancer Institute of the National Institutes of Health during the conduct of the study. T.R. Levin reports grants from Freenome, Inc. outside the submitted work. A.G. Zauber reports grants from National Cancer Institute during the conduct of the study. R.G.S. Meester reports grants from U.S. National Cancer Institute during the conduct of the study; other support from Freenome Holdings, Inc. outside the submitted work. No disclosures were reported by the other authors.

Funding Information:
R. van den Puttelaar, I. Lansdorp-Vogelaar, A.I. Hahn, C.M. Rutter, A.G. Zauber, and R.G.S. Meester received financial support through grants U01-CA199335 and U01-CA253913 from the National Cancer Institute (NCI) as part of the Cancer Intervention and Surveillance Modeling Network (CISNET).

Publisher Copyright:
© 2022 The Authors; Published by the American Association for Cancer Research.

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