The Impact of COVID-19 on Colorectal Cancer Screening in Northern Ireland

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Abstract

OBJECTIVES: In Northern Ireland (NI), approximately 1,200 patients are diagnosed annually with colorectal cancer (CRC), with around 420 deaths annually making it the second-highest cause of cancer-related deaths. The highest survival rate is for patients diagnosed via screening (94.1%), and lowest for those diagnosed via an emergency route (37.9%). Diagnosis requires a colonoscopy.

Due to the impact of COVID-19, faecal immunochemical test (FIT) symptomatic triage was implemented in NI. This research aims to explore the rate of cancer from colonoscopies (cancer conversion rate).
METHODS: Anonymised data from April 2017 to March 2021 was obtained from one hospital trust in NI. A text mining approach was adopted along with descriptive statistics. Seven outcome categories from each colonoscopy were used: cancer, polyps, inflammatory bowel conditions, diverticular disease, other, no information, negative colonoscopy. The dataset was split into pre and during COVID-19 and subdivided by age categories 0-54, 55-64, 65-74, 75+. Results were displayed using an R Shiny dashboard.

RESULTS: An estimated 20,545 colonoscopies were performed, of which 2,200 were after March 2020. During the pre-COVID-19 period (April 2017 to March 2020) there were 159 annual cancers detected, compared to 110 from the COVID-19 period (April 2020 to March 2021). The cancer conversion rate increased from 2.6% to 4.6%. Similarly, the polyp detection rate increased from 29.4% to 36%. The number of negative colonoscopies reduced from 34.7% to 28.5%.

CONCLUSIONS: There was an increased cancer conversion rate and polyp detection rate, and a lower negative colonoscopy rate in the post-COVID-19 period. The age category 75+ had the highest cancer conversion rate compared to 0-54-year-olds with the lowest. There may be equity issues and long term consequences of absolute polyp number reduction. Next steps are to look at the long-term impact of using FIT triage for prioritisation along with the costs and outcomes.
Original languageEnglish
Publication statusPublished - 15 May 2022
EventInternational Society of Pharmacoeconomics Outcomes Research (ISPOR): The Future of HEOR in Patient-Driven Digital Healthcare Systems - Gaylord National Resort & Conference Center , Washington DC, United States
Duration: 15 May 202218 May 2022
https://www.ispor.org/conferences-education/conferences/upcoming-conferences/ispor-2022

Conference

ConferenceInternational Society of Pharmacoeconomics Outcomes Research (ISPOR)
Country/TerritoryUnited States
CityWashington DC
Period15/05/202218/05/2022
Internet address

Bibliographical note

The abstract will be published in forthcoming issue of Value in Health.

Keywords

  • Real World Data
  • Information systems
  • Cancer
  • R (programming language)
  • faecal immunochemical testing
  • Colorectal Cancer
  • Colonoscopy

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