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.
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 language | English |
|---|---|
| Publication status | Published - 15 May 2022 |
| Event | International 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 2022 → 18 May 2022 https://www.ispor.org/conferences-education/conferences/upcoming-conferences/ispor-2022 |
Conference
| Conference | International Society of Pharmacoeconomics Outcomes Research (ISPOR) |
|---|---|
| Country/Territory | United States |
| City | Washington DC |
| Period | 15/05/2022 → 18/05/2022 |
| 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
Access to Document
- The Impact of COVID-19 on Colorectal Cancer Screening in Northern Ireland
© 2022 The Authors.