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Showing content from https://pubmed.ncbi.nlm.nih.gov/35580655/ below:

Impact of the COVID-19 Pandemic on Fecal Immunochemical Testing, Colonoscopy Services, and Colorectal Neoplasia Detection in a Large United States Community-based Population

. 2022 Sep;163(3):723-731.e6. doi: 10.1053/j.gastro.2022.05.014. Epub 2022 May 14. Impact of the COVID-19 Pandemic on Fecal Immunochemical Testing, Colonoscopy Services, and Colorectal Neoplasia Detection in a Large United States Community-based Population Angela Y Lam², Christopher D Jensen³, Amy R Marks³, Jessica Badalov³, Evan Layefsky³, Kevin Kao⁴, Ngoc J Ho⁵, Joanne E Schottinger⁶, Nirupa R Ghai⁷, Cheryl M Carlson⁵, Ethan A Halm⁸, Beverly Green⁹, Dan Li¹⁰, Douglas A Corley¹¹, Theodore R Levin¹²

Affiliations

¹ Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, California. Electronic address: Jeffrey.K.Lee@kp.org.
² Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, California.
³ Division of Research, Kaiser Permanente Northern California, Oakland, California.
⁴ Department of Gastroenterology, Kaiser Permanente Downey Medical Center, Downey, California; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
⁵ Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
⁶ Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California.
⁷ Department of Quality and Systems of Care, Kaiser Permanente Southern California, Pasadena, California.
⁸ Department of Population and Data Sciences and the Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
⁹ Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
¹⁰ Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Gastroenterology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California.
¹¹ Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, California.
¹² Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Gastroenterology, Kaiser Permanente Walnut Creek Medical Center, Walnut Creek, California.

PMID: 35580655
PMCID: PMC9107101
DOI: 10.1053/j.gastro.2022.05.014

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Impact of the COVID-19 Pandemic on Fecal Immunochemical Testing, Colonoscopy Services, and Colorectal Neoplasia Detection in a Large United States Community-based Population

Jeffrey K Lee et al. Gastroenterology. 2022 Sep.

. 2022 Sep;163(3):723-731.e6. doi: 10.1053/j.gastro.2022.05.014. Epub 2022 May 14. Authors Jeffrey K Lee¹, Angela Y Lam², Christopher D Jensen³, Amy R Marks³, Jessica Badalov³, Evan Layefsky³, Kevin Kao⁴, Ngoc J Ho⁵, Joanne E Schottinger⁶, Nirupa R Ghai⁷, Cheryl M Carlson⁵, Ethan A Halm⁸, Beverly Green⁹, Dan Li¹⁰, Douglas A Corley¹¹, Theodore R Levin¹² Affiliations

¹ Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, California. Electronic address: Jeffrey.K.Lee@kp.org.
² Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, California.
³ Division of Research, Kaiser Permanente Northern California, Oakland, California.
⁴ Department of Gastroenterology, Kaiser Permanente Downey Medical Center, Downey, California; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
⁵ Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
⁶ Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California.
⁷ Department of Quality and Systems of Care, Kaiser Permanente Southern California, Pasadena, California.
⁸ Department of Population and Data Sciences and the Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
⁹ Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
¹⁰ Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Gastroenterology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California.
¹¹ Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, California.
¹² Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Gastroenterology, Kaiser Permanente Walnut Creek Medical Center, Walnut Creek, California.

PMID: 35580655
PMCID: PMC9107101
DOI: 10.1053/j.gastro.2022.05.014

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Abstract

Background & aims: The COVID-19 pandemic has affected clinical services globally, including colorectal cancer (CRC) screening and diagnostic testing. We investigated the pandemic's impact on fecal immunochemical test (FIT) screening, colonoscopy utilization, and colorectal neoplasia detection across 21 medical centers in a large integrated health care organization.

Methods: We performed a retrospective cohort study in Kaiser Permanente Northern California patients ages 18 to 89 years in 2019 and 2020 and measured changes in the numbers of mailed, completed, and positive FITs; colonoscopies; and cases of colorectal neoplasia detected by colonoscopy in 2020 vs 2019.

Results: FIT kit mailings ceased in mid-March through April 2020 but then rebounded and there was an 8.7% increase in kits mailed compared with 2019. With the later mailing of FIT kits, there were 9.0% fewer FITs completed and 10.1% fewer positive tests in 2020 vs 2019. Colonoscopy volumes declined 79.4% in April 2020 compared with April 2019 but recovered to near pre-pandemic volumes in September through December, resulting in a 26.9% decline in total colonoscopies performed in 2020. The number of patients diagnosed by colonoscopy with CRC and advanced adenoma declined by 8.7% and 26.9%, respectively, in 2020 vs 2019.

Conclusions: The pandemic led to fewer FIT screenings and colonoscopies in 2020 vs 2019; however, after the lifting of shelter-in-place orders, FIT screenings exceeded, and colonoscopy volumes nearly reached numbers from those same months in 2019. Overall, there was an 8.7% reduction in CRC cases diagnosed by colonoscopy in 2020. These data may help inform the development of strategies for CRC screening and diagnostic testing during future national emergencies.

Keywords: COVID-19; Cancer; Colonoscopy; Pandemic; Screening.

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Figures
Figure 1

The number of patients who…

Figure 1

The number of patients who were mailed a FIT kit, completed the FIT,…

Figure 1

The number of patients who were mailed a FIT kit, completed the FIT, and tested positive in 2019 and 2020.

Figure 2

The number of colonoscopies performed,…

Figure 2

The number of colonoscopies performed, advanced adenomas detected, and CRCs detected in 2019…

Figure 2

The number of colonoscopies performed, advanced adenomas detected, and CRCs detected in 2019 and 2020.

Figure 3

The number of colonoscopies performed…

Figure 3

The number of colonoscopies performed in 2019 and 2020 by procedure indication.

Figure 3

The number of colonoscopies performed in 2019 and 2020 by procedure indication.

Supplementary Figure 1

Flow diagram summarizing algorithm…

Supplementary Figure 1

Flow diagram summarizing algorithm used to assign colonoscopy indication.

Supplementary Figure 1

Flow diagram summarizing algorithm used to assign colonoscopy indication.