Coronavirus: Causes 40% difficulty in diagnosing colon cancer

A drastic 40% reduction in colorectal cancer cases was recorded during the first year of the pandemic due to the reduced attendance of patients in health facilities. The result was to increase by at least 4% the corresponding cancers that are diagnosed at an advanced stage and after causing serious complications in patients.

This is the conclusion of a study announced at the European Congress of Gastroenterology, which was conducted in many hospitals in Spain with data from the first year of the pandemic and the previous year.

Of the 1.385 cases of colon cancer diagnosed during the two years, almost two-thirds (868 cases or 62,7%) were diagnosed in the pre-pandemic year during which 24.860 colonoscopies were performed. In contrast, only 517 cases (ie 37,3% of the total) were diagnosed during the pandemic, and these resulted from 17.337 colonoscopies, a number reduced by 27% compared to those performed in 2019.

Patients diagnosed with colon cancer between March 15, 2020 and February 28, 2021 were also older than the year before the pandemic, had more frequent symptoms, more complications, and presented at a more advanced stage of the disease.

Experts say the decline is due to the suspension of screening programs and the postponement of non-urgent colonoscopy research during the pandemic. Fewer cancers were detected by the CRC during the pandemic period, with only 22 (4,3%) cases compared to 182 (21%) in the pre-pandemic year. During the pandemic, more patients were diagnosed with symptoms (81,2% of diagnoses) compared to the year before the pandemic (69%).

Dr. Maria Jose Dober Arnal of the Gastroenterology Department of the University Hospital of Zaragoza and the Aragon Health Research Institute, who led the study, said: "These are really worrying findings. Cases of colon cancer undoubtedly went undiagnosed during the pandemic. "Not only were there fewer diagnoses, but those diagnosed tended to be at a later stage and suffer from more severe symptoms."

The increase in the number of patients with serious complications - a sign of end-stage disease - was significant and involved symptoms such as perforation of the bowel, abscesses, bowel obstruction and bleeding requiring hospitalization. Such incidents before the pandemic accounted for 10,6% and 14,7% during the pandemic. The number of stage IV cancers diagnosed increased during the pandemic year, reaching 19,9% ​​of cases, up from 15,9% the previous year.

"Although these figures are in a population of 1,3 million in Spain, it is very likely that the same decline in diagnoses will have occurred elsewhere around the world where testing has stopped and surgery has been postponed, especially in countries that have been hit hard by τον COVID-19", Explained Dr. Maria Jose Dober Arnal.

"Colon cancer is often curable if detected at an early stage. Our concern is that we miss the opportunity to diagnose patients at this early stage and this will affect patients' long-term outcomes and survival. It is possible that we will see the consequences in the coming years. "

Colon cancer is the second most common form of cancer in Europe and the most common cancer of the digestive system. Every year, 375.000 new cases are reported in the EU and over 170.000 deaths. Since the launch of screening programs, which now cover more than 110 million EU citizens, Europe has seen a steady decline in mortality rates. A recent global study published in The Lancet Gastroenterology and Hepatology showed a correlation between the introduction of screening programs and the reduction of colorectal cancer mortality rates, supporting the benefits of effective screening interventions.

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