Impact of Covid-19 Related Disruptions to Colorectal Cancer Screening Programs in Three Countries: A Comparative Modelling Study

Aims Colorectal cancer (CRC) screening programs worldwide have been disrupted during the COVID-19 pandemic. This study aimed to estimate the impact of hypothetical disruptions to organized FIT-based CRC screening programs on short- and long-term CRC incidence and mortality in three countries using microsimulation modelling.

Methods Using CRC microsimulation models for Australia (Policy1-Bowel), Canada (OncoSim) and the Netherlands (ASCCA and MISCAN-Colon) participating in the COVID-19 and Cancer Global Modelling Consortium (CCGMC), we simulated a range of scenarios to assess the potential impact of disruptions to screening on CRC incidence and mortality. Modelled scenarios varied by disruption duration (3-, 6- and 12-months), post-disruption participation reduction, and catch-up screening strategy (no catch-up, immediate and 6-month delayed catch-up).

Results Without catch-up screening, CRC incidence increased by 0.1-0.3 %, 0.2-0.6 %, and 0.4-1.2 % over 2020-2050 among individuals aged 50 years and older in the three modelled countries after 3-, 6-, and 12- month disruptions, respectively, compared to undisrupted screening and CRC mortality increased by 0.2-0.5 %, 0.4-1.0 %, and 0.8-2.0 % over 2020-2050 among individuals aged 50 years and older compared to undisrupted screening. A 6-month disruption without catch-up resulted in an estimated 3,552, 2,844 and 803-1,803 additional CRC diagnoses and 1,961, 1,319, and 678-881 additional CRC-related deaths in Australia, Canada and the Netherlands, respectively. A post-disruption reduction in participation increased CRC diagnoses by 0.2-0.9 % and CRC-related deaths by 0.5-1.6 % compared to undisrupted screening. Providing catch-up screening minimized this impact to 0.0-0.2 %.

Conclusions Although the relative impact of the modelled CRC screening disruptions due to the COVID-19 pandemic appears modest, given a high burden of CRC, there is a substantial impact on CRC diagnoses and deaths across all countries considered. It is crucial that, if disrupted, screening programs ensure participation rates return to previously observed rates and provide catch-up screening wherever possible, as the impact of any disruption could be considerably larger otherwise.

Citation: de Jonge L, Worthington J, van Wifferen F et al. OP85 IMPACT OF COVID-19 RELATED DISRUPTIONS TO COLORECTAL CANCER SCREENING PROGRAMS IN THREE COUNTRIES: A COMPARATIVE MODELLING STUDY. Endoscopy 2021; 53: S36.

Publication History

Article published online:
19 March 2021