Work

Impact of the COVID-19 pandemic on adherence to diagnostic colonoscopy after a positive non-invasive screening test for colorectal cancer in two Indiana healthcare systems

Year: 2024

Type: article

Abstract: To describe trends in the use of non-invasive tests (NIST) and the interval between a positive NIST and diagnostic colonoscopy. Using a retrospective time-trend design, we examined medical records of patients within two large Indiana integrated healthcare systems who had a positive NIST between January 2019 and June 2021 and quantified the proportion of patients who had not completed colonoscopy within 60, 90, and 180 days to determine the interval between NIST result and diagnostic colonoscopy in days. Of 1379 patients with positive NISTs, 930 (68 %) underwent diagnostic colonoscopy during the 30-month study timeframe. Median time to colonoscopy completion was significantly longer in 2020 compared to 2019 (50 vs. 37 days, p < 0.01) and 2021 (46 days, p = 0.06). The proportion of patients completing colonoscopy within 90 days of a positive FIT in 2019, 2020, and 2021 were 79 %, 83 %, and 72 %, respectively ( p = 0.63), and were 86 %, 78 %, and 84 %, respectively, after positive FIT/DNA ( p = 0.07). Median time to diagnostic colonoscopy completion was significantly longer in 2020, likely due to the COVID-19 pandemic. Studies of outcomes in those who declined or delayed colonoscopy in 2020 are needed to estimate the potential subsequent colorectal cancer disease burden. • There was a longer interval to colonoscopy in 2020 than in 2019 or early 2021. • The COVID-19 pandemic did not appear to affect uptake of diagnostic colonoscopy. • The longer interval's impact in 2020 on colorectal cancer outcomes is uncertain. • Other healthcare systems are required to validate and extend these findings.

Source: Preventive Medicine Reports

DOI: 10.1016/j.pmedr.2024.102937

Authors: Benjamin Richter, Sarah M. Roth, Lilian Golzarri-Arroyo, Vinod Kumar, Rick Tuason, Thomas F. Imperiale