The increased use of fecal immunochemical tests (FITs) for colorectal cancer (CRC) screening during the COVID-19 pandemic could mitigate the consequences of reduced screening rates caused by the pandemic, according to a study published in JAMA Network Open.
In light of the decline in CRC screenings during the COVID-19 pandemic, especially colonoscopy-based screenings, increased use of FITs could potentially limit the deleterious public health consequences of COVID-19 on CRC mortality. Researchers estimated how expanding FIT-based CRC screening would affect screening participation during the COVID-19 pandemic by comparing 4 COVID-19 scenarios using a simulation model, during which CRC screening was reduced for variable amounts of time with or without increased used of FIT-based screening.
Based on their simulation, researchers found that COVID-19–related reductions in care utilization resulted in an estimated 1,176,942 to 2,014,164 fewer CRC screenings, 8346 to 12,894 fewer CRC diagnoses, and 6113 to 9301 fewer potential early-stage CRC diagnoses between 2020 and 2023.
With a simulated condensed period of reduced CRC screenings, increasing FIT use was associated with an estimated additional 588,844 CRC screenings and 2836 CRC diagnoses, of which 1953 (68.9%) were early stage. In the instance of a prolonged period of reduced CRC screenings, increasing FIT use was associated with an estimated additional 655,825 CRC screenings and 2715 CRC diagnoses, of which 1944 (71.6%) were early stage.
The researchers concluded that, “These results suggest that the increased use of fecal immunochemical tests during the COVID-19 pandemic was associated with increased colorectal cancer screening participation and more colorectal cancer diagnoses at earlier stages.” They added, “Our findings are designed to assist medical professionals as they assess clinical tradeoffs of approaches to increase CRC screening participation in the US during the COVID-19 pandemic and beyond.”
Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Issaka RB, Taylor P, Baxi A, Inadomi JM, Ramsey SD, Roth J. Model-based estimation of colorectal cancer screening and outcomes during the COVID-19 pandemic. JAMA Netw Open. 2021;4(4):e216454. doi: 10.1001/jamanetworkopen.2021.6454