ABSTRACT
INTRODUCTION: One of the main clusters of coronavirus disease-2019 (COVID-19) has been identified in Italy. Following European and local guidelines, Italian endoscopy units modulated their activity. We aimed at analyzing the need and safety to continue selective colorectal cancer screening (CRCS) colonoscopies during the COVID-19 pandemic. PATIENTS AND METHODS: We carried out a retrospective controlled cohort study in our "COVID-free" hospital to compare data of the CRCS colonoscopies of the lockdown period (March 9 to May 4, 2020) with those of the same period of 2019 (control group). A pre/post endoscopic sanitary surveillance for COVID-19 infection was organized for patients and sanitary staff. RESULTS: In the lockdown group, 60 of 137 invited patients underwent endoscopy, whereas in the control group, 238 CRCS colonoscopies (3.9-fold) were performed. In the lower number of examinations during the lockdown, we found more colorectal cancers (5 cases; 8% vs. 3 cases; 1%; P = .002). The "high-risk" adenomas detection rate was also significantly higher in the "lockdown group" than in controls (47% vs. 25%; P = .001). A multiple regression analysis selected relevant symptoms (hazard ratio [HR], 3.1), familiarity (HR, 1.99), and lockdown period (HR, 2.2) as independent predictors of high-risk lesions (high-risk adenomas and colorectal cancer). No COVID-19 infections were reported among staff and patients. CONCLUSIONS: The overall adherence to CRCS decreased during the pandemic, but the continuation of CRCS colonoscopies was efficacious and safe.
Subject(s)
COVID-19/epidemiology , Colonoscopy , Colorectal Neoplasms/diagnosis , Early Detection of Cancer , SARS-CoV-2 , Aged , Colorectal Neoplasms/pathology , Female , Humans , Male , Middle Aged , Patient Safety , Retrospective StudiesABSTRACT
We conducted a colorectal cancer (CRC) screening program, in which public pharmacies provided the faecal occult blood test (FOBT), addressed to 50-70 years residents of 12th Municipality of Rome. A total of 5003 subjects were invited and 1103 (22.0%) performed the screening test, the adjusted compliance was 24.0%. Among 72 (6.5%) FOBT-positive subjects, 50 (69.5%) had colonoscopies; a CRC was detected in 5 subjects. Screening through the public pharmacies was feasible but the limited number of pharmacies enrolled have influenced compliance. A screening model that offers multiple providers (including private pharmacies) should be tested in order to improve screening compliance.
