Presentation (Project) Title

The Impact of the COVID-19 Pandemic on Colorectal Cancer Screening and Post-Test Surveillance at the James A. Haley V.A.

Mentor Information

Fabio M. Leonelli, M.D. (Clinical Research and Education Center at the James A. Haley VA; USF Health; Morsani College of Medicine) & Jose L. Lezama M.D. (Chief of Medicine, James A. Haley Veterans’ Hospital; USF Health Department of Internal Medicine Vice Chair)

Presentation Format

Event

Abstract

Colorectal cancer (CRC) is the second leading cause of cancer death in the US. Screening and post-test surveillance for CRC are an integral part of CRC management. The COVID-19 pandemic delayed access to both screening and surveillance. Delays are associated with an increased incidence of advanced stage diagnoses and mortality. The VA Health system (VAHS) treats 3% of national CRC cases, but the effect of the pandemic on the veteran population’s screening and further surveillance for this disease is unknown. Screening can be done via colonoscopy, sigmoidoscopy, or fecoimmunochemical testing (FIT). While only FIT can be safely conducted from home during a pandemic, patient compliance and the degree of post-test surveillance can limit FIT’s value. The objective of the study is to evaluate the effects of the COVID pandemic on CRC screening/ surveillance at James A. Haley Veterans’ Hospital. The study will retrospectively review the screening modalities as well as the diagnostic incidence of precursors (e.g. adenomas) and manifest CRC in the period between March - December of 2016 – 2019. A similar set of data will be reviewed for March - December 2020 and compared. Analysis will include: 1) The change in distribution of screening modalities including the number of tests and percent-positive 2) The logistical challenges to the increased implementation of mail-in FIT 3) The quantification of screening/surveillance delays This group of patients will constitute the cohort(s) for a future prospective study assessing the effect of screening/ surveillance delays on the incidence of precancerous lesions or manifest CRC.

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The Impact of the COVID-19 Pandemic on Colorectal Cancer Screening and Post-Test Surveillance at the James A. Haley V.A.

Colorectal cancer (CRC) is the second leading cause of cancer death in the US. Screening and post-test surveillance for CRC are an integral part of CRC management. The COVID-19 pandemic delayed access to both screening and surveillance. Delays are associated with an increased incidence of advanced stage diagnoses and mortality. The VA Health system (VAHS) treats 3% of national CRC cases, but the effect of the pandemic on the veteran population’s screening and further surveillance for this disease is unknown. Screening can be done via colonoscopy, sigmoidoscopy, or fecoimmunochemical testing (FIT). While only FIT can be safely conducted from home during a pandemic, patient compliance and the degree of post-test surveillance can limit FIT’s value. The objective of the study is to evaluate the effects of the COVID pandemic on CRC screening/ surveillance at James A. Haley Veterans’ Hospital. The study will retrospectively review the screening modalities as well as the diagnostic incidence of precursors (e.g. adenomas) and manifest CRC in the period between March - December of 2016 – 2019. A similar set of data will be reviewed for March - December 2020 and compared. Analysis will include: 1) The change in distribution of screening modalities including the number of tests and percent-positive 2) The logistical challenges to the increased implementation of mail-in FIT 3) The quantification of screening/surveillance delays This group of patients will constitute the cohort(s) for a future prospective study assessing the effect of screening/ surveillance delays on the incidence of precancerous lesions or manifest CRC.