Pandemic-related excess CRC deaths can still be averted: study


By Michael Woodhead

2 Apr 2024

COVID-related disruptions to bowel cancer screening, diagnosis and treatment in Australia are likely to lead to more than a thousand additional cancer deaths over the next decade, a modelling study suggests.

But many of these deaths could still potentially be prevented if further mitigation strategies are implemented, according to researchers from the Daffodil Centre, a collaboration between Cancer Council NSW and the University of Sydney.

In their study, researchers from the centre modelled the impact of pandemic-related disruptions on colorectal cancer cases and deaths in both Australia and Canada.

The analysis, published in PLOS One (link here) showed that colorectal cancer screening rates dropped by 6.3% in Australia and by 40% in Canada in 2020.

In Australia in 2021 there was a 7.2% decrease in any colorectal cancer treatment procedures compared to expected numbers. It was estimated that 1.1% of patients would experience a wait for treatment in 2020 of two or more weeks longer than typical waiting times; in 2021 this would increase to 23.9%.

The modelling showed that over the period 2020–2030, the combined impact of disruptions to screening, diagnosis, and treatment were predicted to lead to a 2.4% increase in colorectal cancer mortality in Australia.

These changes would lead to an estimated increase of an additional 234 cases of colorectal cancer and 1,186 deaths in Australia over 2020–2030; compared to a scenario with no screening disruption or diagnostic/treatment delays.

A hypothetical mitigation strategy was simulated, with diagnostic and treatment capacities increased by 5% from 2022 to address backlogs. This was estimated to avert 350 deaths in Australia, the researchers said.

“The COVID-19 pandemic has caused significant difficulties in the continuation of health services, and delays to [colorectal cancer] care is just one example among many.  Modelling demonstrates that downstream effects on disease burden could be substantial,” the authors said.

However, backlogs can be managed and deaths averted with even small increases to diagnostic and treatment capacity, they emphasised.

“Careful management of resources can improve patient outcomes after any temporary disruption, and these results can inform targeted approaches early detection of cancers,” they said.

“Targeted investment and temporary increases to services is necessary to ensure health system resilience and reducing cancer burden, both now and for future disruptions,” they concluded.

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