Madrid, March 29, 2021.- Hospitals on the brink of collapse due to the pandemic and the population's fear of infection when using the health system “has delayed carrying out follow-up colonoscopies in the high-risk population and the evaluation of patients with symptoms related to a subsequent diagnosis of colorectal cancer”, says Dr. Jose Ignacio Martín Valadés, head of the Multidisciplinary Unit for Digestive Tumors at MD Anderson Cancer Center Madrid.
"The latter means that we are currently seeing patients not only with more advanced tumors and therefore with a worse prognosis, but with complications derived from their tumors, such as intestinal obstruction, requiring urgent intervention, which sometimes leads to a worse quality of life in patients”, Dr. Martin Valades explains. In fact, “in a study recently published in The Lancet. Gastroenterology & Hepatology1 on the impact of the pandemic on the management of colorectal cancer in England during the first wave, an increase of 56% in the need for colostomies was observed, compared to the same period for the previous year”.
According to research carried out at the University of Bologna presented at the end of 2020, the impact of a delay of between 7 and 12 months in the tests for the diagnosis of colorectal cancer translates into a 3% increase in the mortality rate, and for those over 12 months, 7%.
According to the Spanish Society of Medical Oncology (SEOM), it is estimated that 43,581 new cases of colorectal cancer will be diagnosed in 2021, making it the most frequently diagnosed tumor in Spain (considering both sexes). However, this estimate does not take into account the possible effects of the SARS-CoV2 pandemic, so the real situation may vary slightly.
Colorectal cancer screening programs have been affected around the world by the pandemic, so "most likely, the number of colorectal cancers diagnosed during 2020 has been lower" than the real number. This disruption of screening programs means less probability of diagnosing premalignant lesions or colorectal cancers in very early stages, when the treatments are simpler and the cure rates are up to 90%”.
Measures to cope with the increase in undetected and untreated cases
Therefore, Dr. Martin-Valades believes that measures must be taken to deal with the increase in undetected and untreated cases of colorectal cancer. "Now more than ever, it is important that the general public aged 50 and over undergo screening (a fecal occult blood test) for the early detection of colorectal cancer". "It is a simple test, which increases the chances of diagnosing premalignant lesions or colorectal cancer in its early stages, thus preventing 1 in 3 deaths from this tumor”.
Likewise, the people at risk of this tumor (patients with previous polyps requiring endoscopic monitoring, or with inflammatory bowel disease, or those with family syndromes associated with colon cancer) should continue to undergo their planned follow-up colonoscopies.
Of course, people should consult a doctor in the case of symptoms like the presence of blood in stools, changes in bowel movements, the feeling of incomplete bowel movement, persistent abdominal pain, loss of appetite and weight without apparent cause, fatigue and/or anemia.
"In hospitals we have health care and prevention measures circuits, which allow any procedure performed in them to be done with total safety", he concludes.
- Published: January 14, 2021DOI:https://doi.org/10.1016/S2468-1253(21)00005-4