Impact of COVID-19 pandemic on fecal immunochemical test screening uptake and compliance to diagnostic colonoscopy

J Gastroenterol Hepatol. 2020 Nov 20. doi: 10.1111/jgh.15325. Online ahead of print.

Abstract

Background and aim: During this COVID-19 pandemic, Taiwan is one of the few countries where fecal immunochemical test (FIT) and endoscopic activity for colorectal cancer (CRC) screening keeps ongoing. We aimed to investigate how screening uptake and colonoscopy rate were affected in one of the biggest screening hubs in Northern Taiwan.

Methods: We conducted a prospective observational study tracing and analyzing the screening uptake and the trend of compliance to diagnostic colonoscopy in FIT positive subjects in the National Taiwan University Hospital screening hub since the outbreak of COVID-19 and compared it with that of the corresponding periods in the past three years. Cancellation and rescheduling rates of colonoscopy, and related reasons were also explored.

Results: Screening uptake during December 2019 to April 2020 was 88.8 %, which was significantly lower than that in the corresponding period of the past three years (91.2-92.7%, p for trend <0.0001) Colonoscopy rate in this period was 66.1%, which was also significantly lower than that in the past three years (70.2%-77.5%; p for trend =0.017). Rescheduling or cancellation rate was up to 10.9%, which was significantly higher than that in the past 3 years. (p for trend=0.023) and half of them was due to the fear of being infected.

Discussion: FIT screening was significantly affected by COVID-19 pandemic. In order to resume the practice in COVID-19 era, screening organizers should consider various approaches to secure timely diagnosis of CRC.

Keywords: COVID-19; colonoscopy; colorectal cancer; screening.