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Effects of COVID-19 Mitigation Policies on Diagnostic Conversion to Colorectal Cancer
Safe People
Queen's University Belfast
Academic Institute
Ethna McFerran
HDR-UK & ESRC Impact Acceleration Project
Yes
Safe Projects
E082
In Northern Ireland, from 2012 to 2016, there were 5,985 newly diagnosed cases of Colorectal Cancer (CRC) (1), making it the second most common type of cancer found in men and women in Northern Ireland (2). Screening and removal of early precancerous lesions have been shown to reduce the mortality of CRC (3). Rapid reconfiguration in healthcare in response to the COVID-19 pandemic and a desire to mitigate infection risk profoundly affected cancer care; a 29% reduction in overall cancer survival has been predicted (4). The British Society of Gastroenterology recommended the cessation of diagnostic colonoscopies in April 2020 (5). UK National Bowel Cancer Screening programmes were paused, and faecal immunochemical testing (FIT) triage for red-flag referrals was used instead. This project aims to estimate the impacts of these measures on services, care, and outcomes during recovery by examining the changes in colonoscopy conversion rates before, during and after the COVID-19 pandemic, and to examine these amongst those who received triage testing. References 1. Bannon F, McKenna H, Donnelly C, Mayock M, Harbinson A, Mathieson S, et al. Routes to Diagnosis Report - Main Report Jan 2020. 2. Public Health Agency. Bowel cancer screening: The facts [Internet]. Public Health Agency. 2021 [cited 2021 Oct 5]. Available from: https://www. publichealth.hscni.net/publications/bowel-cancer-screening-facts-english-and- 10-translations 3. Cancer Research U.K. Bowel Cancer [Internet]. Cancer Research U.K. 2022 [cited 2022 Jun 6]. Available from: https://www.cancerresearchuk.org/ about-cancer/bowel-cancer 4. Sud A, Jones ME, Broggio J, Loveday C, Torr B, Garrett A, et al. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Annals of Oncology. 2020 Aug 1;31(8):1065–74. 5. Kennedy NA, Jones GR, Lamb CA, Appleby R, Arnott I, Beattie RM, et al. British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic. Gut. 2020 Jun 1;69(6):984–90.
This project will help understand the potential benefits to the public/ patients of triage implemented during COVID-19, and the implications for resource use, including how this might affect procedural wait times, or enable capacity expansion for screening services, and verify if there are any potential adverse medium-term implications for cancer prevention associated with adenoma (polyp) removal and surveillance practice. Essentially, changing resource use should be evaluated for its potential to reduce wait lists and improve outcomes. The data involved in this study will be employed to address this question and identify the appropriate policy steps necessary for cancer screening programs.
01/03/2023
Safe Data
BSO LIMS
Safe Setting
TRE