Less, but more serious, colorectal cancer diagnoses during Covid

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Diagnoses of late-stage colorectal cancer increased amid the COVID-19 pandemic, but the severity of cases increased, a new study suggests.

Researchers from the Yokohama City University School of Medicine in Japan investigated rates of cancer diagnoses in the country during the Covid pandemic when compared to before the virus arrived.

They found a decrease overall in diagnoses of many cancers, including colorectal, but more severe cases were found.

Many cases were likely missed due to people skipping screenings in fear of going to the doctor during the pandemic. 

While stage 0 diagnoses of colorectal cancer dropped by a third, the number of patients diagnosed with stage III cancer increased by 68 percent.

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For the study, published in Jama Network Open on Tuesday, the team gathered data for a variety of cancer diagnoses around the country, and found the monthly average for diagnoses.

Researchers found that, before the pandemic began in early 2020, 41.61 people were diagnosed with colorectal cancer every month, compared to only 36 per month during the pandemic.

Overall rates of colorectal cancer fell by 13.4 percent during the pandemic. 

Data were also broken down depending on the stage of cancer a person was suffering from when they were diagnosed. 

Stage 0 and stage I cancers both fell, each dropping by around 33 percent.

The number of stage 0 cancer diagnoses fell from 10.58 per month to 7.1, and stage 1 diagnoses fell from 10.16 to 6.7 per month.

Stage II cancer diagnoses fell by around one-third as well, from 7.42 a month to 4.8 a month.

Despite the falls for the earlier stages, stage III colorectal cancer, the most serious diagnoses, increased 68 percent from 7.18 per month to 12.1.

This trend is likely occurring due to the pandemic causing many to avoid seeking medical treatment in situations where they previously would have done so, a worrying trend found by medical professionals last year. 

‘Specifically, there is a possibility that stage II progressed to stage III because of the diagnosis delay related to the COVID-19 pandemic,’ researchers wrote. 

Skipping treatment and not getting regular medical screenings could have potentially deadly consequences, as people are now starting treatment for cancer at a point where it may be too late.   

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‘Several studies, including two systematic reviews have evaluated the intervals from diagnosis to surgery and then to death,’ the researchers wrote.

‘Among patients with colon cancer, overall survival decreases when the time from diagnosis to surgery exceeds 30 to 40 days, and overall survival among patients with rectal cancer decreases when the time from the end of neoadjuvant therapy to surgery exceeds seven to eight weeks. 

‘Six other systematic reviews have also indicated that overall survival decreases when the time to surgery exceeds 12 weeks. 

‘Thus, six to 12 weeks may be a sufficient interval for colorectal cancer to progress, which would support our findings, as many Japanese patients would have had their colonoscopy delayed by more than six to 12 weeks because of the COVID-19 pandemic.’

Health officials believe that as many people have died from the pandemic from not receiving required medical care as have died from Covid itself.  

Colorectal cancer effects the colon and the rectum and is diagnosed around 150,000 times per year in the United States.

Around one out of every 20 men and one of every 25 women in America will eventually develop the cancer, but detecting it early makes treatment simpler and increases survival rate.

Being overweight, smoking and limited physical activity in older ages can increase a person’s likelihood of developing the disease. 

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